Thinking that we can solve our health care problems with one bill is wishful thinking at best, and is no where near realistic. Initially, the bills in the House and Senate are taking the approach that the Government should enter the health insurance business and offer health coverage that would ultimately make it all but impossible for the health insurance companies to compete in the healthcare arena. This is like trying to eliminate criminal behavior by allowing the Government to go into the rackets by creating its own gang with the objective of running the current gangs or mafia organizations out of business by out competing them. One of the biggest problems in our healthcare system is health insurance.
The insurance companies don’t make their money by providing insurance; they make their money by denying it. Insurance companies themselves need to be removed from the healthcare equation all together. They are not in the healthcare business. They are just in business. But they are not the entire problem.
While reading the editorial pages of the Denver Post on July 12, I noticed a letter from a Dr. Patrick Messerli, of Durango, CO, who mentioned that when the Mayo clinic takes on new patients, they regularly perform all lab tests over again so they can bill for them. This is a business model of generating revenue by duplicating all tests and procedures once the patient arrives at the clinic. The tests already performed by the patient’s doctors were good enough to get them into the Mayo clinic in the first place but not good enough for clinic doctors to study and decide upon the proper treatment. While it is understandable that an occasional test may need to be repeated to verify or even clarify what clinic doctors must troubleshoot, it is a wasteful policy that requires repeating them all. The Mayo clinic is not the only clinic our there that practices this way. Health insurance is what makes this all possible.
To make matters worse, Time magazine reported that “research by the Dartmouth Institute for Health Policy and Clinical Practice has found that as much as 30% of our annual $2 trillion–plus medical bill may be wasted on unnecessary care, mostly run-of-the-mill diagnostic tests, office visits, hospital stays, minor procedures and prescriptions for brand-name wonder drugs advertised on TV.” All of this is because they can get reimbursed for these items and procedures by the insurance companies.
Then there is the case of a European physician who was conducting research on human DNA years ago. The CBS news magazine 60 minutes did a feature study on him a few years back and found that this doctor, while his research was admirable and would ultimately result in many good applications and discoveries for mankind, was getting rich by selling all of his DNA data to major health insurance companies. The companies involved were in turn using this information to deny health coverage on procedures for ailments and afflictions that could be predicted by studying this DNA database under the guise of, you guessed it, pre-existing conditions. This is another situation made possible solely from the involvement of insurance companies in the healthcare business.
If you, or your family, decide to have your DNA tested to determine if one or all of you are risk for some hereditary disease with serious ramifications, you should not have to be concerned that your personal data will be used against you by your health insurance company when making your decision. But you now have no choice but to consider that possibility because your health care is not determined by your doctor. Your doctor merely recommends. The ultimate decision on your health care is made by some accountant, actuary scientist (insurance longevity predictor) or some other insurance executive or bureaucrat—and that decision is based upon the cost, not the health benefit.
These decisions that insurance companies make for you have much more far reaching effects on your life than whether or not you get the treatment you need. What if you are the minor bread winner for your family and you work for a small business with less than 100 employees. Maybe you are the one who has employer provided health insurance because, say the major bread winner is self employed or is in sales or some situation where there money is better than your income, but there is no health benefit.
So consider if you will, that you develop an expensive medical issue. You go to the doctor, who then refers you to a specialist. The specialist puts you on a treatment that is effective but extremely expensive. The insurance company covers it because it is not something they can refuse. The owner of the small business where you work is now faced with escalating health insurance costs. The company has no choice but to pay it, but now you are under scrutiny. They cannot just fire you, but they can watch you until you make a mistake. They document it and talk to you about it. It may take them a year or two, but eventually they will get you out of there. Now you are looking for a job.
That’s illegal, you say. True, but unfortunately any company can get rid of anyone for reasons other than what they will actually fire you for. If you watch someone long enough, they will make mistakes. Eventually, these mistakes will ad up to termination. Don’t be naïve enough to think that this does not go on, because it does. If the company where you work is small enough, it could make the difference for them between being able to provide health coverage for their employees or not. They could have very little choice but to take this action. This is more unfortunate collateral damage caused by health insurance.
Under the current system you lose access to healthcare when you lose your job. Yes, you can get cobra, but it costs more than your original healthcare coverage cost you when you were employed. The main difference here is that you no longer have any income with which to pay for it. This is a great system, huh?
A single provider system, like the federal government, is a good solution to this. It won’t fix everything, but it is certainly a great place to start. And before you write in and say socialism, socialism, socialism. I have a question for those of you who believe that gobbledygook. Are you healthy and in no real need of healthcare? Because that is who usually hollers the socialism argument. With the single provider system you will not be sent home without treatment for the cancer you have just been diagnosed with simply because you don’t have health insurance or the $40,000 to pay for the treatment. Under the current system that is exactly what could happen to you.
Healthcare should be part of the national infrastructure of support services, just like police and fire protection, education, highways and protection from our enemies. Detractors will argue that to take healthcare out of the public sector will result in less advancement by removing competition from the system. Competition hasn’t produced an efficient system so far. Besides, this will not remove all competition. There would still be government contracts for everything that goes into any doctor’s office or hospital.
Having government provided Police and fire protection hasn’t resulted in lower quality protection, nor has it removed competition from those endeavors. Healthcare is eventually a life and death scenario for all of us, and we shouldn’t have our healthcare decisions made for us by someone who’s main concern is the profit of his or her company and their secondary concern (if that) is your health and well being.
The insurance companies don’t make their money by providing insurance; they make their money by denying it. Insurance companies themselves need to be removed from the healthcare equation all together. They are not in the healthcare business. They are just in business. But they are not the entire problem.
While reading the editorial pages of the Denver Post on July 12, I noticed a letter from a Dr. Patrick Messerli, of Durango, CO, who mentioned that when the Mayo clinic takes on new patients, they regularly perform all lab tests over again so they can bill for them. This is a business model of generating revenue by duplicating all tests and procedures once the patient arrives at the clinic. The tests already performed by the patient’s doctors were good enough to get them into the Mayo clinic in the first place but not good enough for clinic doctors to study and decide upon the proper treatment. While it is understandable that an occasional test may need to be repeated to verify or even clarify what clinic doctors must troubleshoot, it is a wasteful policy that requires repeating them all. The Mayo clinic is not the only clinic our there that practices this way. Health insurance is what makes this all possible.
To make matters worse, Time magazine reported that “research by the Dartmouth Institute for Health Policy and Clinical Practice has found that as much as 30% of our annual $2 trillion–plus medical bill may be wasted on unnecessary care, mostly run-of-the-mill diagnostic tests, office visits, hospital stays, minor procedures and prescriptions for brand-name wonder drugs advertised on TV.” All of this is because they can get reimbursed for these items and procedures by the insurance companies.
Then there is the case of a European physician who was conducting research on human DNA years ago. The CBS news magazine 60 minutes did a feature study on him a few years back and found that this doctor, while his research was admirable and would ultimately result in many good applications and discoveries for mankind, was getting rich by selling all of his DNA data to major health insurance companies. The companies involved were in turn using this information to deny health coverage on procedures for ailments and afflictions that could be predicted by studying this DNA database under the guise of, you guessed it, pre-existing conditions. This is another situation made possible solely from the involvement of insurance companies in the healthcare business.
If you, or your family, decide to have your DNA tested to determine if one or all of you are risk for some hereditary disease with serious ramifications, you should not have to be concerned that your personal data will be used against you by your health insurance company when making your decision. But you now have no choice but to consider that possibility because your health care is not determined by your doctor. Your doctor merely recommends. The ultimate decision on your health care is made by some accountant, actuary scientist (insurance longevity predictor) or some other insurance executive or bureaucrat—and that decision is based upon the cost, not the health benefit.
These decisions that insurance companies make for you have much more far reaching effects on your life than whether or not you get the treatment you need. What if you are the minor bread winner for your family and you work for a small business with less than 100 employees. Maybe you are the one who has employer provided health insurance because, say the major bread winner is self employed or is in sales or some situation where there money is better than your income, but there is no health benefit.
So consider if you will, that you develop an expensive medical issue. You go to the doctor, who then refers you to a specialist. The specialist puts you on a treatment that is effective but extremely expensive. The insurance company covers it because it is not something they can refuse. The owner of the small business where you work is now faced with escalating health insurance costs. The company has no choice but to pay it, but now you are under scrutiny. They cannot just fire you, but they can watch you until you make a mistake. They document it and talk to you about it. It may take them a year or two, but eventually they will get you out of there. Now you are looking for a job.
That’s illegal, you say. True, but unfortunately any company can get rid of anyone for reasons other than what they will actually fire you for. If you watch someone long enough, they will make mistakes. Eventually, these mistakes will ad up to termination. Don’t be naïve enough to think that this does not go on, because it does. If the company where you work is small enough, it could make the difference for them between being able to provide health coverage for their employees or not. They could have very little choice but to take this action. This is more unfortunate collateral damage caused by health insurance.
Under the current system you lose access to healthcare when you lose your job. Yes, you can get cobra, but it costs more than your original healthcare coverage cost you when you were employed. The main difference here is that you no longer have any income with which to pay for it. This is a great system, huh?
A single provider system, like the federal government, is a good solution to this. It won’t fix everything, but it is certainly a great place to start. And before you write in and say socialism, socialism, socialism. I have a question for those of you who believe that gobbledygook. Are you healthy and in no real need of healthcare? Because that is who usually hollers the socialism argument. With the single provider system you will not be sent home without treatment for the cancer you have just been diagnosed with simply because you don’t have health insurance or the $40,000 to pay for the treatment. Under the current system that is exactly what could happen to you.
Healthcare should be part of the national infrastructure of support services, just like police and fire protection, education, highways and protection from our enemies. Detractors will argue that to take healthcare out of the public sector will result in less advancement by removing competition from the system. Competition hasn’t produced an efficient system so far. Besides, this will not remove all competition. There would still be government contracts for everything that goes into any doctor’s office or hospital.
Having government provided Police and fire protection hasn’t resulted in lower quality protection, nor has it removed competition from those endeavors. Healthcare is eventually a life and death scenario for all of us, and we shouldn’t have our healthcare decisions made for us by someone who’s main concern is the profit of his or her company and their secondary concern (if that) is your health and well being.
In the past few months I have seen a different view of our health system. Myself, being one of the 13 million unemployed am now faced with the dilemma of no insurance and the cobra you mentioned. So for now I cross my fingers and hope I stay well.
ReplyDeleteMy uncle was stricken with an ongoing illness that took his life a few weeks back. He qualified for disability and was collecting his below poverty level pay but the Medicare Medicaid would not kick in for many months. Go figure, the government said you are to sick for work but you must wait for medical help. This is something that needs to be fixed, yes he received medical attention but could not just go anywhere. When he was alive they said there was a pill that would help him, he needed three a day. They were $200. a pill. That is $18,000. a month. Now what is in this pill to be so expensive?
He is gone now and left behind is a stack of bills, I am sure the doctors are still sending him notices.
The other day I took a friend to parkland hand surgery center; she had broken her hand and needed another cast. Parkland is where people go that have no insurance. At 7:30am the line to get in was long. At 8:30am she was called in by the nurse, they kept trying to say her name as if it were Spanish. That was the majority of who were in the room. A nurse to x-rays again and sent her back out. 9:45am another nurse called her back and gave her info on how not to fall dawn and sent her back out. 10:15am a doctor called her back and looked at her hand. Told her to move her fingers as much as she could to keep them from getting stove up then sent her back out. 11:30am the nurse took her to another waiting room for a new cast. This is where the cast guy taped her fingers together so they could not move and then placed a cast on her hand, all the way to her elbow. They told her to go home and they would send her info for her next appointment.
Our wealthy elected leaders said that the bail out was not as effective as they had wanted it to be because they had underestimated the severity of the economy. If the situation at hand does not effect you, then your take on it is much different than the ones that are.