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  • July 2009
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Government health care plans.

The feds are at it again. Health care reform. Yet another attempt to pretend that the government can do a better job at managing health care than private industry can. Lets be real folks, the government of the USA couldn’t figure out how to get out of a wet paper bag without spending a few trillion dollars on pork, bribes, bailouts, and a new Star Wars light saber space alien defense system (to keep the Russians at bay), etc.

Then again, the commercial, private sector health care providers haven’t managed to do any better. Health care costs are absolutely insane – prior to the meltdown, unexpected health care expenses caused something like 80% of all individual bankruptcies. The economic meltdown may have reduced that number a bit, but only because there are a lot more people going bankrupt – the number of medical bankruptcies is being diluted, but not reduced.

So, lets take a few minutes and compare a government run single payer system with current health insurance systems.

OK, first an easy one: we KNOW the government will waste huge amounts of money. The feds can’t pass any type of spending legislation without slipping in a bunch of pork, so lets take a look at private sector health insurance and see if they can do any better. We know that health care executives (who do NOTHING to actually provide health care) are among the highest paid executives in the country. I don’t know if that counts as pork, but it certainly does contribute to the insane costs of health care. Remember: we’re talking about the executives at the local hospital, lab company, health insurance carriers, etc. etc. etc.

Drug costs are also supported by the fact that US insurance companies are willing to pay a lot more for drugs (both name brand and generic) than any other country. The same pill, manufactured in the same plant, to the same spec will cost a fraction as much in any other country.  Why? Because the folks that pay for meds in other countries aren’t willing to pander to big Pharma.  They set prices that are competitive and rational. If the pharma company isn’t willing to accept the prices set, they aren’t allowed to sell ANY meds in that country. Hmmm. This is actually an example not only of how badly our insurance industry manages drug costs, but is an example of how well OTHER governments regulate it. Of course, they don’t have the Pharma companies contributing bazillions of dollars to their re-election campaigns like politicians here in the states do.

Of course, what it really boils down to is quality of care. I constantly hear rants about how bad the medical care in countries with government run health care is. I only have limited experience with this – Canada, the UK, and Israel. In all three cases, there are problems – long waits to see doctors is one of the most common complaints. However, a trip to the emergency room always results in quick treatment…. Of course, we also have good emergency rooms here, with private health insurance. The problem is, so many people who do not have health insurance use the ER as their primary care providers, and avoid going to the doctor until they have no choice. I’ve spent a lot of time in emergency rooms (for a lot of reasons), and I’ve found that in the states, I can pretty much always count on at least one person being there because they didn’t get some basic treatment when they needed it. I’ve never seen that in other countries. (note that this doesn’t mean it never happens, it just indicates that it is a lot less common.)

Of course, if you happen to HAVE private insurance, you are only covered if you see a doctor that is covered by that particular program, so if you happen to have an illness that is beyond their ability, you’re left high and dry. Unless you can afford to pay for it yourself. So we’re back to paying. The simple reality is that folks that have more money will ALWAYS get better care. In the countries with socialized medicine, they are the ones that can afford private doctors and hospitals. In the US, the rich are also the ones that can afford private care, or can go overseas to other countries to get care that is not available here. Instead of looking at the top of the scale, we have to look at the average, and bottom of the scale.

At the bottom, there is no real question: the US already has socialized medicine. Medicare and medicaid provide some of the best (and most cost-efficient) medical coverage in the country. About the only better coverage is the health care plans that the government provides to its top employees (the  ones we vote into office). Yes, there are people that fall through the cracks, and yes, the upper limit of eligibility is so low that a lot of people that need medicare/aid can’t get it, but for the folks that do get it, it works.

That leaves those that are too rich to qualify for medicare/aid, but not rich enough to be able to afford private hospitals and medical care. The vast majority of americans. The same ones that are being forced into bankruptcy because their insurance doesn’t cover their kids broken leg (or whatever the unexpected emergency was). The same ones that are livid because their health insurance premiums have risen to as much as 50% of their take-home pay. The ones that select employment based on the health insurance plan – not pay, working conditions, or anything else. The same ones that voted Obama into office – in part because of his health care platform.

Sounds to me like there is a pretty strong call for major health care reform.

Of course, the health care industry – and the insurance industry in particular  – are lobbying hard to convince us that reform is a Bad Thing. “You won’t be able to keep the health care plans you have and love”they say. OK, I don’t know about you, but I don’t know ANYBODY that is currently satisfied with the way their health care plans work, or what they cost. What they’re really saying is “don’t do anything to make us operate more efficiently”.

So, here’s my idea of how to give everyone a fair shake. the insurance companies insist that the people (that would be you) want to continue with their existing policies, and will continue to accept double digit percentage premium increases every year. They insist that the government couldn’t possibly operate as efficiently as the “free market” economy. They claim that the creation of a single payer system will force them to shut down.

So here’s the gig: they claim that their customers love them, and that they are doing a better job, more cost effectively, and with better care than the government ever could. The solution is just too easy. Let the government set up its own health care systems. Let the private industry continue the way it is. Let the people choose what program they like better.

Now THAT is something that terrifies the insurance companies. They know that even with all the pork, mismanagement, and bureaucracy, the cost of running a federal medical insurance company is a lot lower than the bloated profit centered commercial health insurance industry. The real issue is that the private insurance industry sees real competition coming along, and they know that if it happens, they are going to have to tighten their belts, and stop paying their investors and executives huge bonuses and dividends.

Of course, the best solution would be for a respectable private entity to start offering health care coverage at rational pricing, but that would mean no big bonuses for execs, no big dividends for the stock market, and no money for lobbying. The truth is that the government can’t begin to operate a single payer health care system efficiently. The reality is that the ‘free market’ has proved that it can’t either.


2 Responses

  1. It’s funny that you wrote this now as I am helping someone through a health care crisis of ginormous proportions. The system really IS broken, and I’ve said for about a year now that the people who make such policy need to come and live with my mother for a month (of course, that was back when she HAD a month), and THEN go back and make their laws. Dumbasses.

    I DID, however, used to have a health care plan that I loved.. but only one. Tufts was a remarkable experience for us. Both of our babies were born under the coverage, and I never had even a MOMENT’S trouble with them. In fact, their customer service was top-notch, it cost us something like 60 bucks from pregnancy test to seeing our new babies out the hospital door, and they didn’t give my doctors any shit about my staying longer than the allotted 24 hours. I’d got back to Tufts in a heartbeat (no pun intended).

  2. yeah, but would you pay $800 a month for it?

    a big part of the problem is that the folks that write the laws regulating the health care industry have one of the best private insurance plans in the world – they never have to deal with the results of the legislation that they pass.

    Makes it really easy for the lobbyists to make sure that the folks with the money get what they want…

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