Weekend Op-Ed Piece

Have you ever wondered what would would happen to healthcare and our industry if patients (TSB likes that word better than the MBA invented word "consumer"), decided that its time to cut back on medical care and services because they would be responsible for a higher deductible when it comes to their personal healthcare and maintenance? Considering that every CEO whose company's spine revenue is flat, or moving along at a snails pace is crying "market pricing dynamics (another term for we can't gouge the system anymore because we are euthanizing ourselves with commodities)," could we be seeing the initial stages of underutilizing medical care in this country? So why are patient visits and surgical procedures, down from a year ago?

Besides the economy, maybe the reason is that patients are beginning to realize that they do not have to run to the doctor's office every time they feel an ache and pain? A depressed economy, the real definition of a double dip recession, will affect the way medical care is delivered in this country. I know that there are many readers that believe that the state of our economy and healthcare is attributed to the POTUS, but can we talk? The fact is that TSB's diagnosis sees a societal malignancy that is attributed to other political surgeons like Reagan, Bush, Clinton, Bush II and now BO. The current state of affairs did not occur within the last year and a half. Like any disease, this disease has been festering for a long time and now that it is cascading and exacerbated by an out of control society, we have no one else to blame but ourselves. Not only have Americans done a poor job of taking care of themselves, but they have done a poor job of taking care of their country. The same way that TSB makes fun of people like Fender, Will, Shappley, and Bennett, you know the usual suspects that people continue to hire within our industry, we the people continue to re-elect the Ben Nelson's (Insurance Background), Chris Dodd's (Banking), Charlie Rangell's, Nancy Pelosi's, Mitch McConnell's and Harry Reids. Vote these people out. These are people whose time has come and gone, and quite frankly could not give a rat's derriere about anyone else except themselves. Not only should there be term limits, there should be age limits in order to serve the people. But getting back to the gist of this post, maybe patient's are becoming prudent, and through education and the internet they are learning how to take better care of themselves?

Let's face facts, we are a medically addicted society! Just look at all the ridiculous advertisements on TV. My head hurts, take this pill. I have high blood pressure, take that pill. I have a heart condition, this pill will suffice. Need a new knee, try this one. Need a new hip, this is the one for you. I can't get laid, take this pill. Screw the sunset, how about just getting out of seperate bath tubs, it works for me. You get my point. Oh, and by the way, these are the side effects and in case these symptoms arise, call your doctor immediately! How insane are we? By taking care of ourselves, maybe, we will affect the cost of insurance premiums and the spiraling cost of healthcare by driving down the cost of delivery. It's simple economics. So many people are currently unemployed and unaccounted for, that anyone in their right mind would not incur additional expenditures. As more Americans are forced to buy into higher deductible plans by their employers (we have to take care of the shareholders first), many are re-thinking whether or not they need surgery or the need to run to the doctor when they sprain their ankle. Nature has a way of telling you whether you need care of not.

As the unemployment rate increases for the rank and file (remember those that fall through the cracks), everyone loses, meaning, less business across the board for everyone, including spine. How does anyone afford COBRA when the average cost for a single person is $5,5o0 and a family of four would have to pay $14,500 per year? Even if the government (the root of all evil, OOOOOH), subsidizes 65% of the premium, COBRA is prohibitively expensive, and besides the coverage only lasts 15 months, and people who lost their jobs since May do not qualify for the government subsidy.

Recently, some insurance companies reported their quarterly earnings and predicted that this under utilization will be a short-term situation. Maybe those people are just playing the old game of wishful thinking that they teach you when you go to a Deepak Chopra or Tony Roberts meeting. The fact is, that this environment is not going to change for a long time, and it will not be two years. So what is happening? The insurance companies are raising premium even as there is a decline in utilization of healthcare, their justification is the out-of-control cost of delivering healthcare. The mathematics is quite simple, higher insurance premiums and deductibles mean less doctor visits, less doctor visits mean less surgery, which in turn means less money for the doctor, the surgery center and the hospital, less testing means less money for the labs and MRI facilities, a decline in procedures will mean we need less help, which in turn means that there will be less money for all of us.

If greed is not the demise of capitalism, maybe our national stupidity will bring us down. We don't respect one another's differences, we don't want to pay taxes, we pander to illegal aliens (yes business owners you are part of the problem), Spanish is becoming the language of choice (just dial 411 on your cell phone), we spend money without thinking about the potential long-term ramifications of becoming a banana republic, we export jobs and manufacturing to third world countries, we bail out the banks (socialism at its best), and all for the love of profits. In closing, take this time to smell the roses. I know, most of you will say that you have to generate 30% growth for your company, or you will lose your job. My answer to this is, you cannot squeeze blood out of a stone in the current economic climate. Executive management teams must stop living in the past, either they will change, or, the change will change them.