Thursday, June 18, 2009

Let's Drink To Your Health!

In 2006 I spent three days in the hospital with a kidney stone that ultimately required surgery to remove. It was an expensive three days, with the bill coming in around $24,000. Thankfully, I have health insurance so I spent less than $3000 out of pocket by the time all was said and done. That drain on my savings was painful - almost as painful as the stone was - but without the insurance it could have been much worse. Unfortunately, this was my second kidney stone, and I am told that once you have two, the chances are better than 90% that you'll keep getting them. So it goes without saying that I have a vested interest in keeping my health insurance. $3,000 drains my savings - $24,000 would bankrupt me.

But why was it $24,000? When I examined the itemized bill you see that the cost of treatments were way out of line with what you could expect. Two Advil were $8. Each click on the morphine button was $28 (I actually have no idea if that's high or not - but had I known that I probably would have suffered just a little longer between clicks...). The special circulation-boosting socks they put on my legs before surgery? $128. For socks.

Of course, part of that Advil, morphine and sock charge wasn't really paying for those items, it was paying for the nurses who looked after me, who came in during the night when my oxygen levels dropped too low, who made sure that I didn't, well, die. It takes some of the sting off, but I think next time I will still have my wife smuggle in the Advil for me since $8 buys 1000 pills of the stuff at Target.

Health care has been a big talking point for the Obama campaign, and the mandate he has given congress is to come forward with a plan for national health care by the end of July. The concept of national health care is noble, and people on the left will tell you that the right to health care is a fundamental human right. The government will drive costs down, they'll say. Look at what Britain has done with national health care, they'll say. And just to make you feel comfortable with it, Obama has repeatedly said something (of course I am paraphrasing here) along the lines of "look, no one is going to take your health care away. If you want to keep your employer provided plans, you can!"

But what lies beneath the promises? When the government set prices on flu vaccines in the 90's (remember Hillary-care) the results were horrible. The intention was to make the vaccine affordable for the elderly since they are one of the more at-risk groups for the flu. The reality was that companies could not manufacture the vaccine and make a profit at the government mandated prices, so several of them stopped making it and moved to more profitable pursuits. The remaining manufacturers could make their profits on the volume needed, but lacked the production capacity to keep up with demand, resulting in shortages of the vaccine. Fewer seniors got the vaccine than would have if the prices were just left alone. If this is the effect of government controls on a simple vaccine, what happens when the start monkeying around with more specialized procedures?

Karol Sikora, former head of cancer control at the World Health Organization uses Great Britain as an example. Government controls on the available cancer drugs have resulted in decreased availability of newer, more effective (and more costly) cancer treatments. Result? Men in Great Britain have a 20% to 33% greater chance of dying of cancer than their peers in Sweden. Women have an 18% to 22% greater chance of death. When it comes to YOUR health, is that change you can believe in? Are you chomping at the bit for chance to have a greater chance of dying from cancer so your uninsured countrymen can get their treatment at your expense?

And trust me, it will be at your expense. Not only will taxes have to go up (remember, Obama said he will be cutting income taxes for everyone, but medicare is funded through the payroll tax, and he made no promises there!) to pay for a national health care system, but according to Jim Frogue of the Center for Health Transformation, if you keep your company's plan so you have access to the best health care, you can expect to pay more for the services. You see, the government plan will not pay the market rates for services, so health care providers will face a shortfall in capital and will be underfunded. This can be offset in a couple of ways. One would be to reduce the costs - like employ fewer nurses, use older equipment, opt for lower cost treatments even if they're less effective. Does that sound like improved health care to you? The other and more likely way to cover the shortfall is to raise the rates on the private insurance plans. My $128 socks could easily jump to $150 or more. In effect, then, the cost will hit us twice; once in the payroll tax and again via inflation when we have services delivered.

Lastly, what of the uninsured? According to the National Coalition on Health Care, 18% (or nearly 1 in 5) Americans doesn't have health insurance. The reasons listed are primarily that people do not have either access to health coverage through their employer, or they can't afford the premiums. I have two examples to discuss, then I'll quit beating this horse.

First, I have a friend who was laid off from a title company about a year ago when the housing bubble burst. He lives simply and doesn't have much in the way of expenses, and had substantial savings. He has chosen to live without a job since then, and consequently without health coverage. The key word here is "chosen." He is without coverage BY CHOICE, and I am certain he is not the only person in the nation who has made this choice. Nowhere in the NCHC statistics do I see this number represented. I love this guy like a brother, but why should I pay for his health care through my taxes when he's made this choice?

The second example is another friend of mine. This one is a teacher. He had a SWEET deal on health care through the school district. I forget the numbers, but his coverage was free, his spouse was $1 per month and their kids were covered for a somewhat larger fee. The total for the family of 4 was less than $100 per month. Then the district went bankrupt and his coverage ballooned to over $900 per month (on top of a 7% cut in pay! So much for the NEA protecting teachers - but that's for another day). What did he do? He took a part time job at UPS, working enough hours to cover the cost of the lower premiums UPS offered for their health coverage.

And this is the missing piece of the health care debate. There are absolutely people who are in desperate situations who cannot afford or don't qualify for coverage, but there are also a number of people who abdicate their personal responsibility and wait for the government "nanny state" to come in and take care of them rather than rolling up their sleeves and working harder for what they want. How do we help the former without coddling the latter?

One thing is certain - once we open the lid and let out this entitlement, it is going to be next to impossible to put it back in the box. If you want to make your voice known, go to and send a note to your elected officials. If they value re-election, they will listen to the will of the people.

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