- If private insurance companies have been engaging in unacceptable business practices, to the extent that Republicans are willing to seek legislation to correct the problem, why are we supposed to continue to trust those same private insurance companies?
- If prices for things like medical care, doctor visits, hospital stays, and drugs are too high, how will they be brought down without some form of government involvement?
- If malpractice lawsuits become a thing of the past, what protections will exist for the poor saps that leave surgery with a scalpel sewn inside?
More detail and diatribe after the jump
Health Care Questions for Republicans
Looking around the health care debate, there are a few ideas that seem to be uniformly accepted, even between Republicans and Democrats. Everybody claims (and I say claims, because I’m not sure Republican or even moderate Democrat hearts are in those claims) to want to achieve a few "universally agreeable goals". Namely, to provide affordable access to health insurance, to cover pre-existing conditions, to promote transparency in pricing and effectiveness, and to keep insurance companies from being able to pull coverage or jack up rates on somebody when they get sick. Republicans claim to be behind these things, they're just opposed to a health insurance plan run by the government running in parallel to the other plans.
This doesn't make sense to me. Republicans say that we need to keep the private insurance companies from denying care due to pre-existing conditions, or raising rates on people who get sick, actions that lead to poverty and death for those so afflicted. But then they want to protect and preserve those same private insurance companies. The company that yanked care from a guy because they discovered an unknown pre-existing condition (and the guy died as a result) should be protected? What sense does that make? Say you hire somebody to watch your house while you're on vacation. And you come back, and the place is a wreck and things have been stolen. You ask the miscreant why, and he said it was because he could make more money selling your stuff. Would you insist on hiring that person again?
The "public option" doesn't even solve the real problem, which is that you’d still have profit-driven corporations that make money with premiums from healthy policyholders, and lose money when policyholders require medical care. You're still letting the miscreant house-sit; the public option would be a couple of video cameras possibly keeping him honest. And while I don't think that even that is enough, I think we should fire the crooks and show no pity for financial criminals, the Republicans oppose even the half-measure of installing those cameras! Why, if we have video cameras in the house, then the house sitter might not steal from us! He might even refuse to housesit, and then where would we be?
So here's my question for any Republican: If the private health insurance companies have been unethical in their providing of health care, why is it important that these companies continue to provide health care? Why is their protection and coddling so important?
The concept of health insurance itself is ridiculous when you think about it. "Insurance" is the product of a risk assessment. Auto and home insurance companies make money by having a lot of people who never have accidents, making it affordable for the company when somebody does, and they're typically pretty likely to pay out. However, with car insurance, if you have an accident, odds are your rates will go up, because you've shown you're in a higher risk bracket. It's all a cost-benefit risk matrix. But this works, more or less. It incentivizes you to not have an accident, to be a careful driver who follows the rules. And if you do have a couple of accidents, you pay a little more in premiums or you go to a lower-cost provider.
But a car is not a body. You might go your whole life without a car accident. You will get sick at some point. You'll twist your innards lifting something and experience painful "Epiploic Appendagitis", which feels like a ruptured appendix but goes away after a few days... and after a $5000 CT scan to verify that it isn't a hernia or a ruptured appendix. You'll fall and break your arm and need a cast and an x-ray. A light fixture in your house will fall and hit your head, causing a painful scalp injury that requires stitches, maybe even an x-ray. You'll need a prostate exam at some point if you're male. If you're female, maybe you get pregnant someday, with all the hospital bills associated with that. Maybe through genetics, through no fault of your own, you have a genetic disease or condition. When that happens, a for-profit company will determine how much care they can provide without losing a profit. It's not much.
Even with a public option, the fundamental flaw in the system will still exist; your good health or bad health will continue to be a commodity. The problem with the medical system comes down to one single defining component: Medical care is too expensive in the US for the average citizen to pay out of pocket. Health insurance companies are able to afford the exorbitant fees charged by hospitals because of all the money they collect from healthy people, and from refusing to pay for the sick people. Hospitals charge, say, $5000 for a CT scan, because a health insurance company will pay it, and if they don't, there are always medical collections.
If the prices go down, you won't need health insurance. It's that simple. Wouldn't it be great if you could go to the doctor, get checked up, and the cost of your visit is the cost that your co-pay is now? Just pay right there, out of pocket? No private insurance company bureaucracy with an eye for the bottom line, no government bureaucrat, nobody but you and your doctor?
I've heard a Republican (who is convinced Obama is a socialist tyrant) say that the problem is the health care costs, the cost of a doctor visit, the cost of medication, the cost of malpractice insurance, and so on. And I agree. The problem is that the costs are too high. However, this same individual is opposed to absolutely any government laws or regulations. Up to and including seat belts. So here's my question for them with regards to high medical costs:
How do you propose to bring those costs down, without government regulation or government involvement? How do you propose to take the cost of a CT scan down from $5000 to $500? Ask nicely? How do you propose to have the pharmaceutical companies charge less for the medications they research and develop?
The private health care system has failed us. We're going to just cross our fingers and hope that it fixes itself?
And then there's tort reform. Yes, there are some frivolous medical lawsuits out there. The cost of medical malpractice insurance is high. But all in all, overall expenses due to malpractice lawsuits and the cost of malpractice insurance amount to less then 1% of all health care spending in the US. Take out medical lawsuits entirely, and you still have 99% of a broken system. And yet it's treated like its 75% or more of the problem by Republicans. Would it help? Probably. But it's not the magic bullet. And here's something else, there are people who are victims of medical accidents in this country, every single day. People leave surgery with a sponge sewn inside. Or a scalpel. People get the wrong limb amputated. A drug is insufficiently tested, and people get worse or die. What should be done for them, or for the grieving families? Pat on the back and send them on their way, with a bill for medical expenses incurred? Nobody is even real clear on what they mean by "tort reform", but what do they intend to replace it with? What system will be put in place to protect the victims?
Moreover, given that Republicans are so opposed to government regulation and government involvement, who are they to say that an individual cannot pursue legal recompense for any reason, malpractice-related or otherwise? If someone harms you, don't you have a right to seek justice? Wouldn't so-called tort reform abrogate that right? Wouldn't that be government regulations telling you what you can and can't do? Maybe government regulations like that are only okay when they protect a corporation and not an individual.
So, here are the questions
- If private insurance companies have been engaging in unacceptable business practices, to the extent that Republicans are willing to seek legislation to correct the problem, why are we supposed to continue to trust those same private insurance companies?
- If prices for things like medical care, doctor visits, hospital stays, and drugs are too high, how will they be brought down without some form of government involvement?
- If malpractice lawsuits become a thing of the past, what protections will exist for the poor saps that leave surgery with a scalpel sewn inside?
I'd like to have any Republican answer these questions. Without going off topic or off onto a rant or tirade about Obama and Pelosi.