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HEALTH CARE REFORM — SOME FACTS & MYTHS

Listening to the members of Congress and certainly some in the media discuss the array of impacts that would come from the proposal being contemhealthcare photoplated in the U.S Senate leaves one to ask the question….have these folks ever really studied the topic ?  Do they grasp the very simple economic constructs that drive health care costs up to begin with ? Much of the opposition to meaningful reform is being driven by crass political motives, and the desire by incumbents to “ protect” their coveted seats by not offending anyone.

Insurance mandates drive up costs—period. Let consumers choose what options they want, ala carte . If all I want is a catastrophic major medical plan with a high deductible , only to cover major expenses such as a prolonged hospital stay, major surgery , and I choose to self- insure for the out of pocket routine care such as doctor visits and or screenings, prescriptions, let me make that decision for myself.  Politicians spout that “ they are going to make those insurance companies pay for X,Y & Z” ,  all they actually do is drive up what you ultimately pay for health insurance by this mandate driven mania that ignores simple economics.

If you want first dollar coverage and you insist on your health insurance covering every single medical procedure, every single screening and test known to man, every prescription you need………….then recognize you will need to pony up Spanky and write a big check each month. Otherwise shut up because you don’t have a clue what you are talking about. It’s been cited repeatedly how much auto insurance would costs if we mandated auto insurance cover windshield wiper blades, oil changes, tune-ups, and tires. Risk sharing is a pricing mechanism in all insurance coverages, you self- insure for more of the risk, and you lower your premiums. It is the dumb sheep that fall in line with the bloviating politicians that have caused this mess to begin with.

Then there is of course “ the poor”

State legislators have ducked ,dodged and weaved their way around addressing the run away costs of Medicaid. No one wants to touch it because this program has the warped public image of being for the poor.  If so, let’s take a look at who today is defined as qualifying for Medicaid and the numerous fixes for this program if only our legislators in the General Assembly were not such cowards.

Cost sharing in Medicaid is preposterous. The program has co-pays of some $1 & $3. This drives utilization rates through the roof because with co-pays like this people waste the programs benefits. Many get by without even paying the $1 or $ 3 co-pay ?  Raise the co-pays to $15 –$20 and watch what happens to the utilization problem. The health insurance companies learned quickly how to fix this in the early days of HMO’s that had the same ridiculously low co-pays and utilization problems. The private sector fixed it and fast . I was there and they simply raised co-pays ……………problem solved.

Adding to the growing enrollment of Medicaid is the eligible enrollees coming from the expanded tsunami of those collecting Social Security Disability, a program with well documented fraud. A study in 2013 ordered by then Congressman Tom Coburn ( R ) Oklahoma found that “  a random examination of 300 case files by Congressional staff found that more than 25% of the case files failed to properly address insufficient ,contradictory or incomplete evidence, suggesting a high rate of fraud or abuse”. These same folks then immediately enroll in their states Medicaid programs which grants almost automatic eligibility after qualifying for SS disability .    In Dickinson County Virginia 22% of workers are collecting SSI Disability payments, the highest rate in the nation.

Turning the Medicaid program into a block grant program is the correct first step in reining in the spiraling costs that are burying individual states. Let the wisdom of the founding fathers who understood the value in “ 50 separate experiments” going on simultaneously work.  States with responsible legislative bodies will immediately go to work first and foremost in redefining the term “ disabled”  The explosion in SSI Disability recipients and subsequent payments have went off the charts. One explanation ( besides the clear fraud) is the expansion of medical conditions that now render one eligible for benefits.  Today one can claim back pain, depression and chronic fatigue syndrome ……conditions that are very hard to medically disprove. Turning Medicaid back over to the States will pressure the states to rein in the abuse/fraud.  Little financial incentive exists today since the states are receiving around 50% of the funding from the Fed’s. Watch what happens when that gravy train is cut off—states will scamper like their hair is on fire to trim the abuses and bring down the costs.

The more we do at the state level where the costs and the problems directly impact those paying for them, the less we do in DC, the more choices we give consumers, the less control emanating from above, the better the odds are we will find a way out of this mess.

Bob Shannon King William

2 Responses to “HEALTH CARE REFORM — SOME FACTS & MYTHS”

  1. Gene Lefty says:

    Well, first off I do not see one thing in your post that will put competition in the healthcare/drug company/health insurance establishment run, monopoly rackets. One thing that you have been very consistent about for years now is to let people choose what level of healthcare they would like to have. Correct? Isn’t that what you say in this article???

    Well Bob, then why can’t we let Americans determine if they would like the same type healthcare system that Canada and Great Britain now have? Why is that any different than what you write above, “Let consumers choose”??????

    Go ahead, attempt to shut down the voice of those who stand up to you people and can control the debate by using the truth.

  2. Bob Shannon says:

    Socialized medicine ( national healthcare) isn’t a market based choice that I advocate for. You can’t compare , one is an apple, the other an orange.
    You promote a system that has led everywhere it has been implemented to care being rationed.

    In western Canada one gets on a waiting list for common surgeries like knee or hip replacement. The last time I examined the matter some localities had implemented actual lotteries for those needing care

    I also remind readers that even today some 9,000 Canadians daily cross the border to receive care in the U.S

    We need to break up the cartel mentioned by Gene, he is correct on that point. The hospital, big pharma and the insurance industry should not be writing the legislation being done by Congress.

    Every study that has been done since the passage of Medicare in 1965 has shown the link between the new river of government money and costs spiraling out of control since this programs inception. That is a cold hard fact that proponents of single payer ignore.
    I have yet to hear Gene or anyone else explain why Lasik eye surgery some $15,000 back at it’s inception has now come down to around $250 per eye. This procedure was never covered by any form of health insurance, nor by Medicare or Medicaid . Free market competition brought the costs down to where they are now without any interference or regulation by the federal or state government.

    A convenient truth that clearly shows how only eliminating the —middle man—and allowing the consumer to bargain directly with the provider lowers costs.

    Litigation is another contributing factor, defensive medicine, well documented where doctors routinely order a myriad of needless tests solely to avoid being sued–ask any doctor about this—drives up costs.

    No system is going to change the #1 cause of illness and premature death if patients will not do what their doctor orders/instructs them to do.
    Americans have become reliant on allowing their health to go to hell—-then expecting a doctor to give them a PILL TO MAKE THINGS BETTER.
    If our problems with the delivery of how Americans receive health care are addressed, namely by giving control back to the patient ( consumer) we will see a start to costs stabilizing.
    Any other approach is the equivalent of moving around the deck chairs on the Titanic.
    Bob Shannon King William

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    Tom White Says:

    Nothing is more conservative than a republican wanting to get their majority back. And nothing is more liberal than a republican WITH a majority.

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