Tuesday, September 15, 2009

A Somewhat Imperfect Market-driven Solution to the Health Care Problem

bqswznuphr The reason no one has been able to solve this county's health care problem is that debate over this contentious issue has been focused in the wrong direction. Despite what all the politicians, insurance companies and health care providers claim, the problem is not that too many Americans do not have health insurance. The problem is that too people do.

Since health care is so expensive, most people must buy insurance either on their own or through their employer. The problem starts with the nature of insurance. Since the insurance company pays the medical bills, most consumers don't really feel the true cost of their doctor visits, hospital stays and labs tests. They may see the bill the provider sends to the insurance company, but they know they don't have to pay it directly.

In any case, there seems to be no correlation between the bill and what the insurer actually pays and the provide accepts. How often have you seen a doctor or hospital charge $1,000 for a procedure only to see on the insurance company statement that the doctor or hospital was paid maybe $200 and they accepted it as payment in full? Something is wrong here.

Medical insurance, of course, is basically a great scheme for collecting money from many people, working stiffs and taxpayers, and handing it over to a few doctors and hospital owners. Currently there are no incentives for doctors and hospitals, or for that matter insurance companies, to control costs. The money is just passing through the latter to reach the former.

Requiring that everyone have health insurance will not solve the problem. In fact, insurance only drives up costs. It can't reduce them. The further people get from actually paying for what they want or use, in this case medical services, the more likely they are to want them and use them. The more they use them --more frequent visits to the doctor, more complex and costly tests-- the more costs will increase. The more people doing this the more costs will go up.

To stop this vicious circle, health insurance should be eliminated, and everyone should be required to pay for their medical care on their own. Once doctors and hospitals stop getting paid by insurance companies and instead have to rely on the meager resources of real working people, they will see their incomes fall. At which point they'll have to lower their fees till they're affordable to people instead of to insurance companies.

After all, how long do you think do you think doctors could go without payments from their patients' insurance companies or Medicare. They have to make payments like everyone else on their Mercedes, their fishing boats, their offices, their homes, their summers homes, their winter homes, their...

Before long the doctors will have to adjust their fees so that people who drive Civics, fish off the pier and own one home, or no home, could afford their services.

Maybe for a while, before doctors and hospitals lower their fees, a few people will go without needed medical care. Some heart bypasses may be bypassed. A few people may die. A few children may not get the care they need, and a few expectant mothers may not get the care they and their babies should have.

Come to think of it, isn't that what's already happening.