Thursday, March 16, 2006

A Cleveland Steamer for Insurance Companies

Check yesterday's post to see what a Cleveland Steamer is, if this is not yet clear to you.

Health care in the US is like a drunk, schizophrenic uncle. You don't want people to know how bad things are, let alone that you're somehow related. But like 10 million children without adequate health insurance, drunk, mentally unstable relatives are hard to hide, particularly when the US is always waving the flag and bragging about what a damn good country we are.

I think the US is great, don't get me wrong. But as CowboyLaw has pointed out so eloquently before, it's very important to have a mature and realistic patriotism which takes into account the good and bad of American goverment, as opposed to the Lee Greenwood-esque, real patriots don't question the President-style of patriotism that seems to pervade the right-wing these days. One of the biggest challenges we face is that we do a piss poor job of caring for the children in this country.

For a country that has the wealth and resources of the US, we have no excuse for our half-assed approach to insuring children. I personally feel that everyone should have access to basic health care, but even the most psychotic conservative would agree that children, who can't get jobs or pick who their parents are, should have access to care. When Howard Dean suggested universal healthcare for children during the 2004 Presidential Campaign, he was maligned and called a Socialist.

Critics of universal health care use Canada as the example of why government health insurance won't work. They cite substandard care and long waits for services that characterize the Canadian system. The problem with the US making those kind of statements is that it's like Charlie Sheen calling someone a sex-crazed coke-head: hypocritical. People don't have to wait for care or worry about the quality of care in the US, because a good portion of our population gets no care at all or gets substandard care because they can't afford it.

So before you start singing "And I'd gladly stand up next to you and defend her still today," you might want to take a deep breath and decide how truly proud you are that we can't get our shit together on health care. The costs to cover only the children in this country per year would be about $5 billion. That's what we're spending every three weeks in Iraq alone. And things just keep getting better in Iraq every single day. Money well spent.

Aside from the fact that people have to hold bake sales and spagetti dinners to pay for chemotherapy for their 8 year-old, the fact that people don't have adequate care means that people who do have insurance have to pay more for care since hospitals are forced to shift costs to those who can afford to pay, just to keep their doors open. Having worked for a number of hospitals, both private and not-for-profit, I can attest that most hospitals operate deep in the red and absorb significant costs for patients either not covered or with inadequate coverage.

I can already see the email someone is typing to me: Ryan, all you do is complain! Do you have any solutions to this problem? Actually, for once I do have a solution. Every American gets access to basic health care services like primary care, immunizations, prescriptions etc. Kids get everything paid for until they're 18 years old, and yes, Pope Benedict, even birth control. If you are an adult and want more than just the basic level of care, you purchase a supplemental policy from a private insurance company. This allows the government to purchase drugs in bulk, like the VA does currently, and cuts costs significantly.

Another thing - if you decide to smoke cigarettes, you are not eligible for basic government health care. People can smoke all they want, but you should forfeit your rights to government health care if you choose to smoke, because I don't want to pay for your habit, any more than you would want to pay for my liver transplant because I favor single malt scotch.

This plan works because private insurance companies can still provide supplemental policies, but the government handles all the high-volume services and prescriptions, which should make the insurance industry that much more profitable. Insurance companies are filthy rich, kids are healthy, we all win.

The problem? This will never happen. The insurance industry profits immensely from the current situation. They want to blame doctors or lawyers or patients who abuse the system, but the fact of the matter is that the private insurance lobby in Washington has ridiculous amounts of money, and will destroy any piece of legislation that might cut into their multi-million dollar profits before it even gets out of committee.

Eventually, things will have to change. Until then, eat lots of fruits and vegetables and don't let anyone talk you into doing something they read about in the Urban Encyclopedia.

3 comments:

Anonymous said...

Alright, I'll bite on this. I've been reading Ryan's blog for some time and have had discussions such as this with him in person. To date, I have not contributed to the blog, but as the resident Canadian....perhaps I should. Ryan is partially correct in asserting the differences between Canadian and American health care. The truth is, neither work all that well. let's examine why.

Is the quality of care lower in Canada? The answer is, at times, yes. If I have a heart attack, am I more likely to die because I live in Canada? No. If I have a nagging knee injury that needs non-emergency surgery to be repaired, will I wait a long time? yes.

There is a shortage of physicians in Canada because many Canadian trained physicians go to the US where they make a bundle from insurance companies. We are left with the weaker ones, the ones nobly committed to public health or with foreign MDs.

Why does public health not work? Simple...the politicians' solution is to throw money at the problem. Where does that money go? It gets soaked up without ever changing a wait list. Most of it ends up in the pockets of physicians. But the same is true in the American system. Health care is for profit, and physicians are smart. They will make that profit as large as they can for themsleves. Therefore, there is a performance incentive to work harder and see more people, because the MD makes more money.

Ryan is absolutely correct in the notion that pharmaceuticals are cheaper in Canada due to bulk buying practices. Moreover, generic meds make up most of the drugs consumed by Canadians. I've never paid more than $20 for any prescription, other than that one time after I went to New Orleans.....well...another time maybe.

THe bottom line is this. Capitalism is what makes America great on many levels. It is also what makes it so flawed on a number of issues. America has wealth because its citizens are encouraged to prosper through enterprise rather than waiting for handouts from the government. Health care professionals are not exempt from this. Health care is increasingly becoming a bigger and bigger business with a higher emphasis on selling. I can't imagine the US government ever pissing on free enterprise. Particularly when it involves the nation's medical doctors.

Ryan the Angry Midget said...

Hey man, it's been way too long since we've had one of those discussion in person! As always, your insights on this issue and first hand experience as a Canadian are always appreciated.

CowBoyLaw said...

I think this is all that has to be said: we're the only industrialized country that doesn't have nationalized health care. Are all 30+ other countries just wrong?

And if that doesn't do it for you, maybe this will: Minneapolis (where I live) is the home of United Health Care. The CEO of UHC routinely pulls down more than $50 million. That money doesn't come out of thin air. That's policy premiums that were not passed on to our health care system. $50 million that we Americans spent on health insurance that had absolutely no impact on our standard of care. The only people who gain by our current health care system are upper-level executives at health insurance companies (which I say because I think lower-level employees at those same companies really would be better off if we put their employer out of business).

For reasons which will be apparent only to the Midget, I still favor a federal system which mirrors Oregon's state health care system, a system which ensures access to critical care for everyone by, in part, denying access to frivilous care (i.e., keeping Grandma alive for 10 years with life-support even though she's brain dead).