Healthcareless

Healthcare costs had been rising by about 9% per annum in the last few years, but that growth has slowed to 7.1% and folks are hoping to get it down further, maybe to 5.4% per annum. Problem is, of course, that our incomes are not remotely going up that fast, and while there is Medicaid for those on the lowest economic rungs and Medicare for the elderly, not only are both those programs being cut, but Medicare doesn’t remotely cover the actual costs of care for its constituency. The Kaiser Family Foundation tells us: “The percentage of these workers [in private business] offered coverage rose from 80.8% in 1995 to 84.1% in 2001, before falling back to 80.4% in 2005.” CBS News (April 25^th) tells us that employers offered health insurance to 72% of workers last year, but that number has fallen to 67.5% today. Companies just cannot afford the cost.

We have built a system that we can no longer afford, and consumers are hardly able to price-shop on comparable hospital services because of the complexity of all the items in a typical hospital bill or are they in any condition to bargain in an emergency. A simple appendectomy can run from $8K to ten times that amount depending on the hospital, and the list of separate add-ons takes pages to print out. Medicare will cover only $7.5K for this procedure, which is below cost at the lowest end of the spectrum.

To save money, employers and insurance companies have begun to apply coverage that only recognizes Medicare rates to all covered services, shifting the balance to the insured. Almost no one is sufficiently covered from a hospital stay under this system, and folks with health insurance are facing medical bankruptcy because their coverage is so bad! “[Insurance] companies, across the country, [are] rapidly shifting to another calculation method, based on Medicare rates, that usually reduces reimbursement substantially… ‘It’s deplorable,’ said Chad Glaser, a sales manager for a seafood company near Buffalo, who learned that he was facing hundreds of dollars more in out-of-pocket costs for his son’s checkups with a specialist who had performed a lifesaving liver transplant. ‘I could get balance-billed hundreds of thousands of dollars, and I have no protection.’

“Insurance companies defend the shift toward Medicare-based rates under the settlement, which allowed any clear, objective method of calculating reimbursement. They say that premiums would be even costlier if reimbursements were more generous, and that exorbitant doctors’ fees are largely to blame.” New York Times, April 23^rd. When “Obamacare” passed, the competitive alternative – government-provided health insurance – was clipped from the package to respond to the insurance lobby. The ability to buy cheaper pharmaceuticals overseas will clipped to respond to the pharma lobby. And even now, the Supreme Court may toss the program out, in whole or in part.

GOP presidential candidate Mitt Romney’s plan would let consumers buy healthcare plans and take a tax deduction for the premium. “While offering consumers more choices, Romney's plan would give companies strong incentives to stop providing insurance to workers. It also would overhaul the 46-year-old Medicare and Medicaid programs for the elderly, poor and disabled.

… The plan could swell the federal deficit; a similar plan backed by Sen. John McCain (R-Ariz.) during the 2008 presidential campaign would have cost more than $1 trillion over 10 years, on par with the price tag for the Obama healthcare law.” Los Angeles Times, April 23^rd.

There are millions still without healthcare, still caught in the trap of being “in the middle” where coverage is a consumer obligation. And while costs are moderating, the system is only getting worse in terms of general affordability. If we cannot protect even those with health insurance coverage from catastrophic losses, the system has collapsed. Even the most anti-government healthcare protestors find a different tune when they have a medical emergency that they cannot afford. We need to stop sloganeering, stop trying the easy fixes, and realize that America has one of the worst healthcare systems for its average citizens in the first world, and clearly the most expensive. We need competition without lobbyist carved outs, transparency and a reality check… and we need it yesterday.

I’m Peter Dekom, and I truly wonder how so many people who oppose government intervention on healthcare actually can afford the coverage they need.