Saturday, July 25, 2009

Government Health Care

We are being moved by the president and the Congress toward universal health care. On that we can all agree. And although President Obama is once again calling for speed of passage—even though the implementation isn’t scheduled for four years—more and more of the American people are rising up in protest. Their representatives in Congress are constantly assailed with petitions, faxes, emails and letters from constituents that are urging caution and delay. The more we learn about the 1,018-page bill, the more we find objectionable about it.

Here are two points that I haven’t seen explored yet, but both are terribly important in the debate over universal health care. The first is history that explains why health care costs are where they are today. The second is a projection that will shock you, because it is my estimate of where a lot of the money to pay for the program will be found.

Pretend for a moment that you run a business that provides a service. Further, assume that it costs you $1,000 in wages, benefits, payroll taxes, retirement, and materials in order to provide that service. Now let’s compare two customers for whom you provide your service in exactly the same manner.

When it comes time for the customer to pay you, the bill for each is $1,100 (you do want to make some profit, of course) and Customer A pays the full amount with no complaints. However, Customer B wants to haggle over the bill, and agrees to pay you only $600. You object to the amount, but you know that this customer will give you a lot of referrals for future business, and besides, he is adamant that $600 in the maximum he will pay for your service. You finally agree to accept that amount.

You just provided $2,000 worth of service, but you only received $1,700 for it, so you are now in the hole $300 instead of being up by $200. You also now know that any referrals from Customer B will likely only be willing to pay $600. How are you going to make up the difference so that you can operate at a profit?

Of course, you are going to raise the price for everyone by a few hundred dollars, with full knowledge that not everyone will pay that much. You hope that enough will pay the new amount to make up for those who will not pay what providing the service costs you.

The new price is raised incrementally to $1,500. Customer B and all of his referrals will not pay that amount, but will pay $600. And by the way, Customer B is influential enough that he can put you out of business if you refuse service to his friends.

If we make the service provider you run a hospital, a clinic, or a doctor’s office, then we can identify Customer B as a Medicare/Medicaid patient, and customer A as anyone else who either pays out-of-pocket or has a private health insurance plan.

Health care costs didn’t start to rise until the late 1960s, just after President Johnson signed the Medicare bill into law, and they really took off when Medicaid was added. I know, because I still have the bill form the hospital where my son was born in 1966. The total amount for a four-day stay, mother and child, was under $200. By 1971, when my daughter was born at the same hospital, the cost had already increased fivefold. Ask yourself how much it would cost today with even the normal two-day stay.

Now you know why it costs so much in both premiums and deductibles to use private health care. I also know why the hospital charged me $90,000 for an outpatient surgery, but Medicare only paid about $30,000 of that amount. Who do you suppose paid the balance? The same situation exists for doctors and other health care providers.

Now I’ll disclose that second point. This one you can ignore if you aren’t on Medicare and don’t have any parents who are on, or about to join Medicare. That probably doesn’t dismiss very many of you.

If the universal health care plan does go into effect, what do you suppose will happen to current Medicare/Medicaid patients? Well, we really already know, because they are specifically addressed in the bill before Congress. They will be placed into the same program as all other citizens. And whatever premiums are finally agreed upon for those in the government plan—it really isn’t “free” you know—Medicare patients will have to pay the same rates.

Now ask yourself a few questions here.
1. Will premiums for Medicare Part B go down, go up, or stay the same?
2. Will premiums for Medicare Part A be added?
3. How does the government collect those premiums?
4. Will your Social Security be affected by universal health care?
5. Who will now pay the increased costs of treatment described above?
6. What is the only means of saving money in government health care?

I think you get the idea that seniors are going to be hit hardest by the new health care, because they will pay higher premiums and will receive less treatment. The reason I included those of you who have parents on Medicare is because you are probably going to have to do more to support your parents, not just with health care costs, but with every day costs. Too.

If you followed this to its conclusion, you must know that the decrease in payments and in treatments is going to put a lot of health care providers—especially specialists and surgeons—either out of business, or out of country. That will make even allowed services much harder to find and will increase the waiting time of everyone. Does anyone in Congress even try to listen to anecdotal evidence from Brits, Canadians, Australians or those from any country that currently has national health care? IT DOESN”T WORK THERE, AND IT WON’T WORK HERE!!!!

Lest we forget them, there will be a few winners in this universal health care, but even they are only partial winners. I am referring to the undocumented immigrants and those who are on Medicaid. They will probably not have to pay any more than they do now for their medical treatment—nothing. However, they will lose under the rationing of services and the lack of qualified doctors.