Thursday, September 10, 2009

National Healthcare: The chains that will bind all

What is the definition of a RIGHT? A right is anything that does not require a sacrifice from another person or places a burden on another person to fulfill. Is Healthcare a right, no? It requires sacrifice by others and places a burden on others for it to take place.

Is healthcare a moral obligation? If it is a moral obligation, then what are food, shelter and water? Are these moral obligations and if so are they more important or imminent than healthcare? What we have never created as a nation is a set of priorities. We have many programs that are failures such as Medicaid, Medicare, Fannie May, Freddie Mac, the U.S. Treasury, Federal Pension Guaranty program, Social Security and more.

Now the nation is debating healthcare, another program. The first question that should be asked is, is this a function of government? If it is, then we should look at Medicare, Medicaid and Veterans Healthcare as teachable lessons. Both Medicare and Medicaid have shifted trillions of dollars of costs from a few to everyone else. The payroll tax of Medicare is inadequate and the trust fund will be exhausted in 2017, then what? What about those born after 1952? Do we raise the payroll tax even more; do we charge those born prior to 1952 a higher premium to recoup what congress failed to charge them?

As a parent I am responsible for my families well being FIRST! My first priority is to take care and provide for my family FIRST. However, the government believes my first priority is to support Medicare and Medicaid and takes without asking dollars out of my paycheck. I then compete against those on Medicare and Medicaid for healthcare using my own dollars! Because Medicare and Medicaid cost shift, I pay more for my healthcare. In addition I compete against employer subsidized healthcare insurance when they negotiate rates nearly as low as Medicare again shifting cost to all others.

Government has artificially stimulated the healthcare industry: pharmaceuticals, medical implants, technology, procedures, diagnostics and more. Individuals who work in the healthcare industry are engineers, janitors, maintenance, data processors, nurses, doctors, specialists and more. They are neighbors, parents, brothers and sisters. They all provide labor and as such want raises like everyone else. Healthcare is labor intensive and there is no force multiplier, a doctor treats one person at a time. This makes healthcare costs rise at wage rates, not inflation. In addition the US has primarily private hospital rooms instead of four to a room increasing costs by 300% and decreasing efficiency. The US has the highest ratio of MRI, CT, diagnostic equipment, hospital rooms than any other country. The US System is based on “waiting for a patient to arrive” rather than other countries based on “patients waiting to be treated.” The US has lower utilization rates, yet this technology must be paid for, resulting in higher per service costs.

Medicare began with good intentions. Medicaid began with good intentions. Social Security was begun with good intentions, yet good intentions have never produced a single government program that did not become costly.

The U.S. has not had budget surplus since 1957. Every single stimulus package, tax reduction or fix to government programs that borrowed money to do so has never been repaid. In fact the interest paid on these borrowed funds was in fact borrowed, compounding the problem.

Employers are allowed to provide health insurance to employees in lieu of paying higher wages. This is nothing more than a tax subsidy. The government does this with IRA’s, education credits, charitable deductions, child tax credits, mortgage interest and 401-k’s. The government has been so good at doling out special tax breaks to groups that everyone has a hand out. Who is paying the cost of all these hand outs, the economy? We all want lower taxes and more benefits. The only question is how much are you willing to pay for a new program, or should I say how much are you willing to saddle your children with?

The solution is simple. No healthcare provider can charge different entities, that it sees, different prices for the exact same service (CPT code). This would eliminate the cost shifting of Medicare, Medicaid and insurance (both private and company sponsored) to all others.

The definition of insurance is where a group of people pool resources together where the risk of occurrence is low, yet the loss could be great if it occurred. Insurance does not work when the risk of a loss is great. The risk that people go to the doctors for flue, vaccinations, broken bones and other ailments are frequent. Do you really want to pay an extra fee to cover the cost of administration in paying for these? The simple truth is healthcare costs money and each of us needs to face the fact we are responsible for the basic costs. With that said, the deductible should be about $2,000 per person. This provides incentive not to over use the system, reduced processing and puts controlling cost in the hands of the consumer. It would also provide catastrophic coverage for the low risk occurrences that if they did happen could bankrupt you.


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