Monday, July 20, 2009

Does the US Healthcare System require a Tune-Up

Today, the President mandated that it is time the Congress work towards enacting new legislation that will truly affect the way all Americans and illegal immigrants are provided with some type of healthcare coverage. The challenge that we as a nation are confronted with is reshaping healthcare due to exorbitant healthcare cost and lack of coverage. The annual cost of healthcare is $2 trillion dollars per year, with an estimated 46 million people whom lack coverage. This includes illegal immigrants, healthy young adults who choose not to have coverage, probably because they cannot afford it, and people eligible for Medicare. Regardless, lack of coverage is lack of coverage. If this group needed medical attention they add to the rising cost of healthcare. The major challenge that Obama faces is that both parties agree to disagree on how this plan should be shaped. How divisive and selfish of a nation have we become? Yet, they do agree on some issues.

Supposedly, the Democrats and Republicans agree on setting a precedent for quality of care rather than quantity of procedures (I think that's funny). That would be like asking a lawyer to be compensated on quality of representation versus quantity of billing hours (leave it to a bunch of lawyers). Who intends on establishing this criteria? Both parties would like to create an on-line market place where consumers can shop pricing. Can we really simplify medicine and offer it on the internet? Has anyone ever looked at CPT and ICD-9 Codes? The parties want to bar insurance companies from denying coverage to a subscriber that has a pre-existing condition, yet, the insurance companies want something in exchange. They would like to make sure that all those young people that have fallen through the cracks are forced to have some type of coverage. This is based on a statistical probability. US Healthcare was once accused of discriminating against elderly subscribers because they wanted young people who tend not to get sick as easily. But would this be affordable coverage? Young people (many college graduates) cannot afford healthcare insurance because they cannot find a job.

So the real question is; what would a public plan look like? And, would it drive private insurers out of the marketplace? The only model that the government has is Medicare and we all know how physicians feel about compensation under a federally subsidized program. You don't think doctors dropped out of Medicare because they were fairly compensated? So the real question is, would a public plan that offers affordable coverage to any of those 46 million drive private insurers out of the marketplace? Probably not! What it would do is cut into their profitability and provide their shareholders with less than optimal return on their investment. Let's be honest, the US insurance industry has taken advantage of the Anti-Trust Laws by colluding with Congress and ripping off its subscribers and particularly physicians that initially wanted to participate in their plans. You don't think doctors dropped out of insurance plans because they were compensated fairly? Doctors are you starting to see the picture?

The REALITY is that most people (you and I) would not even be eligible for a public plan if we already have some existing coverage. What the government needs to figure out is how to provide healthcare for individuals that have fallen through the cracks or are unemployed. So why is the cost of this plan much greater than expected? Because when someone loses their job and needs to continue coverage the cost of COBRA premiums or premiums in general are mind boggling. Recently, someone that lost his job was paying $1,500 premiums per month for a family of five. Someone that was single and lost their job was paying a premium of $500 per month. Even with sound financial planning what are the consequences if you or anyone has a catastrophic illness? Should you have to foreclose on your house because the system has failed us? People who cannot afford insurance or are not covered have to be supported by some type of plan. But why do we continue to debate this issue and what will it take for the government to act? Special Interests!

We live in a country where you the reader has freedom of choice to become what you can be, and make as much as you can, yet when it comes time to paying taxes to offset a national healthcare crisis we bitch and moan about contributing. Let's face economic facts, the government cannot keep printing money unless you want to be a Banana Republic and we cannot keep borrowing money from the Chinese unless you want your grand-children to speak Chinese. How indifferent can we be? For those of you that complain about a senseless war that is costing us trillions of dollars, have you stood up to be heard? Probably Not! The cost of this war alone could have covered a plan. Unfortunately, many people in Congress are subsidized by the military industrial complex. When the Stimulus Package was passed, did anyone complain about how much the Democrats and Republicans took in pork? Probably Not! Did anyone complain about TARP? The bailout of AIG and Goldman Sachs? Probably Not!

Whether we like it or not, everyone is going to get squeezed. Companies are going to have to make concessions on pricing, it's already happening with capitated markets. When that happens, physicians, distributors, and direct sales people will earn less money. The Spine Blogger wants to know what you think?

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