My Health Insurance Epiphany
I saw the light last week, though some of you may think I'm in total darkness by the time you finish reading this.
So I was sitting in a hospital waiting room for Mrs. B's doctor to come and tell me she was out of surgery - outpatient procedure from which she's recovered fine - and in the recovery room, and it struck me that I'm finally falling off the fence. I don't like the idea of universal healthcare.
Now, before anyone on the right of the political spectrum jumps for joy, let me explain: It' s not a political or partisan thing with me. If it was, I'd point out that the first close-to-universal healthcare system ever proposed in this country came from the late Richard Nixon, 37th president of the United States.
I believe many - maybe most - doctors do what they do because they care and want to contribute to healing folks. But human nature being what it is, I'm sure plenty of them also enter the medical field 'cause there are potential big bucks to be made. And when the average person thinks his enterprising spirit is going to be taken for granted or ignored he loses some incentive and some motive to try to outdo his peers. Trust me, if my bosses said tomorrow that the market size-plus experience-plus merit pay scale was being dropped, and that my salary would become the same as that of some guy who writes his condo association newsletter for $15 per week, I'd lose the fire in my belly. Sure, I'm in this business because I believe in what I do. But I'm human. I also want a good salary for good work. And I promise you a part of me would ask "what's the point" if that distinction in pay was dropped. The last group of people we want to stop trying to be the best is doctors. I like the idea of fixed rates being set for certain services, but we have to factor in quality. Better doctors with better skills and better facilities should be able to charge more than their weaker colleagues, I think. But the scale for medical services needs to be lowered all around, in order to make things more accessible.
So my problem is not so much with the costs of health insurance as it is with all costs associated with healthcare. I have a problem with medical suppliers and equipment suppliers overcharging hospitals and clinics and private doctor's offices, because those hospitals and clinics and private doctor's offices pass those costs on to the few patients who can pay for everything. And for those of us who can pay a portion, those hospitals and clinics and private doctor's offices, simply pass the high costs on to our insurance companies. So yes, I have a problem with $3 hospital bandaids, when they take five seconds to apply, and you can buy them 20 to a box for less than $5. I have a problem with $200 charges for a saline solution drip in an IV. I have a problem with $1,000 injections of anesthesia, $20 3-foot-long strips of ace bandage, $500 a night for "room and board" when you have to stay overnight in a hospital, $10,000 for 20-minute-long, barely invasive, non-life-threatening surgery.
Simply put, "things" like bandages and "relatively" minor services in hospitals and clinics just shouldn't cost so much. If I can buy those "things" in the civilian world for pennies their cost in a hospital, something is wrong, 'cause you know the hospital is buying those "things" in bulk. The cost of a strip of ace bandage in a hospital should be less than a buck. The cost of that salt water drip should be a few bucks. The cost of that bandaid should be a quarter.
What should be left to the free market is the actual cost of a specialist doctor's services. Doctors who are the best at what they do should get paid more than Dr. Nick from The Simpsons and other colleagues who graduated last in their class at the Tijuana Mail Order Medical College. That's only fair. Mrs. B's doctor? I've done my homework. He's been described by colleagues as a star among his peers. His work on Mrs. B has not led us to think otherwise. So I have no problem with him getting the big bucks. He's earned it.
Here's the rub: Everything associated with Mrs. B's procedure last week was covered. One hundred percent of the tab was picked up by our insurance company. Good, right? Maybe, unless you consider we pay the equivalent to a Volvo payment - a Volvo for which you put zero down - for our health coverage each month.
No, the way to make healthcare affordable for everyone is not to nix traditional insurance and give health coverage away. Let people continue to pay. But have them pay what's reasonable. And the truly poor among us? Well, what they can't pay in $$$ can be supplemented. Why not? That's essentially what Medicaid and Medicare do. Let's just expand those platforms to make sure that folks who can't pay for all their care get access to doctors.
That's my generic plan. And if you think I'm all wet, consider this: If those "things" and those simple services about which I wrote were actually more reasonably priced, then the health insurance companies MIGHT quit passing on to consumers the screwing they're receiving from hospitals and clinics and private doctor's offices, who are in turn being screwed by medical equipment suppliers and suppliers. And if that happened, my and Mrs. B's health insurance would probably only cost about as much as a bicycle payment each month.