If you are lucky enough to have health insurance, you know that the one hassle-free procedure you undergo is a routine annual physical. Your health insurance provider is pleased as punch to pay for this service. In fact, they might even send you a reminder that you're due for a physical. Why, do you suppose, would they do that?
Why, for the same reason they do everything else, of course, profit! It makes economic sense for them to do this.
A modest and cheap first step in health care reform would be to provide everyone with a routine annual physical. Such a program would have a tiny up-front cost and would lead to multiple billions of dollars a year in savings throughout the health care universe.
Read on.
Ever wonder why a hospital stay costs so much? After all, once surgery is done, they're just giving you a bed and a nurse to administer your meds. Why are you paying $20 for a dose of generic acetominophen, not even Tylenol? That $20 dose of Tylenol pays for all the people they treat who can't pay and for all the wrangling the hospital goes through with insurance companies to get them to pay.
It's also a function of supply and demand: Too many people need hospital care. When I say, "too many," I mean, there are a lot of people in the hospital who wouldn't be there if we had a decent preventative component to our health care system.
Let me illustrate my point with an anecdote:
There is a guy named Frank. He's a 39-year-old independent contractor. Mostly, he works alone, though he does hire the occasional illegal or kid off the books during busy times. Because of the payments on his truck and tools, and because of his relative youth and good health, and because of the high cost of health insurance premiums, Frank foregoes health insurance.
Frank likes to go out after a hard day of work and tip a few. He just drinks beer, hardly ever gets drunk, seldom gets a hangover. No problem, he thinks.
He thinks wrong. Actually, he's progressively damaging his liver and, in fact, is in the early stages of liver disease. If Frank had a routine check-up, he would know this. His doctor would say something like this to him, "Frank, I have bad news and good news. The good news is that we caught your reduced liver function early and that if you quit drinking, your liver will repair itself. The bad news is that if you keep drinking, you will develop cirrhosis and die."
In the above hypothetical situation, Frank would quit drinking, his liver would repair itself, and he would live happily ever after. But in the real world, Frank foregoes the physical, develops cirrhosis, and winds up in the emergency room. After tens of thousands of dollars of expensive hospital care, he dies.
So, gee, ya' think it might make sense for taxpayers to subsidize the $200 cost of Frank's physical? Of course it would. That's why Frank's non-existent insurance company would have been so delighted to pay for his physical. It costs them a hell of a lot more if Frank ends up in the hospital or in chronic treatment.
A visit to any emergency room will reveal that there are tens of thousands of Franks out there whose minor, lifestyle-change-treatable conditions balloon into serious ailments. Most serious disease starts small: heart disease starts with high blood pressure or high cholesterol, both treatable with lifestyle changes if caught early enough; little tumors show up as elevated white blood cell counts and are far less costly and easier to treat than big, nasty tumors; early stage adult-onset diabetes can always be managed effectively through dietary changes and exercise alone; etc.
So here is what I propose as a first step in health care reform: A national program to provide an annual physical to every American. The government could negotiate with providers and work out a reasonable price averaging around $150 (doctors and labs might accept lower fees if they knew they were going to get paid in full right up front). Just for giggles and shits, let's say 300 million people take advantage of the program. The total cost is a "staggering" $45 billion -- about half the cost of a year in Iraq.
If the average hospital stay costs $10,000, only 4.5 million hospitalizations would need to be avoided for the program to pay for itself. That is to say, if two percent of the total pool were in the early stages of some serious health issue -- a ridiculously conservative assumption -- the total savings would be massive. Insurance companies know this. Why don't we know it as a society?