Elizabeth Hartline Green

What’s more frightening than Captain Hook? The health care pirates.

Paul Krugman's editorial in the New York Times this morning discussed the fallacy in assuming that if we don't employ the current health care system exactly as is, the system will be untenable. Actually, Krugman says, America is the worst among advanced countries in the ability to obtain medical attention on nights or weekends, and at the bottom of the list when it comes to obtaining any short-notice care.

Here's a somewhat silly but amusing video about our current health-care system entitled "Pirates of the Health Care-ibbean." Though it is a bit over the top, it definitely hammers in the point that a system motivated purely by profit may not be in the best interest of the average citizen. The video was created by the Foundation for Taxpayer and Consumer Rights, whose founder is Harvey Rosenfield. Rosenfield spoke in the Drum Major Institute's Marketplace of Ideas event on affordable insurance.

As for me, I'm not saying that a system like Canada's or Germany's is the way to go, necessarily--I don't claim to be any expert on health care policy and what would work given what we have now. What I'm saying is that our system as it stands now is not serving the American people well. The solution to our current health-care crisis is not simple, and so grounded in politics that sometimes it's hard to see the reality. But as long as there are 4.1 million uninsured children in this country, we have a responsibility to rectify the situation.

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Posted at 3:49 PM, Jul 16, 2007 in Health Care
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Awesome video. I agree--I think the problem is that we're told that our only options are the way things are currently, or substandard care. This in itself is problematic because it ignores the fact that the current system provides some people with only substandard care. We have to shift focus to look at why we pay an arm and a leg to then worry about whether we'll be covered for proper treatment if we ever get sick. And we have to look at to whom we are paying the arm and leg--I'd rather pay it to the government in the form of taxes and then be able to hold someone responsible if I am denied adequate treatment.

Posted by: Kia | July 18, 2007 10:48 AM

Kia, I agree with your comment that we have to look at why we pay and arm and leg for healthcare in order to figure out what to do. The first thing to do is look at where the money enters the healthcare system. This is generally from two sources, employers and government. Since government gets its funding from tax dollars, the real only major sector paying for healthcare is employers. Next, the money goes to insurance providers or the goverment where it is metered out for care. Insurers make more money the more money they have to work with. That is to say, their best business plan is to have the most number of people insured for most that they can charge until the market forces them to correct.

Now, lets look at how health dollars are spent. First, both the government and private insurers know that medical facilities will have many patients who are uninsured. Therefore, they include some funding for this. This is the basis that we already have socialized medicine in EMTALA. Here in the US, the main expenditures of healthcare dollars are in the last months of life, (ICU, etc) and in elective procedures. (note that many of these ICU costs and elective procedures are limited in Canada, UK) As for elective procedudres, think of all the surgeries your friends have had (elective tubals, knee scopes, tonsills) etc. These can be high dollar surgeries that are not for life ending conditions but those dollars help defray the cost of things like cancer surgeries which generally pay little.

So now we have employers paying either directly to insurance companies or to the government through income taxes on their employees to pay for our medical system. This system overcharges those with private insurance and to a degree government insurance to help defray the costs of those who do not have insurance. We call it Robin Hood medicine.

Now, here is the kicker. Who is making the most money in healthcare? It is not the government. It is not the patient. Hospitals are making on average of 2-4%. Doctors get 20-35%. Who then. Insurance companies can only make money in two ways, both of which are highly regulated by the government. They can make money by collecting in premiums more than they pay out, and they can make money off the interst they collect from the premiums. At present, United Health is making record proffits. Many Blue Cross programs are being forced to be private companies as they have record surplus. How do they make record proffits? There is a great incentive to make things in medicine as costly as possible, this raises what you have to pay in insurance which inturn lets the insurance company make more in interest. Having more and more uninsured is no problem as this further raises rates as hospitals have to charge more to cover the uninsured.

How do we fix the problem? A market can only correct if it is allowed to. To allow the healthcare market to correct, it is necessary to correct where the money is coming from and how it is distributed. If money comes from the individual and not from the employer, people will think differently about how it is spent. For example, take tubal ligations. If you met your deductable, no big deal. You would think twice about it if you had to pay $15,000. The same with a knee scope to play softball with the boys. (This is the basis of the med savings account). Secondly, we have to have insurance reform. We have to change the laws governing how insurance complanies do business and are protected. We can't let them continue the environment that encourages the maximum cost for the maximum number of patients so they can increase their proffit margin. Guess who has a very strong lobby? In the meantime, invest in United Health.

Posted by: Throckmorton | July 21, 2007 10:21 PM