The furor over the recent mammogram recommendation illustrates how distorted our assumptions about health care and health insurance have become, distortions which the Senate and House bills only exacerbate.
In a saner world, where medical consumers paid for routine services, women would use the new information about breast cancer screening to decide for themselves how the costs of possibly superfluous screening measure up against their own tolerance for risk. If they wanted the extra security, they would pay for it. Instead, thanks to our assumption that every medical procedure should be paid for by someone else as a virtual entitlement, any new treatment consensus becomes a matter of national concern—and, in the case of Republicans, a certain amount of opportunistic grandstanding as well.
It’s no more logical to have so-called “insurance” for foreseeable, routine medical needs than it would be to have employer-subsidized grocery insurance. Food costs would shoot up as grocery stores hired reams of clerks to manage the reimbursement paperwork. Hungry customers would wait in little antechambers filling out forms in triplicate before they could collect their “free” gallon of milk.
Rather than giving health consumers more choice, however, the Senate and House bills define a minimum level of benefits that all insurers must offer and fail to allow consumers to buy insurance across state lines. As a result of this regulatory paternalism, any promise of savings is chimerical.
I’m inclined to support a mandate to buy insurance, since I’m not charitable enough to happily bail out someone who decided to take a risk on catastrophic health costs and can’t pay his hospital bills. I suppose, however, that in a world where the bad bets of the uninsured get passed along to the insured or to the taxpayers, one very quickly reproduces the over-regulated insurance mess that we find ourselves in.
I could be very wrong about this, but I blame the rise of HMOs for a lot of this mess. With an HMO, you could basically go to the doctor “for free.” Which meant that the hypochondriacal, the pathologically in need of attention, and the hysterically neurotic started clogging up doctors’ offices with imaginary complaints. As one who’s had to pay for her own health insurance for most of her working life, I’d far prefer a system where I could just buy hospitalization coverage and pay for everything else out of pocket. It would be a hell of a lot cheaper than my current deal.
Spot on, Heather! As a young worker with an employer sponsored “Cadillac” plan, my employer is spending a large percentage of my “compensation” on a service that I neither desire nor utilize. Obamacare is only going to increase (indeed, mandate!) these inefficiencies.
I wonder if our lawmakers have considered that raising the costs of employing a worker with this healthcare mess is precisely the WRONG THING to be doing when national unemployment is near 10%.
.. thanks to our assumption that every medical procedure should be paid for by someone else as a virtual entitlement …
The working assumption of left-wing elites is that people are too stupid to make medical decisions for themselves and that they require a panel of “experts” to decide for them. Physicians are apparently motivated only by profits and are only too willing to resort to amputation, rather than treatment, if it means more money. Leftists are the ones who, through the media and the academy, have drummed into people’s heads that health care is a right. “The Constitution, after all, is just a charter of negative rights. It says what the government can’t do to you, but not what it must do for you.” – Barrack Obama Their mission is to correct that oversight.
.. in the case of Republicans, a certain amount of opportunistic grandstanding as well.
So, when Republicans reject the idea that a politically appointed panel, which in this case did not have a single oncologist, should be making treatment decisions, instead of the patient in consultation with their doctor, it’s “grandstanding”?
I’m inclined to support a mandate to buy insurance, since I’m not charitable enough to happily bail out someone who decided to take a risk on catastrophic health costs and can’t pay his hospital bills.
Perhaps you haven’t noticed, but that mandate comes with government subsidies for dependent constituencies. Guess who pays for those?
HSA’s are the obvious answer to controlling health care costs since they eliminate third party payers and force people to make decisions more in line with their resources and their tolerance for risk. They also allow employees to capture income that would otherwise be directed toward unwanted health care. Not surprisingly, the Democrats are trying to eliminate them.
I wonder if our lawmakers have considered that raising the costs of employing a worker with this healthcare mess is precisely the WRONG THING to be doing when national unemployment is near 10%.
I’m sure they’ve thought about it, and don’t care. Free health care is a RIGHT–so what if a bunch of people lose their jobs or have to take pay cuts because of it? The one good thing about the recession/financial crisis is that it gives the Democrats less ability to implement big spending bills. If Obama hadn’t spent 2 trillion dollars on bailouts, he might have already been able to pass Obamacare. Now it’s not a sure thing.
Sheesh.
#1 “… thanks to our assumption that every medical procedure should be paid for by someone else as a virtual entitlement …”
Mammograms are NOT a medical procedure, they are a screening procedure unless there is some other indication of disease or risk, at which time it becomes a diagnostic tool. The problem is that “some” entity has been pounding into the heads of women for years that this screening is necessary to “prevent” cancer. That’s a crock of you-know-what.
#2 – Requirements to purchase financial responsibility do not work where health is concerned. Unlike automobile insurance, the responsibility cannot be shirked simply by not owning a car. We sort of come with bodies whether we want them or not.
Also, we get the bodies we’ve got and nobody gets to ask if they’d rather have one with a better immune system or “perfect” DNA. While certain risks can be minimized, the reality is that eating a perfect diet and maintaining the perfect exercise regimen doesn’t mean you are not going to have a heart attack, stroke, or grow a tumor at any given age.
@Susan — I disagree about the rise of HMOs being the cause of the problem because they were an experiment in rationing and the idea of a gatekeeper (what primary care docs seem to have become) to prevent over-use/abuse of the system.
But, I do think you have a point where payment is concerned. Before I became a member of one of the earlier HMOs in the ’80s, I had to pay up front or make arrangements for payment and file a claim with my insurance company for reimbursement. I always knew what the care actually cost.