The Health Care Debate

Maria Bartiroma hosted an interesting program entitled, “Meeting of the Minds: The Future of Health Care”, which brought together  various factions involved in our current health care debate.  It was a fascinating show where representatives from insurance, pharmaceutical, and medical industries as well as government and big business had a conversation.  Not a confrontation brought to you by conservative whack jobs trying to mainstream the idea that health care reform is, as Rachel Maddow likes to put it, “a secret plot to kill your grandparents”.

In honor of open dialogue and persons of differing opinions coming together with solutions and ideas rather than disruption and finger pointing, here are a few of the points brought up during the hour…

Getting Out Of The Way Of The Free Market: Often times TV pundits discussing health care throw around this idea that government involvement is bad because it gets in the way of the free market.  Yet, John C. Lechleiter, CEO & President of Eli Lilly, pointed out that there’s never been a free market with regards to health care.  He notes, “We’re in a system today where the person who needs the service or the product can only get it through a learned intermediary, and somebody else pays for it.  Thus people are incented to get as much as they can get whether they need it or not and that’s not the way a market works.”

Then Dr. J. James Rohack, President of the American Medical Association, jumped in and noted that the health care system does have a free market but only in the area of cosmetic surgery as it’s the one area not regulated by the government or the insurance industry.  He stated that, “Cosmetic surgery is a direct transaction between the patient and the doctor, the fees are set, a negotiation occurs, it’s not paid for [by anyone other than the patient].”  He went on to give the example of lasix surgery where technology has improved while the price has gone down.

So the idea that free market competition and leaving government out of the equation is a mute point unless we get rid of insurance all together and make health care something we pay for out of our pockets like car insurance. But even car insurance is required, unlike health insurance which is optional.  Besides, the insurance industry isn’t going anywhere, so the dream of a free market that behaves like an actual one isn’t possible.  Where it stands now we have a system where the health care industry only makes money if you’re sick,  the insurance industry only makes money if you’re well, the “haves” have no incentive to worry about either and the “have-nots” aren’t able to participate.

It’s no wonder this system doesn’t work.

Personal Accountability: Michael Milken, Chairman of The Milken Institute spent most of his air time focused on personal accountability.  He said, “If the average weight of American’s simply returned to early 1990s levels the reduction in chronic-disease costs would boost our economy annually by an estimated $1 trillion – at no cost to the government”.

That seems reasonable.  Keep health care costs down by by improving the baseline health of the average American.  But where’s the incentive?  Most American’s are less interested in long term, possible outcomes and more interested in a quick fix. As we live longer, it becomes harder to look into our crystal ball and make choices today that benefit us 50 years from now.  Add to that our notion of a free society with various personal liberties and we don’t like to be told what we can and cannot do. Thus health care costs sky rocket because we have the right to smoke, drink excessively, do drugs, over-eat and ride a motorcycle without a helmet without being penalized or denied coverage for our actions.

If you think about it, health insurance isn’t tied to our commitment to wellness but rather our commitment to job performance.  Lose your job – you lose your insurance.  Gain 300 pounds and four chronic conditions – no problem – as long as you’re employed, you have health insurance.

It’s no wonder this system doesn’t work.

The special was fascinating and covered a ton of topics.  It’s well worth your time to view online if you want a serious discussion of the issues in lieu of the political in fighting, posturing and fear mongering going on at present.  Health care is complicated and messy and needs to be figured out.  Angry mobs aren’t going to help the situation.  Which has got me thinking lately…

Is Health Care a Right or Isn’t It?

The Health Care Freedom Coalition as well as other groups, like to point out that health care isn’t a right and therefore not something the government should be involved in.  Yet education isn’t a right and we all pay for it collectively.  We’ve agreed that educating our youth for the first 18 years of life helps our country thrive.  I’m shocked that health care isn’t viewed like education, as an investment in our society. Because frankly, paying to educate kids that are the first generation to possibly not outlive their parents seems like a wasted investment. I’d fire a stockbroker that put my money in an unhealthy company yet we’re more than happy to put our money into an unhealthy group of kids and, fingers crossed, hope they’re around in 40 years.

“Life, liberty and the pursuit of happiness,” are our inalienable rights, i.e., rights that are not to be taken away from us as citizens of this country.  When we discuss health care, we’re talking about life, the life we must protect if we’re ever to pursue happiness.

But what is the government’s role?  Does it merely ensure the opportunity or does it make a social contract with us to help foster this life in some way?  Does society suffer when a growing portion of it doesn’t have the opportunity to create a life via providing basic care for their physical bodies? I honestly don’t know the answer to these questions.

HENCE THE DEBATE.

My mind keeps coming back to the education example and wonders what society would be like if only children that could afford school, went to school or weren’t required by law to attend school.  Luckily that doesn’t happen here, where kids learn all sorts of things like, for example, The Rules Of Debate.  You know,

  • Avoiding the use of the word never.
  • Quoting sources and numbers.
  • Not presenting opinions as facts.
  • Attacking the idea not the person.
  • Avoiding bickering, quarreling and wrangling, etc.

Just imagine if the children of this nation didn’t learn these ideas in school.  I guess they’d grow up to skew the national news, present opinions as facts, incite riots, hijack town hall meetings, and scare the shit out of people.

Thank God that doesn’t happen here.

John C. Lechleiter, Ph.D.
CEO & President, Eli Lilly
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4 responses to “The Health Care Debate

  1. I’ve always maintained that the problem with healthcare is NOT the fact that “50 million” are uninsured (which by the way when you remove illegals and the young who don’t want insurance, the number drops considerably.) the problem is the cost of health care and depending on who you listen to, this reform only will increase costs.

    Is it any wonder public skepticism is as high as it is when on one hand the presidents promises to cut costs while at the same time insuring 50 million more people. The CBO says the leading health-care-reform proposals will increase health-care spending and make the budget harder to balance in the long run. Yet saving money is the President’s principal stated rationale for reform. How do you explain that?

    And we’re not talking short term spending here either; this is a trillion dollar investment in a new system that is supposed to save money. In the meantime the president’s congressional allies seek to raise taxes to pay for all this cost cutting. It’s almost laughable, do the democrats really think Americans are that dumb? If this package is passed, I guess we are.

  2. If I was a single mother of three with skin cancer, uninsured because Walmart was too damn greedy to give me another hour per week so I can get coverage, I’d definitely disagree with you.

    It’s a problem. I think we all need to start there. Until we agree that everyone in this country should have access to health care or disease management we’re never going to get anywhere on this.

    Then and only then can we debate how this can happen and the best medical/business model to provide it.

    At least the conversation has started. Should we rush it, hell no. Should those bitching about it have an alternative solution, hell yes.

    In terms of how health care saves money – All of those that have lost their job and hence there health insurance this past year – have less money to pump into the economy. When your disposable income goes to your monthly prescription bills, you don’t have extra money to spend. Likewise using the single mother example again – when she skips her annual check up and diseases aren’t caught in the beginning, the price goes up. It’s a lot cheaper to removal a mole than to fight skin cancer. And when that single mom dies from said skin cancer, we have to pay for the SSI and the medicaid benefits of those children that she left behind. Again, cheaper for everyone if she gets to raise them.

    Seems like simple economics to me.

  3. Everyone in this country already has access to health care and\or disease management. Have you been to the ER at Children’s or Johns Hopkins. I would be willing to wager that the majority of the people in there are 1) illegal 2) unemployed or 3)uninsured. Availability of treatment is not based on ability to pay. Quality of treatment? Whole other issue.

    Its a problem alright, I think neither side would argue that. The sticking point, is who should pay for it. Personnally, I think we need to be weaned off insurance. We’ll always need a plan for the bad stuff, but running to the doctor everytime we have a sniffle has to stop. The other thing is we need to be better consumers of health care as well. Do you have any idea what your doc charges for a physical? Insurance makes us think we’re only paying 20 dollars which leaves the medical profession free to jack up prices on everything with no recourse.

    What bothers me most about universal health care is that its been tried, tested and proven a failure time after time after time. Only liberals think they can get it right. The whole state of Massachusetts can’t even get it right. People are not going to France, England or Canada for major issues. If you live in one of those countries and you need serious care and you have the means, where do you go…? You come to the USA. Why is that, I wonder.

  4. If you have a DKA and go to the emergency room, yes they will quickly test your urine, diagnosis you with insulin dependent diabetes and give you insulin to bring your blood sugar levels down and stop you from lapsing into a coma. But what about once you’re discharged? You need insulin at every meal, not to mention the glucose monitor to test your blood prior to the meal and the needles to inject yourself – oh and regular blood tests/appointments with an endocrinologist to manage it. Without insurance you’re screwed.

    I agree with you – we need to be more responsible for our health and rushing through a bill isn’t the answer, but not dealing with this is not the answer either. We tabled health care during the Clinton administration and now we’re back to this issue that is so tied to job/income.

    I don’t necessarily want universal health care. It’s interesting, you keep mentioning illegals in your responses – I keep thinking of regular hard-working Americans that don’t have insurance and are losing everything.

    This is a huge, multifaceted issue that needs to be addressed. At least we’re finally addressing it. What’s pissing me off that this has become such a political issue. Both sides need to stop the bullshit and figure this out. This September deadline really bugs me – why does it have to be a now or never type of thing?

    We’re better than this. We can figure out it. Both sides need to be less concerned with being right and more concerned with solving the problem.

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