If we want to bring down the cost of health care, it’s easy. What we lack is not the way but the will.The simplest solution is usually the correct one, and the nice part is, Occam's Razor can also be used to lance boils, shave off cancerous moles, and perform other money-saving forms of self-surgery!
The way is simple.
First, eliminate the federal requirement that hospitals have to treat any patient who shows up. That’s the place to begin.Well, if that's the solution, then we'll probably have to begin outside, since we'll need to clear a space where we can stack the bodies of untreated coronary and gunshot victims like cordwood. I suggest we mark off a section of the parking lot with traffic cones (there'll be fewer visitors anyway) or maybe tear out those shrubs near the ER entrance.
Get government out of telling hospitals who they have to do business with.Maybe this whole business model is flawed to begin with, and instead of dealing with sick people, hospitals should be doing business with Fiberglass insulation manufacturers, or novelty gearshift knob wholesalers.
There is simply no way to control the cost of health care if hospitals are obligated to provide healthcare to all regardless of their ability to pay.It's Economics 101. Taking a commodity and making it rare and something that only the rich can afford is the best way to drive down prices.
How long would a mechanic last if he was required to fix every automobile anybody brought to his shop, regardless of ability to pay? He’d be broke and out of business in a week, and pretty soon there would be no mechanics for anybody. We’d all be riding bikes to work.Is the mechanic tax exempt, like a non-profit hospital? Does he accept automobiles on Medicare or Medicaid? Do our car insurance premiums go up if he performs an emergency water pump replacement on an indigent 1977 AMC Gremlin? And if mechanics are treating cars like people, does that mean doctors get to start treating patients like cars? ("I'm afraid your father has a faulty heart valve. Now, we can replace it, and you might get a few more years out of him, but between the parts and labor, you're better off junking him for the scrap value.")
People need medical care, you will say. Right. People need to eat, too. How long would a grocer stay in business if he was required to offer food to everyone who walked in the door regardless of their ability to pay? He’d be broke in a week, and then nobody would have food.Or the government could issue Food Stamps, thereby permitting poor people to feed their children, while simultaneously allowing Mr. Drucker to maintain his quaint corner grocery and continue to live the Hooterville Dream.
But I think I see where you're heading with this Bryan, and I have to admit, between the starvation and the withholding of medical care, you may have finally solved the problem of our permanent underclass.
There was no such emergency room law prior to the one Ronald Reagan - yes, that smaller government, government-is-not-the solution Ronald Reagan - signed in 1986. For the first 200 years of our life as a republic, hospitals through charity and charitable donations offered health care to the neediest among us, and did so without anybody having to order them to do it.It's baffling that Congress would go to the trouble of drafting and passing a law -- let alone that Reagan of all people would sign it -- to solve a problem that didn't exist. But then, I felt the same way about the Clean Water Act, since for the first 200 years of our republic, polluting industries were scrupulous about saving their noxious effluent in Mason jars in the basement, much like Howard Hughes' bowel movements.
Anyway, I don't remember anybody worrying about doctor bills prior to 1986, although that could just be the result of this untreated head injury.
Most hospitals were started by Christians or Christian organizations, and will find a way to offer care to the indigent whether the federal government is standing over them with a cudgel or not.I always thought Community Health Systems, Inc. was a huge, for-profit corporation, but apparently it's an order of Carmelite nuns who rebranded.
The American people, because of the spirit of Christianity, are the most generous people on earth, which they prove time after time when disasters hit anywhere in the world. Let’s not insult our own people by saying they are not generous and compassionate enough to help the needy with medical care.So if you need a couple thousand dollars to get that abscess taken care of before you die of blood poisoning, just organize a telethon for yourself, or persuade Bob Geldolf to write a song about you.
Health insurance should be for emergencies, not routine maintenance. We don’t expect auto insurance to cover oil changes and tire rotations.And that analogy would work brilliantly, if people were born with warranties. ("I'm sorry, Bill. If we'd detected your cancer earlier, we could have done something, but now, well...it's 25 Years or 25,000 Miles and you're 26 and a half. Your parents should've bought the Extended Warranty when you were zygote.")
It’s there for accidents. And so health insurance should not be there for checkups but for major events.This may come as a blow to insurance companies, who often prefer to pay for mammograms rather than mastectomies, and prescription birth control rather than pregnancies, because they're cheaper, but if we're going to make Bryan's plan work, we're all going to have share the pain.
If people paid out of pocket for all medical expenses up to a high deductible, they’d be much more careful about their use of medical services and they’d take better care of themselves in the meantime. The cost of medical services would come down as health care providers lowered prices to attract business.Having a heart attack? Master the Art of the Deal and meet the Hospital's fee schedule with a low-ball counteroffer, then watch 'em sweat!
In the meantime, I look forward to the day when Big Pharma, desperate for business, is forced to open the equivalent of those "day old" bakery outlets, where they'll sell stale and expired medication at marked down prices.
Consumers would have an incentive to take good care of their own health and use medical services sparingly, because every dollar they save they get to keep.Well, "keep" in the sense that it'll go right into your health savings account. "Sorry, son, I wanted to save for your college education, but I had to put that money away in case I needed a hip replacement. But don't be mad -- the joke's on me, right, since the bank just failed. Oh well, good thing I never had to do that Sophie's Choice thing like your uncle Jim did, when both his kids were in a car accident and he could only afford to save one. I know that was a tough decision, but I still think he shouldn't have done it with a coin flip. At least, not in the Gift Shop."
Right now, employees using employer-provided insurance have zero incentive to reduce the use of medical services. In fact, the incentive, perversely, is the other direction. Employees who make healthy lifestyle choices and rarely need medical care wind up with nothing to show for it, other than higher premiums to pay for other employees who don’t look after themselves.No offense, Bryan, but wages are stagnant in this country, and if my employer isn't giving me a raise this year, then I'm gonna take it out in free colonoscopies.
Third, get rid of all government-mandated coverage requirements.Honestly, you can probably get five, maybe six uses out of a good hypodermic needle before it's too dull to break the skin.
A huge driver of the cost of insurance is that government regulators, including Benito Obama with MussoliniCare...have a policy of hanging all patients upside down by their heels, which is pricy, although admittedly effective for lower back problems and gout.
...require insurance companies to cover a host of treatments, whether the consumer has any interest in them or not.Many people are under the misimpression that insurance companies routinely attempt to breach their contract with policyholders by denying coverage, because it pays off financially -- sick people often being too sick to fight back. In truth, it's because insurers are the only entities in the health care industry who are willing to stand up and defend your leisure time hobbies and interests. Sure, some doctor might think you need "emergency surgery" to repair your "ruptured femoral artery," but what if your insurance agent realized, during the ten minutes you spent together in his cubicle while you signed the paperwork, that your interests and aptitudes really ran more toward getting a pressure bandage and a quick trip in a wheelchair back to the loading zone?
Let’s allow insurance companies to offer a range of packages and allow consumers, cafeteria style, to decide what kind of coverage they want.Hey, we still can't do this with our cable channels, even though giving up ESPN or the Game Show Network isn't nearly as likely to kill you.
If they will never resort to acupuncture, why should they be forced to pay for it?Exactly. I'm pretty confident I can predict, with 100% accuracy, what kind of accidents and diseases I'm going to suffer, and the only thing I need to insurance against is having my soft palate impaled on a scale model of a church steeple, like Timothy Dalton in Hot Fuzz.
Highly paid lobbyists get state regulators to mandate coverage for all sorts of things, whether it’s psychiatric care or chiropractic care, that many consumers would not purchase if the choice was left up to them.I'd recommend that Bryan consider checking the "psychiatric care" box on his insurance coverage menu, but as D.Sidhe has pointed out in the past, there's a difference between being an asshole and being crazy, and like the common cold, there is no cure for being an asshole.
Let’s get employers out of the health-care-providing business and let them give the money they spend on premiums to their employees in the form of raises.Or to themselves in the form of bonuses. Either way, it'll be a glorious blow to Big Chiropractic.
I flat out guarantee you that employees who are spending their own money will be more frugal about the choice of insurance products than their employers are.Hell, I have insurance, of a sorts, through Mary, and I've still been putting off back surgery for the past three years because we can't make the deductible. But imagine how much for frugal I could be, with the right disincentives!
If ObamaCare is shot down by the Supreme Court, as it certainly should be, the possibility of major health care reform will be sitting right in front of us. We can preserve the status quo, which nobody likes or should like, or we can make reforms that will reduce costs and improve access to health care for every American for decades to come. It will be time to choose. Let’s choose wisely.I'm sure Bryan has heard the bad news by now, and, considering his passion for the subject, is undoubtedly taking it hard. I'd like to help, and considered buying him a box of tissues (the nice soft ones, with Vitamin E and aloe), but alas, I also expected the Supreme Court to overrule the Affordable Care Act, so most of my money is tied up in Burial Insurance, and there are substantial penalties for early withdrawal.