6.22.09

The universal health coverage debate seems to be going in the direction it should - into the quagmire, thankfully. There has been a lot of debate and plenty of double-speak but in the end, let’s hope this whole deal dies again. Let me share a couple of reasons why most of the way it is now is good for us:

1. WHOEVER PAYS, CONTROLS - REMEMBER that - this is the technique used by many parents of college-aged children when they want to control them. Parents would say something like “if you want your tuition paid you better straighten out your act!” (in other words, get at least a B average and take school seriously or you’ll be cutting grass for a career).

Do you really think that if government paid (a two word way of saying your taxes dollars turned around and spent by somebody with either a 1. PhD in BS or 2.  a political connection - i.e. gloried Mass Pike toll collector, only with a bigger title) for your health care, that YOU would have any control? Remember, Whoever pays, controls - I pay for my health insurance so I control what I get done. I have never had an exam refused to me nor has my primary care physician ever appeared to be trying to save a buck (she’s quite thorough).  WHOEVER PAYS CONTROLS.

For reason 2, I must refer back to an article I wrote last year titled “How Much Can I Buy You For?” I made the point that it is amazing to me that people would give up their health care freedoms for $300/month. Let me quickly outline for those who haven’t read it. My personal health insurance currently costs me $292/mo. I’m in my thirties so I know it’s more expensive for older folks - but Medicare supplemental plans often cost the same or less than I pay. My point though is, if I pay roughly $3,600 year, does it make sense to pay Canadian tax rates to have government cover it and control it.

Which brings me to Point Number 2 - the financial aspect. Most things run by a large bureaucracy where you can’t fire people easily and cut costs (think Medicare, can you cut that without political consequence? Can you easily fire gov’t employees either?) is BOUND to have EXPLODING COSTS.  Put another way, why would I first, give up all my health care control for $300/mo (I don’t come that cheap - you’d have to pay me $1,000,000 a month to voluntarily give up my health care freedom) and then likely pay 10% higher taxes? Let’s say someone makes $80,000/year. Is it a “benefit” to pay $8,000 in taxes to save $3,600 and lose total control?

On two fronts - Control/freedom and cost, the average person will likely lose in America with bureaucratic health care.  Amusingly, when I talk to Brits or Canadians, they are very proud of their socialized health system. Of course they have, like whipped dogs, come to accept the wait for service happily (they tell me they don’t wait to see a doctor, they can go in anytime and get in line - but I’d rather have an appointment in the future than wait 3 hours in a “queue”). But what is bad, is the long waits for advanced procedures. I see reported many things and hear many things so it seems to all be anecdotal - I just know that I have never had to wait in an emergency or for vital tests (see John Stossel on ABC 20/20 for a report on Canadians coming to the US for health care).

And who’s kidding whom here? Did we MASSIVELY miscalculate social security costs and medicare? YES. Did we have to raise taxes FREQUENTLY in our history to pay for them? YES. Do you have a hidden tax increase every year if you make $110,000 or more? YES. Do self employed people get double screwed by paying ridiculous payroll taxes for social security and Medicare but don’t get the same tax deduction on health insurance as everyone else? YES.

Folks, when will you learn? When will you learn that government types are jokers - they are motivated to get re-elected - that’s it. Power corrupts (or turns people into control freaks who think they are benevolent: these are very dangerous people - the ones who, in their mind, think they are doing good) as does money. Once this system is set up, it will go the way ALL OTHER government programs go. First some dork with a PhD will be appointed to run it - with a board full of other academic derelicts who will decide your care - then pass down dictates to THOUSANDS of new government workers paid for with the higher taxes.

It’s like anything else that is sold - if you don’t see the money leave your wallet, you think you’re getting a deal but you don’t see money siphoned from you in a slow drip until you’re financially dead. I’ll write another article soon to explain just how much of a waste it is to pay social security taxes and you’ll see another example of wasted tax dollars disguised as a “benefit.”

So what can we do? I think a good first step is increased consumer control of costs. I very much like the idea of insurance costs being reviewed and controlled by the user - if people know what they’re paying, they can ask more questions and shop a bit for costs. Cost differences between providers is very large from reports I’ve seen (e.g. an X ray at one hospital is priced much different than another).  This could be a first step so people can start SEEING what some of this stuff costs and perhaps we can all work together to lower costs by smarter usage. Then we can reassess.

There is one last point that drives a lot of the cost and it’s a point few want to discuss: that the USA is a big scale GM. What do I mean? We have a very large and growing older population - with high promised benefits. Our population is not growing so fast (we discussed before how many of these social schemes require a consistently growing population with no bubbles to maintain benefits). This is a rising tide under all of these medical costs that no one talks about. Another issue few want to tackle because  it confronts ethical issues: many reports have stated that we spent a large percentage of health care dollars on extending life efforts (keeping people alive).  What should we do about that? In universal coverage we will likely kill all these people off because if the choice is  either a. lay off a bureaucrat or  b. kill off some patients, my money is on option b. The whole debate will never confront these issues - more smoke from wind-filled elected officials. Let’s hope this whole idea gets “option b’ed.”

Chris Grande