Letters to the Editor

• Healthcare Drill Down

  [Read the article: Why are parents miserable?]
  [Read more letters about this article: Here]

  Not to pick on this specific poster in a the reply, but it did get a "star" so seemed worthy of the one to which to reply:

  "Health care? "Get a good job with health benefits." What an incredibly short-sighted answer. I can drive a car with good car insurance benefits without having to get a job for it."

  Right. And you can also buy health insurance on your own without the benefit of an employer if you are so inclined. You can also self insure or opt for "catastrophic" plans with high deductables that will cover the catastrophic health situation that has everyone worried. I know. I had to do exactly that when the company for which I worked closed its doors while my wife was pregnant with our third child. It took me a couple of weeks, but I did find an organization that would not deem the pregnancy to be a "pre-existing condition" so that the pregnancy would be covered. It sucked, but we got through.

  " Never mind single-payer, the law actually prevents health insurance from establishing risk pool groups based on anything other than jobs and trade organizations. I cannot found a company which offers health insurance to anyone in risk pools based on zip codes, the way car insurance does; the *government* will not allow it. "

  Well, you need to think of the economic factors surrounding insurance. For cars one's zip code represent a very large determinant of likely outcomes as it says something about crime rates, traffic congestions, and the like. It therefore stands to reason car insurers will set prices based on zip code.

  For health care the zip code is considerably less of an economic driver than the factors cited as the ones around which health organizations build plans and premium costs.

  Nationalizing health care is not the end all be all it gets touted to be. Costs do not necessarily go down. Hillary's health plan had a fundamental flaw in that it chose to impose on the private side the flat fee reimbursements provided on the public side in the medicaid model. In that model a hospital receives a flat fee per procedure. If a person has a heart attack and dies two days later, they get the same rate as if they person recovers from it.

  That it is mandated by the government means the rates on the private side have to rise to cover the government loses. In actuality the rising premiums are at least IN PART driving by having to overcome this government shortfall. You can think of those rising premiums as a hidden tax covering losses associated with mandates to accept government reimbursement rates that do not cover the true expenses.

  Medicare cost projections were ridiculously low. The prescription drug plan for seniors operates from within the same Trojan Horse of low ball cost estimates going forward.

  Healthcare is a service. Services have three driving components: Price, Quality, and Timeliness. No side gets to dictate all three. HMOs were a market driven reaction to consumer complaints about the price of indemnity plans. The HMO offered the consumer price concessions in exchange for the consumer ceding certain decision making rights impacting quality and timeliness. Now the bitch about HMOs is over the decision making. You don't like not having total decision making control? Fine. Move to an indemnity plan, pay a higher price, and you will get them back.

  We now want it all and see government as the solution. The best government run plan of late happens to be the one in Oregon where they essentially looked at all available options and determined which ones they would not allow to keep costs reasonable. This resulted in whines about rationing.

  A ridiculous amount of one's healthcare costs come in the end of life time element, which stands to reason. Here in MA, there was a story a few years back about an aids patient complaining about getting passed over on a transplant list. The cost was on the order of $250,000. That's a lot of child immunizations for inner city poor sucked up on what was essentially a lost cause. (The person died within months of the article.)

  Government will not solve the problem. We need to lower our expectations. We do not have a "right" to all the extraordinary medical advancements know to man within weeks at affordable prices.

  Price, Quality, and Timeliness.

  Pick two.

  Permalink Monday, July 17, 2006 11:59 AM