A Health Care Prescription

We would all like to see our health care costs decline. According to the Kaiser Family Foundation, employer funded health plans have more than doubled in cost since 2000. Keith Hennessey does a good job of explaining how technology is driving the increase in health care costs in Part 3 of a series of posts on Third Party Payments for health care. Please feel free to read Part 1 and Part 2 as well. I recently heard another analogy to explain rising health care costs. Thirty years ago, if you tweaked your knee, you were given a cane. Cost? Maybe $10? Today there are many other options, from physical therapy to arthroscopic surgery to knee replacement. Cost? While not priceless, I would venture to guess that the cost is a bit more than the cane. And let's be honest about this, as I am sure that nearly anyone that has had a knee replacement will tell you, it is well worth the price.

Let me start by stating that I am inclined to support the Republican proposals for health care reform than I am the Democrats. We should give individuals the same tax breaks for purchasing health insurance as we currently give businesses,. If individuals owned their own policies, concerns about pre-existing conditions would become a thing or the past. We should remove any restrictions on purchasing insurance across state lines. States should no more determine what is covered by an insurance policy than should the federal government. and then there is tort reform We have forgotten that doctors are human. They make mistakes. There is a difference, however, between a mistake and negligence, and we, as a society, have forgotten this.

I have long been a big fan of purchasing insurance for catastrophic medical care, and paying for normal medical costs as they come. When you purchase homeowners insurance, does it cover painting? And if it did, don't you think that we would all repaint our homes much more often, increasing demand for house painters, and thus driving up the price? Homeowners insurance, like just about every other type of insurance policy sold, is a catastrophic policy. Health insurance is about the only insurance policy that we expect to cover day-to-day maintenance, similar to a warranty on the purchase of an automobile.

So, if this is indeed a better model for health insurance, how is it that we could properly incentivize it so that more people would choose this option?

One idea that I have had recently, is to give people a tax credit for a percentage of their out-of-pocket, non-premium/co-payment, medical expenses. What would happen if we said that people could get, say, 25% of their out-of-pocket medical expenses returned to them at tax time? One thing that they would be likely to realize is how small a portion of a normal office visit their insurance company pays. From experience, there was a time (not too long ago) when I was uninsured. When I needed to see the doctor, it cost $50 for the visit. Now that I am covered, I have to pay a $35 co-pay. (If you do the math, that isn't too far from my hypothetical 25%.)

The key to making something like this work, of course, is having some sort of health savings account. People need to make sure that they have the money put aside to pay for their day to day medical expenses themselves. The common, day-to-day medical expenses of most people are not overwhelming. What starts to get expensive are extended stays in the hospital, chronic care, and some of the newer drugs. When you go to the doctor and need an antibiotic, that doesn't cost much - I've paid for it myself, as mentioned previously, and it was $50 for the office visit, and another $20 to fill my prescription. It is important to remember that, if we were only too need the same sort of medical treatment that was available 25 years ago, it would cost about the same as it did 25 years ago, or maybe even a little less. If there was a simple solution, such as my suggestion of a tax-credit for a portion of your out-of-pocket medical expenses, that would move more people into this kind of model, I think this would be a move in the right direction.

I welcome any and all comments.

Truth or Consequences

December 18^th saw the publication of two articles, Climate E-mails Don't Alter the Evidence, by Michael Mann in the Washington Post, and How to Manufacture Climate Consensus, by Patrick Michaels in the Wall Street Journal. Both of these articles discuss the implications of the hacked/stolen emails from the East Anglia Climate Research Unit commonly referred to as Climategate.

Mr. Mann contends that, although he doesn't condone many of the actions described in the emails, the emails themselves do not change the evidence of anthropogenic global warming. He further argues that the emails themselves are being "mined" and that excerpts are being taken out of context, and distorted.

Mr. Michaels, on the other hand, makes a case that a more serious problem is evidenced in the East Anglia emails, that of the suppression of contrary viewpoints. It should be pointed out that Michaels, himself, is not a skeptic of anthropogenic global warming, but that he has written articles that question it's magnitude. For this, he says, he has found it increasingly difficult to be published in peer-reviewed journals.

The International Panel on Climate Change, as well as the United States Environmental Protection Agency, has used a compendium of peer-reviewed articles as a basis for its findings on global warming. If this data is compromised, the entire basis of their decisions is undermined.

The basis of Science is the search for Truth, no matter how uncomfortable it makes us feel, or how it may undermine some of our core beliefs. The reason that scientific discovery has advanced at such a rapid pace over the past several centuries is that it has been based on the free interchange of ideas, which are continually submitted to rigorous examination and scrutiny. Any undermining of this free interchange of ideas, is no different than the Church censoring Galileo for having the temerity to suggest that the Earth travels around the Sun, rather than vice-versa.

An Open Question for Keith Olbermann

I remember the good old days, back when Keith Olbermann was just a local sportscaster. Back then, we didn't have to endure his nearly constant stream of ad-hominem attacks on those that he differs with. At the end of a twelve minute diatribe on December 17th, 2009, in which he attacked everyone from Max Baucus to Barack Obama, Olbermann let something slip. Watch this clip, and see if you catch it.

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Did you catch it? Keith Olbermann is self-insured. By choice. Now I ask you, if health insurance is so important, if the future of this country is tied to reform of the entire Health Care Industry, and especially the insurance industry, why doesn't Keith Olbermann, who seems relatively well educated, own it? More importantly, if Mr. Olbermann doesn't own it for himself, why does he think that it is so important that it should be forced on everybody else?

The answer, of course, is that, barring catastrophe, it is cheaper for Olbermann to contract for his own medical care than it is to do so through an insurance policy. I have said this for some time. An insurance company has considerable overhead in addition to paying your medical bills. They have to pay all of their employees, as well as attorneys and investigators. They have infrastructure that has to be bought and maintained. There are court costs. Oh yeah, it would be nice to turn a profit as well. All this is on top of paying medical expenses.

So, Mr. Olbermann, it would seem that you are among the ranks of that blight upon society, the uninsured. But if it is so important not only that everyone has access to health care, but health insurance, why, Mr. Olbermann, do you not own it?

A Modest Trillion Dollar House

What we're buying here... is not a mansion. We're buying a modest home. But it's got a great foundation. The key to this is that this modest home, we can put additions onto it in the future. But if we don't have the starter home, we're never going to be able to put those additions on. The time is now. I plead with all of my progressive friends, now is the time to get over this hurdle.

Sen. Tom Harkin, D-IA

There really isn't much else to say here. If you are concerned about the costs associated with the Health Care Bills in either the House or the Senate, but are leaning in favor of them because they are better than nothing, do not delude yourself. This is just a starter home. This $1 trillion is merely a down payment. The real cost has not been revealed... yet.

Fuzzy Logic

Anybody who says that they are concerned about deficit, concerned about debt, concerned about loading up taxes on future generations, you have to be supportive of this health care bill because if we don't do this, nobody argues with the fact that health care costs are going to consume the entire federal budget.

President Barak Obama

I have a question, Mr. President. How is it that, in order to keep health care costs from "consum[ing] the entire federal budget," we have to increase federal health care obligations by approximately $1 trillion over the next 10 years? Only in Washington is it possible to say that I am going broke because I am not spending enough money.