Healthcare, An Analysis

In the midst of all the name calling, sign snatching and general chaos of ignorance going back and forth during this healthcare reform debate, I have come across a few points that merit bring up.

Here they are:

The Free Choice Fallacy
Currently, you do not have a choice in healthcare as it stands. Probably, it's your employer who picks your plan. Maybe you get to chose between between chocolate and vanilla, but certainly not between hotdogs and ice cream. Your boss might have some choices in the free market, but he’s most likely looking to maximize the tax rebates he gets for paying part of your insurance.

If you are one of the people who can afford and are healthy enough to buy insurance on the free market, huzzah! You do in fact have a choice, unfortunately you’re only 9 percent of insured adults in the market according to the most recent census data from 2007. Enjoy it while it lasts, try not to get sick, whatever that costs you.

(Just for reference, the data also show that 59 percent of the population is insured through their employer, almost 28 percent by the government and 15 percent of the population were uninsured.)

Rationing, It ain't nothing new
It already exists. Your health insurer provides it. For example, my health insurance “rations” the amount of insulin pump supplies I can get by putting a $2,000 per year cap on what they will pay. Incidentally, I was never told that there was a cap when I selected this “chocolate” version of my healthcare plan and just got a notice, buried in fine print this very evening.

Death Squads, Call Vadar
Reference "rationing" above. Why do you think insurance puts those $1 million caps (or rations) on lifetime coverage? Cause they don’t want to pay! Companies make the same decisions as said “death squads” would all the time. After $1million, your life, no matter what you do or how young you are, is not worth it to your insurance company. At least in Britain, the NHS is more than willing to pay up to $49,000 to increase your life by one year National Institute for Health and Clinical Excellence’s June 2008 report.

Show me the (lack of) money
Health care is not only bankrupting the country, it’s bankrupting individual citizens, too. It is the primary reason people in this country declare bankruptcy. It’s out of control. Why spend three times as much per person and end up with a less healthy population? That’s like paying the same price for a Toyota as you would a Porsche. Full disclosure, I LOVE Toyotas.

How will we pay for it? How about taking all the collective insurance premiums, co-pays and deductibles those insured Americans are already spending for a start.
To find that number I found the Agency for Health Care Research and Quality. The precise link to the data, here.
My calculations end up at $359 billion. (I completely low-balled it. Email me for my rudimentary calculations).

Now, let’s take a large part of the money Medicare and your insurance company spend on prescription drugs because they’re not allowed to get wholesale prices even though they are the largest drug buying organization in the world. That’s an easy $2 billion more.

Full disclosure on that number, the best I could come up with was from the Snowe-Wyden amendment to the health care bill. They projected that number on a 5 percent decrease in drug costs. The Medicare Prescription Drug Part D saw an 11 percent decrease (for some Medicare recipients) so that $2 billion is another low ball. The Congressional Budget Office puts this figure at $110 billion.

How about changing our medical care to follow what science shows actually works and change the way doctor’s are reimbursed so they aren’t incentivized to order unnecessary tests and procedures. Turns out it’s hard to pin people down on this number. One study found that $2.76 billion could be saved by streamlining pharmaceutical care using Ace-inhibitors, drugs commonly used to treat high blood pressure.

Using the same format to address heart disease, diabetes, high cholesterol and common types of cancers, I think we can get that number to $200 billion easily. (If you have more data on this, please send it to me! I’d like to really get a handle on this number).

So, our running total now, $359 billion, plus $2 billion plus $200 billion. I’m at $601 billion dollars and I haven’t touched what the government is currently spending.

Now, let’s not be unfair about this. Want more treatment? Want to upgrade to the triple bypass from just the double. Go for it, but I’m not paying. Perhaps you can buy yourself some supplemental insurance, like in France. You don’t need this, let’s be clear, but if you’re prone to hypochondria or know you’re going to incur a lot of medical bills (I might, with the diabetes and all) go for it.

And woah. Lookie there! That’s a publicly-provided basic level of care and an additional privatized market for additional care. Am I dreaming, or is that cake I’m having and eating, too?

No body’s dying here, or are they?
Lastly, I’d like the conversations we as citizens are having with each other and our legislators are having with each other to start being actual discussions on how to fix this problem. Whether you’re a red state or a blue state, your pockets have long been turned inside out because of health care. And if you live in a red state or a blue state, someone on your block is negatively affected by the health care industry now. Negatively affected like stuck in a job because they offer health insurance because of a preexisting condition. Negatively affected like being bankrupted by a catastrophic illness. Negatively affected like choosing between prescriptions and groceries.

Life, Liberty and the Pursuit of prescription drug coverage
What is missing from this debate is whether health care is a right. That conspicuous hole in the discussion indicates to me that Americans believe, at least on some level, in a basic right for health care. So lets start the new discussion there. Let’s start the new discussion with the compassion and analysis such a vital issue deserves.

This arguable a complete oversimplification of a very difficult problem. But I'm impressed with myself for having an idea that seems more comprehensive than any legislator's I've heard at the town meeting coverage. This is one of the most important issues in my life, and will surely be one of the most important issues in my lifetime. Show me the discourse!