12 August 2009

Healthcare…Ah, Sweet Healthcare

So, what is up with this whole health-care freak out? It is ridiculous. My favorite part is how we, as a nation, have skipped right over the research and development phase and proceeded directly to the “blind hysteria fueled by fear-mongering phase.” It makes me proud to be an American. Truly.

As a raging, some might even say “bleeding heart-socialist freak,” liberal, I naturally support any attempts at health care reform. I feel pretty strongly about the idea that health-care is not a privilege that should be granted only to those who can afford to buy into the insane system that currently exists. I would like to think I live in a country where providing basic health care to all our peoples is considered a good idea. Sadly this may not be the case. I also can say that I currently utilize a model of health-care and insurance provision that parallels what government run health care could look like. I am an end user of the finest the Military Health System has to offer in government subsidized HMOs: TRICARE.

TRICARE is far from perfect, for a while I even ran a blog chronicling the trials and tribulations of getting sufficient care via this system. TRICARE provides an interesting hybrid of government and private health care and has its advantages and real disadvantages. At the end of the day, TRICARE is an HMO. Therefore, it suffers from the classic disjoint between the end user and the insurance company. Military treatment facilities move blissfully along completely unaware of the inner working of the insurance system while the insurance system probably could not find said clinic on a map without a full executive team of support. As with many HMOs the motivation of TRICARE to provide decent customer service is low since they get their government money one way or the other, just as private companies get to keep your premiums regardless of if they actually ever cover any services you choose to use. The flip side: it is cheap. For us, thankfully, it is free. (We do pay something crazy like 12 bucks a month for full dental coverage via a sub-insurer. That covers all routine care and almost any other dental care you might decide to have to the tune of no less than 80%, for all of us. You can’t beat that for a deal.) Additionally, you receive the same level of care and coverage regardless of rate or rank. Families of freshly enlisted 18 year-olds get the same access to care and specialist as four star admirals. It is pretty sweet. Hells bells, I had a baby, for no out of pocket medical costs.

Sure the plan has its flaws, but the benefits of universal coverage to society as a whole cannot be overlooked. Since the bottom line is often, well, the bottom line, let us consider costs. A universal system, like TRICARE or any of the proposed variations would cut costs to everyone. Some free-market economy for health insurance would still exist given that the government plan will not eliminate private insurance companies. What a government plan would do is create some much needed competition. If a lower cost for equal coverage option exists, not only can you choose it and just plain pay less, private insurance companies may have to price match to lure in customers. Either way, you can pay lower monthly premiums.

Having fewer uninsured people will also decrease costs. One might think that suddenly paying for everyone who is currently uninsured, by choice, chance or otherwise, would be expensive. It is, but here is the thing: uninsured people get hurt and sick all the time, and their uncovered expenses do get paid. They get paid by your tax dollars and your ever increasing insurance premiums. For those who argue that the uninsured are that way for a reason, think again. The populations in this country that go without health-care coverage might surprise you. It is not all illegal immigrants and people who “can’t be bothered” to provide for themselves. The uninsured are recent college grads who can't afford premiums while paying rent and student loans, or dual income families struggling to make ends meet who just don’t have enough in each paycheck to pay double their housing costs in group premiums. The irony being that many of these people can’t afford the rates offered by their employer, but almost by definition of having a job, they do not qualify for any existing government subsidized programs. I have many friends, all college educated and working full time at “real jobs,” who had to make that choice. If those who followed all the rules that our society believes makes one “worthy” of a decent lifestyle can’t scrape together the cash to see a doctor, what kind of system is that? That is a spot between a rock and a hard place in which no one deserves find themselves.

Finally, the cost of insuring everyone to ensure preventative medicine is the best cost-cutting move a nation can make. Vaccinations, physicals, PAP smears and mammograms don’t cost much, but measles outbreaks, cancer and chronic, untreated illnesses do. Anyone who works in public health, or healthcare of any kind, will tell you that preventative medicine is the best medicine. Routine, and properly covered, care will cut down on the exorbitant costs of people seeking acute care in emergency rooms for conditions that should have been caught, treated and managed by a primary care managers as part of routine screenings. I may not know politics or economics, but I do know epidemiology and this will be better for us all.

At the end of the day this system will not be perfect. We may not even see the savings in any appreciable time frame. It could be many years before it all falls into place and starts making health care better, and cheaper, for all. However, government health care can do a lot to improving the overall health and wellness of this country. I for one would be proud to live in a nation where this kind of guarantee of health care is considered a right and not a benefit of making more than a certain yearly salary.

I could go on and on about this forever, but since most of you probably stopped reading ten paragraphs ago, that is enough for today. As this debacle continues to unfold, I am sure I will have more to share...

PS The idea that there will be "death councils" that place a value on human life? That is hilarious. 1. Do you think that your current insurance doesn't have a maximum allowance for sustaining your life? Trust me, it does. For those with chronic, debilitating conditions that require end-of-life care, there is only one way to go when it comes to covering those services. That way is up. And 2. Only factions of society that feel water-boarding is appropriate would even consider such a thing...I think you get what I am hinting at here.


Ginger said...

I completely agree with you on this. After seeing firsthand what can happen when you're not insured--I was between jobs and couldn't afford Cobra, and ended up with a severe health issue that ended up derailing my finances for years--I'm totally convinced that there has to be a better option than what we currently have. I don't know exactly what that is, but it's got to be something!

Kerry said...

I am not sure I can discuss this topic without ranting anymore, so I'm going to refrain.

But I have to say that it blows my mind that people talk about how awful it would be to have a "government bureaucrat between you and your doctor." I would much prefer the government bureaucrat to the guy who's in that position right now--an insurance company hack whose bonus rides on whether he can keep me from getting the care in I need in order to save a few bucks.

Oh, seriously, don't get me started.