Health Care and More Legislative Railroading
In only a few days, with little in the way of committee input, with no coverage of the process, once again a backroom deal is being crafted that will have a huge impact on the lives of Americans with this new health care legislation. Since there seems to be very little understanding in Congress of how we got into the mess we are in with continuously rising premiums so that more and more find the premiums unaffordable and opt out of coverage, we rush headlong into a total makeover of the health care system with little thought of the consequences.
Let’s think about some of the consequences of this plan. Of course, like Congress, we won’t look at the reaction of businesses that are being forced to provide health care coverage for employees who have little education and little skill, and so, are both low-productive and low-wage workers, whose payroll costs will soon be higher than their revenues. Like Congress, we won’t look at businesses destroyed and employees who become unemployable because they are now unaffordable.
We are told that the costs of this new government-provided benefit will, in all actuality, be a rich-provided benefit, provided of course, by gunpoint from the IRS. Unlike Congress, let’s see how it affects the great majority of Americans who have been paying for their own health care plan for years, those not so rich that they will see their taxes go up, just those whose premiums will shoot up and those whose doctors will tell them that by-pass surgery is no longer being covered or that it will take 5 months to see an oncologist and then another 4 months for surgery and then another 4 months for any follow up treatments.
As Congress and state legislatures have mandated more and more to be covered by the health insurance plans in their jurisdictions, the demand for health care has risen, pushing up prices dramatically. What many of us have not noticed, is for years, the providers of health care, the doctors, nurses, and hospitals, have had protections from new entrants into their markets in the forms of licensing and occupational control over access to medical and nursing education while legislature have placed limits on hospital competition.
Here is the problem. With more and more seeking health care under these new legislative mandates, but with the providers of health care limited by their occupations and by government restrictions, and doctors only having so many hours in the day to work, somebody will denied care, coverage or not. There is nothing I have heard of in any plan from Congress that increases the flow of doctors into the country, either form new doctors and nurses or from experienced doctors and nurses from other countries. Without more health care workers, especially doctors and nurses, more demand through extended coverage will either mean rationing through higher health care prices so that those who cannot afford their co-pays will not seek care or rationing by telling certain people that their condition will not be treated.
So, by covering more people without expanding our human and physical resources to be able to actually treat more people, someone will not get health care. Many of those who will be denied care will be those who have paid for years. Like my own congressman, I have not had time to read the whole bill, and like my congressman, I probably will not be able to. However, if the legislation or what it becomes in the future through “fixes” that will have to be imposed because of the haste and thoughtlessness of the Obama legislative agenda, does not include ceilings on health care prices, the prices we pay for health care and for our health care premiums will go through the roof. Price limits will only mean shortages that will show up with longer and longer delays in diagnosis and treatment, just as we see ever expanding waits for care in Canada. In 2008, it took about 4 months to see a specialist after seeing a general practice physician. It also takes months to get treatment after the initial trip to the specialist.
One vivid picture of government-run health care is painted by the 1992 movie called “Article 99″ . you have not seen this movie about too many patients in a VA hospital to be treated, try to find it from your favorite video store.
Besides contacting your senator, what can you do? Perhaps you should consider increasing your life insurance coverage.
-MC
August 4th, 2009 at 5:17 pm
Should health care coverage be a privilege or a right? I think a privilege is driving a car, not deciding to provide health care for you and your family. Sure the entries into the field of medicine are limited, due to insiders versus outsiders, but it should not allow for doctors and nurses to dictate who can have health insurance and who cannot. I think the new plan would increase the competition in the health care market. An increase in competition would mean for the other firms to lower their prices, so that they could compete, in this case the government. I think the new plan should allow Americans who have health insurance keep their current plan. A government health care plan will also help people with preexisting conditions get insurance, under certain current plans people are either denied or have a grace period until they can receive full coverage. So, should our Congressman deny Americans health care, but continue funding projects that are unnecessary. Sure Congress cannot pass health care reform before the recess, but it needs to be done.
August 5th, 2009 at 5:45 am
Thanks for your comment. While it is not the doctors and the nurses deciding who has health insurance, the doctors and nurses, through their organizations have tried to restrict the number of doctors and nurses in the market. There are many entry barriers all over the health care industry, including those that limit licensing and even entry into the country of trained doctors and nurses from other countries (though these are given some preference for entry). So, without doing anything about the limited number of suppliers (limits by our state governments’ licensing regulations and federal immigration laws, among other laws), any increase in coverage will only push up prices of health care (doctors’ and nurses’ pay would increase, hospital charges would go up) and so insurance companies would have to pay out more, so that they would have to increase the premiums. Note that if there is a government plan out there that is taxpayer funded, it will be receiving an unfair subsidy from taxpayers that would lower the price that they could charge to customers and competition between a subsidized and an unsubsidized plan would evolve into a single-payer plan, as no unsubsidized plan could compete.
People with pre-existing conditions naturally use more health care. For these people, insurance will not be paying for a risk (like auto insurance for a wreck for a good driver), but is paying for the certainty of high cost use. Somebody will have to pay for these costs. Either pre-existing condition costs are paid by the person who has that condition before they get the insurance, or others insured with that person in their risk pool will have to pay for it. Here, the insurance becomes something like “beer insurance” for college students. The all-you-can-drink beer insurance leads to heavy drinking by some, and light drinkers decide not to have beer insurance because the premiums are too high. The pool of drinkers shrinks to only heavy and moderate drinkers, so fewer people paying in means less beer money available so premiums have to go way up, forcing the moderate drinkers out, leaving only heavy drinkers buying beer insurance, forcing premiums up, causing heavy drinkers out, leaving only those who are very heavy drinkers out, eventually forcing all buyers out of the beer insurance market. This is a problem in insurance called adverse selection.
Higher prices for health care are brought on by increasing coverage and increasing the areas covered by insurance (such as coverage for massages). This is only made worse by restricting entry into these professions through licensing and restricted entry into health related schools. HIgher prices force healthier people out of the market, so we see much of the uninsured are 20-30 yo males who choose not to be insured because the premiums are too high.
Health care reform is surely needed, but it must be thought out, not knee jerk as we see in this still very rushed piece of legislation that the ones voting on it have not idea what they are voting on (even Obama will not be reading the bill). Too much focus is on coverage of insurance and not on how we will provide the producers.
August 7th, 2009 at 10:25 am
First I want to point out that we are talking about people lives! Life or death! And though it is sad that it carries a price tag we need to realize the advancements in medicine and technology doesn’t pay for itself. Healthcare Management is my passion so I have very strong beliefs regarding the current issues and watch and listen everyday when it is brought up.
I feel that with our expectancy lifespan increasing from what used to be around age 70-75 and now it is rising to 75-80, shouldn’t the medicare age increase with it. For years the age has been 65 or with some guidelines that include the disabled. If the age guideline doesn’t go up and change with our aging population, of course the funds for it aren’t going to stretch that far. I realize this would be hard for those who are retiring or are looking forward to these benefits so the change would be difficult.
Also as a previous nursing major I feel that the guidelines and restrictions for entering nursing school are outrageous! Most nursing programs only accept 50 students per semester and there is a huge demand for nursing instructors. If there were more incentives for these teachers to teach, everyone would see an increase in nursing applicants and graduates. The bar is held so high for those applying that it is very discouraging to them. This is a reason for the lack of nurses available today.
Any changes in the healthcare system are going to be drastic and expensive but someone has to pay for it. Right!?! Hopefully the house comes to an agreement and we fix this mess that America is in right now.
August 24th, 2009 at 3:54 pm
Hello Mr. Coats, I see that the Canadian health care system has you flustered with the waiting times in some health care institutions. But, in the end, i’d rather wait a few hours to see a doctor, like most people, then pay the high costs of health care in America. I’ve recently spoken with a young girl attending Nicholls who paid 370$ to get a large splinter removed from her foot, that makes no sense. Also, in Canada, any life-threatening injuries or problems are dealt with immediately and are not denied or associated to your financial state. Although, there are some flaws in our healthcare system as there would in any, but in most cases its only in the large cities like Vancouver and Toronto where they are flooded with people due to immigration, that suffer waiting times.
With the little much I have learned about the new healthcare system that is supposed to be implemented in America, I do agree with you that Obama’s new system will probably fail miserably due to the high population and the lack of medical assistance that is offered. But I believe with lots of ”tweeking” and trials with a reformed health, more and more suffering people in the United States with recieve medical attention that they diserve. And I do strongly believe that if everything goes as planned, maybe in a minimum of five years or so, there could be a change for the better, not only in price for health, but for availability if people don’t mooch off the services offered.
August 27th, 2009 at 8:19 pm
I think this new health care system is bogus. It’s just another problem to add to everything else that we, Americans, have in our so said free country. I pay for my health insurance and have always paid for it. I don’t want to pay a higher premium and have to sit and wait for hours and then months to be treated as if I were sitting at charity. Not that there is anything wrong with charity, except for the fact that you might die before they treat you, but those who can pay for there own insurance now should not have to change. What will be the difference in the new health care system versus the old? Don’t the people who do not have health care now go to charity? Their cost is based on their income so what’s the problem. So what will change, we will all be waiting those long periods to get the medical attention that we need. So really what is the difference. Not only do we have charity but there are many American’s who are on government funded insurance including children of single households or the elderly. Not that I disagree with government-funded health care, but you should take what you can get. Maybe if some American’s didn’t rely so much on the government to help them make it through life we wouldn’t have this health care problem. Allowing more people to have health care and making it mandatory (or you’ll have to pay a fine for not having health care) will only make things worse. Already we don’t have enough health care providers and there is little to no competition when it comes to medication. The prices of medication are ridiculous and we think they are trying to help us, but in reality they are only doing what’s in their self-interest. Yes, it is also in the social interest, but let’s be real here they are out to make the money, and there are many people who cannot afford to buy the medications that they need due to no competition.
Are doctors and nurses over paid? Yes, they are. With out insurance, to see a doctor for the common cold will cost you about $150, not including the medications you will need. How could someone looking in your throat, ears, and nose be worth so much? I do understand that surgeons, anesthesiologist and so forth have a greater liability and should charge extended prices, but the general practitioner, should not. Instead of worry about the health care, why doesn’t congress take a look at homeowner’s insurance? Sometimes I am not even sure why I have homeowner’s insurance, I would be better off saving my premium and paying myself if my home was damaged. The only way my homeowner’s insurance would benefit me is if I had a major lose. I often wonder what the future of the United States of America will look like.
September 11th, 2009 at 12:02 am
Hi Joel,
I appreciate your perspective as a Canadian. But I am not talking about waiting a few extra hours in a waiting room. I am taling about waiting several months before you can get to a specialist. The Fraser Institute in Canada, using survey data, has estimatedthe median wait time between visiting a general practioneer and seeing a specialist at 8.4 weeks and then the median time between visiting a specialist and recieiving treatment at 9.5 weeks. If you have never needed a specialist, this waiting time is something you would not have noticed. By the way, for cardiologists and oncologists these wait times are much worse.
This is not a matter of three hours in the doctor’s office. I should point out that these wait times vary by not only specialty, but also by Province.
I am also worried about the costs, not just those for a visit or for an ailment, but also for premiums, those monthly payments. What happens as we insure more people (BTW, I am not against this in principle) and cover more procedures? The demand for health care goes up. The problem is that we have allowed the doctors to limit entry into med school, nurses to limit entry into nursing school, and the hospitals to limit entry into hospital markets. What will happen with increasing demand without increasing the supply of providers is that costs will not just continue to rise, but rise at a faster pace. That is what happened after Medicare and Medicaid in the US were passed. Thanks for the comment. We will talk more as the term goes on.