brotherpeacemaker

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Solutions For The Healthcare Crisis

Medical Insurance 20080111s

One of the solutions being bandied about to counter the healthcare crises impacting America is the single payer solution. When I think of a single payer health plan I am reminded of my experience here with the single provider of electricity. Ameren UE denied me service because my last name matched the last name of somebody who stayed in my apartment previously and stiffed the sole electricity provider in the area. Despite the fact that I presented my out of state identification that should have proven beyond a doubt that I was new to the area and that I didn’t know the previous tenant, the representatives I spoke to, the clerk, supervisor, and the manager, were obstinate that I pay the previous tenant’s outstanding balance. They hung up on me in the middle of me pleading my case. It wasn’t until I called the Governor’s office that I got the situation resolved. I honestly believe that if Ameren had competition in the area their customer service would not have been so shitty.

So now some political candidates want to offer a single payer solution for the healthcare crisis. Maybe my understanding of the whole healthcare issue just isn’t deep enough because I’m still trying to figure out how this is going to help those people who don’t have health insurance. Whether it is a plethora of for profit insurance providers or if it is just one what will be the difference other than the fact that now somebody has a government sanctioned monopoly on making money by minimizing expenses and maximizing income. That still spells a recipe for denying medical service as much as possible in order to boost profits. And when there’s just a single provider making the profit, the customer service is bound to follow the Ameren UE model.

Another solution being talked about for combating the healthcare crisis are tax credits designed to help consumers pay their insurance premiums. I guess the theory here is that if you give people a break on their taxes that money will automatically take care of people’s health insurance expenses. A two thousand dollar tax credit for the year isn’t going to cover the fourteen thousand dollar health insurance expense for coverage on a family of four. However, this solution does nothing to change the conditions of the unemployed or the low income earners enough coverage. And even if I did get a fourteen thousand dollar tax credit the American public will continue to work with a for profit healthcare system bent on maximizing income and minimizing expenses.

These two solutions that are nothing but bandages for a problem that requires extensive surgery mirrors the extent of the medical treatment some people get authorization for from their insurance providers for their life threatening conditions. The root of the problem is that somebody wants to maximize their profit by minimizing the level of care offered. Medical treatments can be expensive and can eat away at profits. Why pay for somebody’s chemo therapy when there are investors in the company looking for profit, executives looking for bonuses, and employees looking for raises? It is cheaper to let people die, let their families that are capable take the company to court, throw a gaggle of lawyers into the ring to fight an immoral legal battle, and then settle for an undisclosed sum of cash and no admission of guilt when the crack legal team can’t make the lawsuit problem go away.

It would be reasonable to assume that the best way to handle the distribution of healthcare is to remove the profit associated with denying care from the equation. When the decision to provide healthcare is managed by the company that can make more money by offering the least amount of care possible you have a system with a contradictory agenda. The goal of the company is not to give the highest quality of medical care possible to its clients. Anybody who operates in this environment and with a straight face says that they care about your health and want to give you the best healthcare possible is a liar. What the majority of these people want is to get paid fat checks that are only possible if they provide you with the least medical assistance that they can legally get away with. When your claim goes to your provider it doesn’t just go before someone to assure that you are getting the best care. Your claim goes before a series of investigators to find a glimmer of a discrepancy that will give them cause for rejection.

If we want to end the healthcare crisis we must do away with a system that makes it more profitable for any healthcare insurance company to deny coverage, whether it be the broad number of companies in operation today or the single provider. People shouldn’t be able to make money off of other people who have paid their premiums and are in need of help. We see the people who run these insurance companies make salaries and bonuses that would make an oil company executive’s eyes bulge like Erkel. We see the marketing campaign that has been successfully implemented to make us think that socialized medicine is some form of evil filled with government bureaucracy and inefficient management. But how could it get any worse than the bureaucracy and inefficient healthcare management that we suffer now?

We have been bamboozled to believe that universal healthcare will bankrupt the country. Taking the potential for billions of dollars of profit out of the healthcare industry is supposedly going to cost us more in the long run. And people buy this argument simply because it sounds bad when someone on television says it with a sneer. However, until the day somebody can show me how a system where there is no incentive to deny me medical care for the sake of profit is actually worse than a system designed to make it profitable for others to deny me coverage, I’ll hold out for the former. A single payer plan or a tax credit plan will only provide the insurance industry with more money for their potential profits to get even bigger.

Tuesday, August 5, 2008 - Posted by | Barack Obama, Hillary Clinton, Life, Michael Moore, SCHIP, Universal Healthcare

15 Comments »

  1. You always hear that somehow we will be bankrupt by universal coverage or that it will cause crazy long waits for service. And yet places such as Norway, Canada and Holland have some of the best health care around and it is universal. Not to mention they don’t have these crazy wait times etc.

    Have you noticed that there aren’t a lot of long crazy wait times for people on medicaid or medicare. They seem to be able to get their health concerns taken care of in a timely matter. So why don’t we just expand the medicaid and medicare to cover everyone. People say that it will be bankrupt in a couple of years that way. But, the insurance industry is billions of dollars. With all that money going into the system instead of pockets of businesses we can cover it. Then we won’t have to worry about all these stupid tax cuts for medical that won’t even pay for 3 months of the premiums for these plans.

    Thanks

    Comment by theblacksentinel | Tuesday, August 5, 2008 | Reply

  2. TBS- England has instituted a 4 hour maximum wait in the ER, and have often times, in order to meet this rule, left people in the ambulances outside the ER. Which only serves to tie up ambulance service as well. In Canada, I have talked with some (albeit, unable to verify their stories myself, as it was more casual conversation while playing online cribbage) who say that they are dissatisfied with their service, and those with the money will still take precedence over the poor for certain major procedures. Others still, come over the border to the US for certain operations because they wait time on scheduling surgeries was far too long. Not to say our system is perfect by any stretch of the imagination.

    Now, to the overall post. I believe tort reform is the biggest chance at improving healthcare costs. They have done it in Texas, and from what I understand it is working. More doctors going to work down there, providing lower costs and well as more expansive ability to see patients.
    The biggest thing driving up costs, in my mind is the laywer factor. The doctor is forced to run expensive tests for anything possibly related under the sun to your symptoms..JUST IN CASE. Otherwise they can be sued for God only knows how much for “negligence”. Now there are legitimate lawsuits, but anymore in our society, everything is lawsuit worthy (my annoyance of this is shown on certain tv stations that constantly air these lawyers’ commercials), because there is no longer such a thing as a accident or a chance of overlooking anything.
    If we got rid of the crap lawsuits, we’d free up courts, keep malpractice insurance under control, which could reduce doctor’s personal charges to patients.
    As for insurance companies…that’s such a huge subject in and of itself, but a lot can be tied right back to legal teams with them, trying to increase their profits through premiums, and reduce expenditures by refusing coverage over whatever they feel like at the moment.
    And then there are the drug companies….
    One big mess, for sure, and while I don’t have an answer to it…government controlled single payer systems don’t fit the bill.

    Comment by Mike Lovell | Tuesday, August 5, 2008 | Reply

  3. Thanks for the feedback Mike Lovell,

    I lived in Houston, Texas for ten years. I was not impressed. I lived in Saint Louis, Missouri where the state implemented torte reform. When my mentally retarded sister was killed from sloppy medical care in the hospital, we were told that since she was not earning an income and was dependent on family for so much, her life wasn’t worth that much financially. The way the lawyers talked, it was as if the law was interpreted to make it seem like the hospital did us, a mentally retarded girl’s family, a favor. Lawyers play a significant role in the cost of medical care. So do doctors and medical staff who are sloppy in their work. But, so do people who invest in healthcare facilities for the sole purpose of earning a respectable return on their investment.

    Peace

    Comment by brotherpeacemaker | Tuesday, August 5, 2008 | Reply

  4. Mike,

    I have a problem with the so called torte reform bills. What price would you be willing to place on being injured, maimed or killed by a medical facility? I personally would not want to gamble on the health of my family members. I am sorry no amount of money would be enough to pay for the loss of my family.

    I understand that the doctors feel that they are under heavy fees from insurance due to lawsuits etc. But, what are they doing that is going to change the high amount of injuries and death due to negligence. Is saying that you can’t get anything if a doctor injures or kills you going to make the doctor give the best care possible? I doubt it. As far as I have seen the torte reform has NOT made care better nor cheaper. So where does that leave us? To me it leaves us with the same crappy care and no recourse when things go wrong.

    Also, maybe England and Canada are running their programs badly. Because you can ask anyone who comes from Norway or Holland and they don’t have those complaints. They talk of how good they have it. I don’t know what the differences in systems are but you can’t just implement universal coverage and then neglect it. You don’t hear people with medicaid or medicare screaming that they can’t get proper care. They get things done immediately. They don’t have to wait, and I don’t see why anyone would have to wait unless it is because now ALL the people are seeking care who couldn’t before. That may cause a backup but shouldn’t be continuously.

    I mean it would be the same if everyone who couldn’t afford food were to be given food money. I think the stores would be overwhelmed for a bit. But they would recover. I guess what I am saying is that not all governments are created equal. Some just have worse planning than others. Hopefully the people who are overseeing the running of the programs are competent and not placed there by cronyism or nepotism.

    Thanks

    Comment by theblacksentinel | Tuesday, August 5, 2008 | Reply

  5. “To me it leaves us with the same crappy care and no recourse when things go wrong.”

    First off, let me clarify that I’m not negating all lawsuits. The question I have in most of the medical suits brought forth is this: Was it a mistake, or blatant disregard on the part of the doctor, staff and/or hospital facility. For instance, My uncle is a police officer in California. He began blacking out, and having numbing issues from time to time. After talking with the doctors about things (namely my grandpa suffering terminally from California, and also his father-in-law facing prison for embezzlement charges) the doctor chalked it up to stress and that was it. Didn’t really look him over or even run the general routine blood or urine work that often comes with non-visually found ailments. If he had stressed out, he would’ve lost everything he worked for, including his pension and the job. After a 2nd opinion was sought from independent doctor, they discovered a blood clot on his spinal cord. He sued and won because of gross negligence on the doctor’s behalf. A doctor like that definitely contributes to high malpractice issue. Now, if the doctor had run any tests on him, he should’ve found it, but if it had been missed, the doctor most likely, in any logical conclusion, not been found guilty. I don’t think, in that instance my uncle would’ve sued, but I’m sure there would’ve been lawyers lined up for it all.

    As for no recourse….if the government runs it, what’re the chances of legitimate recourse in the event of the same case? Would the government pay out, or would they run up a taxpayer funded bill, and/or deny any responsibility?

    As for how its run, who knows, maybe America would get it right. Too hard to tell, but I’m not sure I’m comfortable with the idea to begin with. Things have to change, that’s for sure, but putting it into the hands of a government that can’t even run a localized DC restuarant network without losing $18 million in 15 years (btw- they’ve determined privatization is the only way to turn the program around) is the absolute solution to it all.

    Comment by Mike Lovell | Tuesday, August 5, 2008 | Reply

  6. Mike,

    It really doesn’t matter if it was an accident or gross negligence, he would be dead all the same. If we apply that to all situations then if someone wrecks your car shouldn’t you have to prove it was gross negligence to get anything paid for? Since it could have been an accident, so then you would be liable for your own damage even though if they hadn’t of had their little accident you wouldn’t have?

    The problem is that if the doctor took the tests and didn’t find the clot, couldn’t his lack of care caused negligence because he was nonchalantly looking over the tests? Maybe if he had been more thorough he would have found the clot. That is the problem. Even when it looks accidental, it is their job to be thorough and to make sure that they get it right. And if they don’t then we should have recourse. Because any way you slice it if the doctor blatantly cut the wrong arm off or mistakenly by accident cut it off due to bad x-rays. I DON’T HAVE AN ARM. Not to mention they still have to take the bad arm. Now I have NO arms. Someone has to pay for that and I don’t care if it was an accident. We shouldn’t be made to pay for some stupid asses accident.

    Privatization does nothing but cause more problems. That is NOT the only way. That is the ONLY way that makes the most money. That is the bottom line. Name one thing that has been privatized that has worked to the benefit of the people. Not one. It benefits the private companies. Remember they are still out to make a profit. And we are talking about health care. What is the way to make money in health care? You have to cut costs, which are the procedures, surgeries and medicine. How do they maximize their profits, denying people from getting those things which are costs. Then the people pay but get nothing. That is what is happening now. And to privatize it will only make it worse.

    Lawyers aren’t all bad. Ask your uncle. If a lawyer hadn’t helped him or they had already passed torte reform he would have gotten bumpkis. And that would have been a travesty. The doctor would have gotten away with his negligence. I don’t see the medicaid as being that horribly run. They are underfunded right now but the program runs smooth enough to extend it. We have to use our noodles and deny the candy coated things they tell us. They told us that social security would be better if they privatized it as well. We saw through that bunk and we need to do the same with health care.

    Thanks

    Comment by theblacksentinel | Tuesday, August 5, 2008 | Reply

  7. Mike Lovell,

    Who pays when the government gets sued now? When law enforcers have been found negligent because they’ve murdered an innocent person or they railroaded an innocent person who pays? When cities neglect maintenance on bridges and they fall into the river killing passengers, who pays? If somebody trips and falls in a government office because of negligence, who pays? But now the issues associated with suing somebody for negligence in a single payer health system is too difficult to be solved?

    All levels of government gets sued all the time. Besides, who gets sued when the doctors commit negligence these days? It’s usually the doctor. Why should this change?

    Peace

    Comment by brotherpeacemaker | Tuesday, August 5, 2008 | Reply

  8. TBS and Brother P-
    Good points, both of you. I knew I came to your pages for a good reason (you help me think things through to a finer point)!

    The whole thing, like I said, needs a good overhaul, but while I can see some government oversight, I just don’t want it completely in their control. We can argue profits vs mission all we want, and I don’t think we’ll get anywhere. Private institutions have their benefits to society, afterall without them, you would find no infrastructure, or a middle class to begin with. And Government has its benefits (my dad is a city level employee, who got great benefits and gave us a summer vacation every year), like running things such as infrastructure, and stepping in to make sure certain entities aren’t hurting others…whereas the private market may overlook this, and let the dogs fight it out for the worse.
    My sister and I got into an argument over healthcare through IM once. We both managed to concede our sides weren’t perfect, but wouldn’t give in to the other (could be were just too stubborn?!?)
    So, when I run for President in 2016 (1st election I’m eligible for….I need ideas on perfecting the system), maybe i’ll run on the “housecall doctor” platform, in addition to my pro-transfatty acid plank!

    Thanks for the conversation, both of you! And thank you for listening!

    Comment by Mike Lovell | Wednesday, August 6, 2008 | Reply

  9. Mike Lovell,

    I understand the reservation to see the appearance of more government control of the healthcare approval process. Trust me, everytime I have to go to my local post office I’m reminded of the inefficiency and lack of customer service that is the norm of government service. But I don’t see the government taking complete control of the system. I do believe it can be done in such a way that the market for health services will remain intact. For example, if you are not happy with the service from your health provider, you should be able to move your business to another. That should keep the incentive to provide better service, unlike the post office’s setup which is a virtual monopoly. I think it can be done.

    The problem is that we’ve been made to fear changing the system. We have been trained to reject the idea of a taking the profit out of the system by people who make profit off of the system.

    Peace

    Comment by brotherpeacemaker | Wednesday, August 6, 2008 | Reply

  10. “The problem is that we’ve been made to fear changing the system. We have been trained to reject the idea of a taking the profit out of the system by people who make profit off of the system.”

    I can respect the first part of this. The second part…don’t you believe profit helps to drive innovation, whereas the opposite might stymie development?

    I don’t know about you, but I work my job to make money and pay my bills, hopefully having a little left over to treat my family to a vacation. And if a job comes by that pays better for the same work, you bet I’ll take that one, as long as it meets my requirements for time, schedule, etc. While I do my job to my best, and make the extra effort to keep my clients safe and happy with my security work, I certainly didn’t get into it for those latter reasons.

    My point being this: While we may work for the greater good, without profit, I don’t see those people going the extra mile throw there spare change at an expensive idea to make things easier for everyone, if he or she isn’t going to see a return on investment.

    Comment by Mike Lovell | Wednesday, August 6, 2008 | Reply

  11. Mike Lovell,

    I don’t believe profit drives innovation. I believe the need to work is what drives innovation. Most people who are the innovators are not the ones who profit the most from innovation. It is the people that they work for that profit the most. You might get a bonus for a good job. But the person who writes your check is making far more off of your innovations than you are.

    The person who invented peanut butter was not named Skippy or Jiff. The man who created the DOS operating system was paid something like fifty thousand dollars while Microsoft went on to become an institution worth hundreds of billions of dollars and making a lot of people billionaires many times over. People like Albert Eistein, Madame Currie, George Washington Carver, and the like lived well. But other people lived far better off of their work.

    With all that said, how do insurance companies innovate healthcare? Are the insurance company profits going into research for new treatments? I seriously doubt it. Medical research that develops new techniques and new technologies gets much of its funding through private grants and through government funded programs. The insurance companies are not known for their philanthropy in this regard. In fact, if anything they hinder innovation by refusing to pay for unproven or experimental processes and techniques. Taking away their profit will have no affect whatsoever on innovation.

    Peace

    Comment by brotherpeacemaker | Wednesday, August 6, 2008 | Reply

  12. Well no, insurance companies wont drive innovation, but private medical R&D facilities are the innovators. the researchers themselves obviously make the bigger profit for their company than they do personally, usually under the intellectual property laws applied to the employees. But the company was started by SOMEONE, it didn’t just appear out of nowhere. You could argue that investors put money up for the idea that became the company. And why did they? Return on investments, generally speaking, although there are those selfless souls who do provide their investment in the name of better ideas and methods toward a better life.

    As for “I believe the need to work is what drives innovation”…I respectfully disagree. The people who innovated ideas were most likely already working. They didn’t need work to do. It isn’t the unemployed that usually create jobs, money, and great ideas (well, one exception is the guy who took Mary Kay from unknown to major corporation.. he stayed in a back room of the office, and ended up creating better marketing plans for her).
    Here’s an example…engineers who designed fighter planes created the SAAB line of vehicles. Was it a need to work, or a dream to provide a better car while making money on their own terms, instead of that of an employer, that led them to go into the automobile manufacturing business?

    (ps- I am loving this exchange!)

    Comment by Mike Lovell | Wednesday, August 6, 2008 | Reply

  13. Mike Lovell,

    I work for a non profit health provider that was started by someone. My company is affiliated with a university that is one of the leading medical research and development facilities in the nation. It was started by someone as well. As a non profit, the company that I work for does not have investors and does not innovate for the sake of profit.

    As far as innovation and who is properly compensated for it, we will just have to disagree. You said yourself that the people who innovate are already working. Therefore, people working drives innovation appears to be a straightforward concept to me. Obviously you see things differently.

    I’m not familar with SAAB and how it got started. I know they make planes and I know that they make cars but I don’t know what was the genesis for their conception. I know one rule of entrepreneurship is that the entrepreneur should go into business for his or her love of what they do and not to make huge sums of money. However, I must confess to some amusement over the fact that you mentioned a company that makes automobiles in a country that has universal healthcare as an example of your point.

    I know Colin Chapman of Lotus fame developed his car company strictly for the love of automobiles and racing. The fact that he could make a profitable company was in essence, a secondary thought. Further proven over the fact that the company has filed or nearly filed bankruptcy a number of times and has exchanged owners a number of times as well. He did it for his love of cars.

    Some people are solely motivated for profit. However, these are usually the people who make money off of people who do what they do simply because they enjoy what they do as a career choice. Some people are motivated by a sincere desire to help their community. Not all innovation is driven by profit.

    Peace

    Comment by brotherpeacemaker | Wednesday, August 6, 2008 | Reply

  14. “Some people are motivated by a sincere desire to help their community. Not all innovation is driven by profit.”

    I wholeheartedly agree with this statement.

    Comment by Mike Lovell | Wednesday, August 6, 2008 | Reply

  15. Mike Lovell,

    I wanted to add an example of my point:

    Berry Gordy made a huge fortune with Motown Records by investing in people who had a love and a need to sing and write songs. Many of those people were pioneers in the music industry such as The Jackson 5, The Supremes, Marvin Gaye, The Temptations, etcetera. Many of these pioneers signed away ownership of their creations. Many of the early music artist struggled to get by while Mr. Gordy was making bank. Many artist learned from these lessons and abandoned Motown when their contracts terminated. Why? Because they were not the ones profiting off of their work.

    Peace

    Comment by brotherpeacemaker | Wednesday, August 6, 2008 | Reply


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