Sunday, July 19, 2009

Health Care: Not The Duty of Others

When you read the following, keep these three things up front where you can remember them:
1) "Health insurance" is NOT "insurance", because there is NO party who will NOT access the benefits. This is actually socialized medicine. Be honest and enforce that term.
2) The entire purpose of "health insurance" is to pay doctors. Keep that in mind, and you will be able to ask yourself and others real questions and see some absurdities. Some questions: How is involving government going to get me better care? Why are so many people being paid that have nothing to do with treating me?
3) If you do not pay, you are not a customer, you are a commodity. Things will be done by policy, not the way you desire.


In the debates about the current status of health care, there is a gap. This gap contains basic questions, which do not get asked as often or as loudly as they should.
  • Why should government pick up all of the cost of anything?
  • Do you recognize that all resources, government included, are limited?
  • Do you know what your insurer's current practices are, and their relationship with your doctor? Other doctors? What do they have to say about non-routine procedures?
  • Why does your Explanation of Benefits - from your insurer - have dollar numbers on it that no one was paid?
This last is an artifact of the insurers agreement: a doctor will provide services for less than a "list price" in return for guaranteed payment.

What? Do you really believe that?

Really? The doctor doesn't adjust his prices to deal with the overhead of hundreds of forms he has to submit, and the correspondence regarding his services? Extra people in the office and at the insurer's offices do their jobs for free?

Ha. Gotcha.

So, the status quo isn't the best it can be. So people want government to step in. What? Aren't you really, seriously insane for proposing that? You don't like what government is doing in Iraq, you know public housing sucks...

The IRS is not your friend. Why would you even begin to think a Federal medical authority would be?

The Affordable Health Care Act has penalties in store for you if you get care other than by Federally approved means. Your health care plan cannot be better than Federal authorities decree. Yes, you're sick; sorry, fill out the form and wait. Wait some more. You've been promised that no one will be denied care. "Sorry, madam, you'll have to wait. You're not being denied care, it just isn't available right now." Oh, you want to go somewhere else, because some bureaucrat has not got it through their thick head that disease does not wait? How about jail?

Jail, for being sick and seeking a cure. Oh, joy. Did you vote for this? It's what you're looking at. There's a good chance it'll happen, as the ignorant clamor for government to give them something for "free".

In addition, this monstrosity is set up so that not only initially, even after you are signed up for it, it will "reset" and cancel the arrangements you have made with your doctors!

The President of the United States LIED about this Act. Why would you even think about supporting it?

I have another proposal, which will still ensure doctors get paid. Here's the message I sent my Senators:

Dear Senator:

I believe I have a model for health care which could revolutionize the industry, improve efficiency and even put you in the White House. Bold claim, no? Well, let's see.

I think you and your staff know the issues with health care today, so I won't bother you with outlining the status quo. I'll get to the point.

We should set up the "Medical VISA Card" - like this:

• This card would be issued by an existing Federal agency or contractor to every person attaining majority, or to the guardian of every person for whom one is appointed, upon their acceptance of a contract. This would establish positive ID for that person. There would be benefits to this - see below. I call this a VISA card just because that company has all the assets in place to do this already.

• The card would be usable ONLY for prescription medicine and for visits to licensed doctors and dentists.

• The card would have a credit "trigger". Reaching this number would trigger agency review of the use of the card and their participation - just like reaching a deductible works in your current insurance policies. Think of a value determined by the person's economic status - the method by which credit is responsibly extended today.

• The balance would be due from the holder to the "medical VISA" agency, exactly as bank and other credit cards are handled today.

• An interest rate on outstanding balances would be established to collect two things: direct cost of the program (overhead), and an investment fund to be used for catastrophic illness and disability of all participants in the program.

• Card holders could be shown instructions for getting medical attention, and encouraged to avoid using emergency rooms for routine care. Emergency rooms can require the medical card to send patients to other clinics.

• Medical VISA card holders could build a positive, interest-paying balance in their medical account, as this is portable (not job-dependent) medical insurance.

• This system does not discriminate between individuals based on anything but their reported income, and then, only to determine when the agency steps in. It doesn't care about citizenship or race. If you are an immigrant, you would be positively identified by this card. The system relieves the nation of the burden of those immigrants who are undocumented.
Make no mistake about the fundamental nature of this card: up to the spending limit, the holder MUST pay. People simply won't be careful with other people's money.

Senator, people understand credit cards, however woeful the current credit situation might be because of public confusion between ownership and possession. I myself am mystified by my own Blue Cross, Blue Shield statements, which routinely say my treatment cost twice what anyone was paid.

It's time to re-establish the patient-doctor relationship. This will do that.

I recognize that a lot of work would be necessary to turn this into reality; I don't pretend to know this field as well as you and your staff must, just to run your office.

But I suggest that this is a good start.

If you find merit in this, feel free to add to or subtract from it and pass it on - because there is a truth you cannot escape or deny:

You will not get to say what happens unless you are the one paying.