Wednesday, August 19, 2009

Life, Liberty, Property and the Pursuit of Health Care

The health-care crisis began when the public was sold on the deception that health-care is a right. It is not. Rights are defined as things that our government can not take away from us, among these are the rights to life, liberty, property and the pursuit of happiness. The government has no obligation to provide you with these things, but we are protected from the government taking them away. Of course there are exceptions like taxes, prisons, capitol punishment and eminent domain, but I will not discuss them here. The point that I am making is that rights are not entitlements.

In my opinion, there are seven reasons why health-care costs have risen so dramatically within our lifetime.

1) Insurance is a financial tool intended to reduce one's risk of unlikely, yet catastrophic events. The entire system becomes skewed when insurance is used for every-day expenses, such as routine doctor's visits, minor injuries and common illnesses. Automobile insurance guards against major losses from the unlikely event of fire, theft or collision. Automobile insurance was never intended to pay for routine maintenance, repairs, tolls and parking fees. Likewise, health insurance was never intended to cover routine check-ups, child birth, coughs, colds, childhood measles, mumps, etc. The fore mentioned heath concerns should be planned for and payed for as they arise. Just as most responsible Americans save for their retirement, responsible Americans need to save for the inevitability of their own medical costs. Just as with retirement, the only way you won't need to plan for these expenses is if you die early.

2) Medical advancements, innovations, procedures, drugs and equipment are available today that were not available 50 years ago. There is no doubt that many of these things save lives that would have been lost 50 years ago, however if we wish to take advantage of the miracles of modern medicine, we must pay for it.

Examples of these lifesaving innovations are kidney dialysis and transplant, open heart surgery, cancer treatments, laser treatments, MRIs, CT scans, etc.

We should be grateful that these miracles of modern medicine are available in today's day and age. John Rockefeller couldn't have attained lifesaving kidney dialysis if he required it in his time, yet this lifesaving treatment is available to everyone in today's America. As far as health-care is concerned, today's poorer Americans have much more health care available to them than wealthy people of days-gone-by.

The money that today's wealthy people spend for expensive drugs and "cutting edge" treatments, pave the way for routine and inexpensive treatments for the future. We need wealthy people to pay the high costs of cutting edge treatment so that some day, it will be within everyone's reach. This can only happen in a free market.

3) Most patients do not pay directly for their own treatment. When the government or an insurance company pays, this limits the options for the doctor and the patient. Often more expensive options are available, while cheaper ones are not.

For example, Medicare payed for my father's physical therapy for 3 months after he suffered a stroke. I estimate that the cost to medicare was $600.00 per week for the PT. After medicare determined that My father was no-longer entitled to physical therapy, I enrolled him in 2 programs that offer him virtually the same therapy, using virtually the same equipment and the same intensive supervision and one-on-one attention, in the same facility, for approximately $70.00 per week.

Another example is that physicians automatically prescribe costly name brand medications for those who's insurance will cover the cost. They often ask about your coverage before deciding whether to prescribe a costly name brand medication or a generic. It the patient was paying directly, the physician would discuss the pros and cons of name-brand versus generic medications and the patient would ultimately decide. This process would undoubtedly bring the price of name-brand drugs down because the drug companies would try to get a bigger market share by being more competitive.

4) The huge role that government plays in health-care (Medicare, Medicaid and other government programs) has crowded out families, churches and private charities from filling these needs. Families, Churches and charities used to provide a safety net for those in need. They did it in a more personal and efficient manner. Centralized bureaucracies are always inefficient and impersonal and leave the those they are trying to help with a feeling of resentment and entitlement, rather than with gratitude, appreciation and a willingness to give back.

5) Defensive medicine costs billions. A large expense in Americas health care system is defending heath care providers from costly litigations, judgments and settlements. Doctors often provide unnecessary testing, medications and procedures, just to "cover their asses" in case something goes awry. When something does go wrong, which is inevitable in any business, huge settlements and judgments are paid out. Health care providers routinely pay huge malpractice insurance premiums to protect themselves from this inevitability.

All medical outcomes are not good ones, regardless of good intentions. When things go wrong, patients and families seek someone to blame and to pay restitution. If the patients were paying for each test, procedure and medication, they would choose the most cost effective procedures and have no one to blame if something was undetected because a costly test was not done.

6) Hospital costs are extremely high because they must provide free emergency services to anyone who shows up at their door, regardless of their ability to pay for services rendered. The cost of uncollected hospital bills is passed on to all of the other paying customers.

I agree that this is the humane thing to do in a society that can afford this, but it turns out that people are taking advantage of this by showing up at ER's for non emergency treatment. This not only clogs up ER's with people who don't belong there, it also increases the cost and availability for true emergency services.

Just like there are penalties for those who commit false alarms for fire and police services, there should be criminal and civil penalties for those who misuse emergency medical services. Also, those who can not pay, should have their wages garnished to pay for their treatments, until they have payed for the emergency services that saved there life or their limbs. Few people will argue that there life or limbs are not worth any price.

This will lead to much less unnecessary use of ERs and this will create the need for more Charity hospitals, free clinics and/or cheaper hospitals that would offer an cheaper alternative for those with financial hardships.. Charitable Americans have always risen to meet such challenges in the past and will meet these challenges in the future by their own free will.

7) "behavioral risks". Health care expenses should be higher for those who practice behaviors that present a risk to one's own health. By some estimates, behavior accounts for one third of health care costs.

The cost of all auto insurance policies is based on the driver's behavior. Motorists with bad driving records, including traffic tickets, accidents, DUIs, and sports car owners are charged substantially higher premiums.

If the government sets the rules regarding health insurance premiums and rationing of limited medical resources, it is likely that the government will dictate personal behavior. They might make certain unhealthy behaviors illegal or certain risky behaviors might deem patients ineligible for certain treatments. This is an infringement on personal freedoms that I strongly oppose.

Once the government takes over, it is likely that the government will regulate the foods that we are allowed to eat, the sports that we are allowed to participate in and even the number of children we are allowed to bear. The government may mandate that we we take certain medications (cholesterol medications, blood pressure medications, psychotropic medications, etc). Smokers may be ineligible for heart surgery.

There are also many risky behaviors that are actually politically correct. I have read studies that assert that homosexual behavior is linked to more disease and a shorter lifespan, than heterosexual married men. Homosexual men are barred from donating blood due to this risk. Women who practice lesbian behavior are more prone to domestic violence, suicide, drug abuse and mental illness than married women.

Of course when the government gets involved, they will skew their regulations to accommodate political correctness which is inherently unfair.

My niece has a knee injury that is exacerbated by dancing. If the government sets more health-care rules, she might be barred from dancing and or working as an aerobics instructor, or face forfeiture of any treatment for related injuries. Although I think that my niece should have enough sense not to dance on bum knee, I think it is her right to make her own choices and live with the consequences and associated expenses.

Of course much government control in the areas that I mentioned already exists. The Government already provides half of our health-care through Medicare, Medicaid and other government programs. If we expand government involvement; regulations, restrictions and loss of freedoms will surely increase.

In my opinion, the government does not belong in the health care business. However, once they get their foot in the door, it is impossible to get them out because people feel a sense of entitlement. When the size and scope of the federal government increases, our individual freedoms, choices and aspirations will decrease. Our constitution guarantees us freedom from the government infringing on our right to life, liberty, property and the pursuit of health care.

1 comment:

Anonymous said...

Thanks for the first coherent argument against healthcare I've seen yet. However, one point sticks out to your last example you say that your niece would not be allowed to dance due to her knee. What would prevent a stipulation in the government plan similar to those in private plans, or the auto coverage you described, which makes it so that she would not recieve benefits for a clearly self-inflicted injury?