NOTE TO MY READERS: This was originally sent to The New York Times as a response to an Op-Ed piece by Paul Krugman, entitled "The Waiting Game", published July 16, 2007, all editions.
OK, let’s talk about health care.
Last week Tuesday, I had terrible neck pain that was radiating into my upper back. I mean, we’re talking agony. It hurt to move, it hurt to sit and it hurt to lay down. Being the industrious non-government dependant American that I am, I took it upon myself to go to the Peterson Park Urgent Care Center on Peterson Avenue just East of Western Avenue in Chicago. It was about 7:15 PM when I was able to get over there – what Paul Krugman and his NY Times pals would likely opine to be “after-hours”. According to the folks of Krugman’s ilk, I should have expected to be turned away at the door because the clinic was closed, or at least have to face long lines of people dealing with the red tape and insurance hassle that is the failed American Medical System. Bracing myself for the worst, I pushed through the door only to find *GASP* a friendly receptionist who greeted me with a smile, and an empty waiting room! The onerous “red tape” consisted of filling in a 4 page form detailing my medical history and personal information because I had not previously been to the clinic. Now, I can imagine that this might have been a very onerous process for some of the many million people who couldn’t be bothered to learn English when they came into this country, or for the average recent public high-school graduate, but I was through it in less than 10 minutes and placed in an examination room. The Doctor (a foreign product of the American Medical Education System), was in to see me in less than 5 minutes and performed a very thorough examination. He took some blood for testing and proscribed me a cocktail of several drugs. I went back to the receptionist, took care of the payment, and was out the door. Less than 45 minutes from intake to exit and, considering the circumstances, a very good experience.
I can hear the liberal self-righteous cries now, “but you have insurance! But you’re not one of the ‘millions of Americans who don’t have a voice’! (we really should investigate the muteness epidemic in this country.) You’re privileged!” And, my personal favorite, “You’re White!” (When in doubt, play the race card and beat the war-drums, it always seems to work.)
You might think all those things were true, but you’d be wrong (except for the white thing). I don’t carry health insurance. It’s not provided at my workplace, and I have not yet elected to purchase individual coverage. Am I foolish? Perhaps, but if I get burned I’ll have no one but myself to blame for it. You won’t see me blaming the Government for my lack of insurance.
The total bill for the in-office medical care? $260, including blood-tests at an outside laboratory. The total cost of the prescriptions? $49.92 with tax. Hardly a usurious sum for good quality medical coverage.
Now, here’s what I haven’t yet told you. I commented to the receptionist that the bill was a bit lower than I expected, and I was pleasantly surprised. Her response was that, since I didn’t have insurance, I got a discount. Apparently, the blood tests that cost me $125 would have cost an insurance company over $300!! Likewise, according to the CVS pharmacist, the drugs which cost me $49.92, would have cost an insured patient (or, more accurately, the insurance company) over $120!! HERE is the root of the problem with the American Medical System! It’s not the lack of insurance, but rather the inflated cost of the care that’s passed on to the insurance companies for those people who ARE insured!
I’m a businessman. I understand the need to make a profit. It is the drive to make a profit that dictates the private sector, when properly monitored, will always outperform the public sector in providing services because of the inherent checks on profligacy. It’s amazing how budgets get streamlined when the money spigot gets turned down to a slow trickle. Competition breeds streamlining, streamlining breeds discounting and discounting makes everything more affordable. If you disagree with this statement, simply look at the cost of DVD players today compared with 8 years ago. Did the clinic and pharmacy make a profit on me, as an uninsured individual receiving a discount? You’d better believe it! Is that wrong? Of course it isn’t for the reasons indicated above. However, let’s say that 10 people had the same problem as I. Statistics say that at least 7 of those 10 have insurance. At an additional cost of $240.80 per insured individual, that’s an additional $1680.56 in profit paid for by the insurance companies! (We accepted that the system profited from my care, so any additional charges for the same services must be pure profit.) This dollar figure is for a relatively minor complaint.
I was in the ER for an irregular heartbeat in January of 2006 (again, without insurance). There was an EKG, plenty of poking and prodding with blunt (and rather cold) objects and a barrage of tests generally reserved for people twice my age. My 5 hours in the ER cost me $1270. Right on the billing statement, it told me that I received a discount of over $1100 because I did not carry insurance. Do the same math as we did in the above example, and you find an additional $7700 in profit paid by the insurance companies for the 7-out-of-10 insured people in my little "hypothetical microcosm" for this not-so minor complaint.
Now, try and get your head around the sheer number of extra dollars paid out by insurance companies! Even if you account for the fact that hospitals and medical personnel must accommodate for the percentage of uninsured individuals who do not pay the bills they are sent and ignore the offers to enter into payment agreements (for the record, I am NOT one of these individuals), the dollar amount of additional profit must be mind-boggling! If an insignificant 14 individuals do not receive the discounts outlined for the 2 examples I use above, an additional $9,380 is paid by insurance companies. Now, let's go outside the microcosm and apply these numbers to the general population. Anyone want to venture a guess at the dollar amount that insurance companies overpay each year? I may have to add another microchip to my financial calculator to get the number!
Universal health care? Sounds fantastic as a plank in a political campaign, but it’s not needed. I’ll repeat, and feel free to quote me – we do not need universal health care. Like every failed liberal program since the 1960s, it will amount to nothing more than a bureaucratic money pit failing to accomplish its intended goal. If you don’t believe this, you may want to ask the City of New York why it spends more of its education dollars on people and offices that have no actual contact with the children than it does on paying teacher salaries and buying textbooks. That, however is a topic for another discussion. What we need now is not universal health care, but affordable health insurance. The way to affordable health insurance is not to assign Government the task of insuring all citizens (that will have quite the opposite effect), but rather to trim the dollars that insurance companies pay needlessly to institutions. Would it be such a stretch to create a uniform code for all diagnostic and medical services, find out the cost for each code and set a percentage-over-cost limit (profit margin) that insurance companies would pay for the services? I don’t think so. Logically, that would make premiums more affordable (given free-market competition without collusion), which would allow more people to buy additional coverage that is not provided to them by their employer. Medical personnel and institutions would continue to profit, insurance companies would continue to profit, losses through uninsured people failing to pay their claims would fall because the number of uninsured would fall, and even the Government would save money because Medicare and Medicaid pay identically to private insurance companies! Of course, we’d have to take a lesson from the Alternative Minimum Tax and adjust for year-over-year inflation, but everyone benefits. Government would, of course, continue to provide insurance coverage to the SMALL MINORITY of folks that truly cannot pay (not those who claim they cannot pay for insurance, yet manage to pay for cable TV, fancy cell phones, MP3 players and high-speed internet access among other discretionary services.)
Of course, I don’t expect resounding support from the left on this, as it accomplishes a goal without expanding government. This, of course lowers the number of government-dependant citizens lining up to vote Democrat and get on the “big-D free ride”, but then again, when was the last time the left favored a common-sense private sector approach to problem-solving when the opportunity to increase their political base by creating a big-government money pit was there to tempt them?
Copyright 2007, Peter Citera
All Rights Reserved