As I changed jobs over the years I never thought much about the medical benefits offered by a prospective new company. Yes I wanted benefits, but I was more interested in the duties of the job and how much it paid. It was only during the years I worked as an independent consulting engineer that I became more consciously aware of the convenience and savings associated with a company provided plan.
While the self-employed or unemployed may have a different perspective, it seems most regular fulltime employees of corporations see medical benefits dimly in the background – alongside furniture, stationery, and other things companies are simply expected to provide. Over the last year, thanks to layoffs and the chaos we call our government, healthcare and corporate medical benefits have been anything but a background issue. Hyperbole reigns on both sides, from "Electronic health records will save us billions" to "We are headed down the rat-hole of socialism".
I'm not a financial or healthcare professional, but I do have several decades of experience thinking logically. It seems to me that putting everyone into a national healthcare system will have several consequences. One is that we will gain revenue from those who are young and healthy and consciously taking the risk of carrying no health insurance. Had I done this over the last 30 years, and been disciplined enough to save the extra money, today I would be able to pay for a couple of heart transplants out of the savings. The trick, it seems, is to have genuine fiscal discipline and to not spend the extra money. I can't guarantee I would have been able to do that. Even our government was unable to resist spending the entire Social Security surplus – leaving us with debt and IOUs for the coming years.
Another consequence of the proposed new healthcare system, which I'm surprised few are talking about, is great risk for insurance companies no longer allowed to reject sickly applicants and no longer allowed to limit expenditures for any customer. Insurance companies that, for whatever reason, accumulate a large number of such expensive patients will be forced to raise their rates – causing customer exodus to the cheaper companies. In a world where insurers must take all applicants, it seems reasonable to expect a great deal of customer turbulence. One can envision wholesale customer migration from expensive companies to economical companies as ailing clients drive the rates up everywhere they go.
Several years ago I had a cold that turned into a cough. The cold was unremarkable but the cough lasted and lasted and lasted. After maybe three weeks my cough had become an irritant to everyone around me – including my coworkers and family. I'd spent a couple of weeks guzzling over-the-counter cough medicines but they seemed more useless than I remembered. Evidently genuinely useful cough medicine is no longer available over the counter. Finally I decided to call my doctor. He refused to write a prescription based on a phone call but I was able to get an appointment the next day. I paid my $20 co-pay and was seen by a physician's assistant. He asked me a few questions and listened to my lungs. His diagnosis was… a cough. He wrote a prescription for codeine cough medicine and had the real doctor sign it. My office visit was $110. The drugstore sold me the medicine for $10.
After a few days my cough was gone. The "real" cough medicine broke the cycle of the continual coughing repeatedly irritating my throat. Breaking this cycle allowed me to quickly heal. I was cured at a cost of $20 co-pay + $110 office visit + $10 cough medicine + about $20 in over-the-counter "pretend" cough medicine that did nothing.
So here is the question: If we are SERIOUS about reducing the cost of healthcare why don't we give more power to the people and let them obtain real medicines? Let it be the individual's choice as to whether to see a doctor and perhaps get expensive tests. Yes we have to protect people from themselves and people are clueless and will overdose and kill themselves and their kids will get the drugs and they won't understand the contraindications and can't read the labels and yada yada yada…
Blah, blah, blah – danger… blah, blah – controlled substances… blah…
Laws written by our government with the intent of protecting people from themselves are costing us money and lots of it. Maybe this was good 20 or 30 years ago but today's national debt is staggering and the cost of healthcare is spiraling out of sight. We need to at least have the discussion as to whether such restrictive laws have a place in our current society.
If we want to continue spending money, albeit far less, we could add a safety net by implementing a national tracking database that would email your doctor with a notification every time you purchase a medicine. We could even implement an Expert System that would warn of excessive purchases, flag interactions, and suggest addiction counseling. All this can be done far more cheaply than requiring everyone to pay $150 for some cough medicine.
