Larry Bradley's Weekly Ezine #58 Piracy and Hostages
1. Piracy and Hostages
2. College World Series Tickets Available
Piracy and Hostages
1. Much has been in the news lately about pirates and hostages as if the phenomenon was something new. Actually, the American public has been the hostage of a pirate called medical insurance for some time.
(By the way, kudos to those Navy Seal sharpshooters. My bet is the public was given the sanitized version of the rules of engagement, i.e. only shoot if the Captain’s life is threatened. That’s their story and they’re stickin’ to it, which is fine with me. The more probable rules were—shoot when you have simultaneous line of sight on all three pirates with no chance of collateral damage to the Captain and when you shoot, shoot to kill. Remarkable shooting, really, when you consider having to continuously coordinate three shooters and they’re probably shooting from the prone position on the deck of a ship with the sea making the rifle sights roll up and down. Over time, however, the pirates and the stars aligned with the sight pictures and we had the ending we did.)
Now, let’s go back to medical insurance and making the case for being held hostage. If you are someone with a medical condition so severe you can’t change jobs without losing your health insurance, then aren’t you being held hostage by your medical insurance? Think about how many people are in this country going through the motions in a job they hate because they can’t afford to lose their medical insurance. In one sense, those in that situation have gone beyond being hostages to being slaves.
If we Americans want to talk about needing a surge in productivity to help get us out of the economic doldrums we find ourselves in, then perhaps one way to achieve that surge would be to free workers to seek the work they crave by making their health insurance portable. We’ve already let you keep your cell phone number when you change cell phone carriers. Let’s fix it so you keep your medical coverage when you change employers.
You can hear the naysayers already, can’t you? “We don’t want socialized medicine,” they say. “Don’t let the government get between you and your doctor.” Or finally, (and even worse) “You keep the government out of my Medicare.” Would anyone who has made that last statement and actually believes it please contact me? I have some ocean front property in Western Nebraska I want to sell to a special buyer and you may qualify.
With regard to letting the government get between patient and doctor, here’s a dose of reality. There is already someone between patient and doctors—insurance companies.
I wrote earlier this year this is the 10th year since . . .
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Categories: Politics, Weekly Ezine
Tags: Health Care Reform Piracy Medical Insurance Hostages
Max Skidmore had several comments on my Ezine about Pirates and Hostages he sent to me on email and gave me permission to publish here. Here is our dialogue.
Subject: Re: Larry Bradley's Weekly Ezine Number 58
Larry,
Now you’re hitting on another of my specialties, the politics of health care. It’s a superb column. The president is proposing a program designed to lead ultimately to universal health care. It consists of several options for citizens, among which is a public program, or an expanded Medicare. Opponents are charging that including a public option is unfair competition, that it would force private companies out of the picture, since they couldn’t compete. In other words, a public program is more efficient, and does not have to make a profit. The opponents say “unfair competition;” I would say that if they cannot compete, that speaks volumes. If a public program costs less (and they do) and if it has no obligation to make profits and pay huge salaries to administrators and investors (and they don’t), then that means that it would free up more dollars that would go to provide health services. If that is “unfair,” then I am all for such “unfairness.”
As you have discovered, we (alone in the industrialized world) not only have large numbers of people who have no coverage, we have many people who think they are covered (and who therefore may not be interested in universal care) who are not covered at all, in that their companies can deny payment. I knew one couple who had a Humana policy that explicitly discussed maternity benefits. When she became pregnant, the company pointed to a very obscure clause far back in the fine print, that denied maternity coverage. Their lawyer said it was certainly misleading, if not deliberately so, but they had no money to pursue a lawsuit. Fortunately, because it was a pregnancy, and not another condition, they found Medicaid coverage under Schip (President Obama recently signed legislation expanding coverage under that program; President Bush had vetoed it, because it might permit some patients to opt for government coverage when they could otherwise have private insurance).
Your comments are consistent with my point that our system presents an inherent contradiction: it relies for help (coverage) on institutions that make a profit by denying services, rather than providing them; in other words, the more claims they can deny, rather than pay, the better their bottom line. Medicare presents no such difficulty. Why isn’t this obvious, even to ideologues?
Good work,
Max
Max,
Thanks very much for your comments.
I really like how you point out the contradictions between for profit and not-for-profit. What would you say to the inevitable argument government will eventually become inefficient because government has no competition?
Would you mind if I posted your remarks on my Blog?
Larry
(To be continued)
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Here is the remainder of Max Skidmore's comments about my Ezine #58, Hostages and Pirates.
Subject: Re: Larry Bradley's Weekly Ezine Number 58
Well, there are several answers to that argument. First, experience demonstrates that it isn’t true; in health care, at least, govt. programs here (and around the world) are far more efficient than private programs. Second, the competition argument can be compelling, but in the real world, there isn’t true competition in the private market. How many people would elect to go to one hospital over another because it costs less? Or, would anyone elect an insurance policy because it costs less, unless OTHER THING ARE EQUAL? That is, isn’t the criterion for selection a good buy for the coverage one needs? Certainly, restricting coverage can lower cost, but to what end? One could wind up facing bankruptcy (or death) because the coverage needed isn’t there. That raises another point. “Competition” inevitably involves cost-benefit analysis—at least for the intelligent and well-informed consumer. Yet with regard to health care, it is impossible to know what one will need in the future—it isn’t that one simply can extrapolate one's current health status for decades. I, for example, always thought I was bullet-proof, only to be shocked to discover a dozen years ago that I had prostate cancer (I’m OK now; my PSA is zero). Had I been offered a chance to save great sums by foregoing that coverage, I might have done so (probably not, but many people would).
Also, I argue that there can be effective competition solely within the govt. sector. My solution is to shore up and expand Medicare and make it available to all, and also to expand the Veterans’ Health Administration (or create a parallel agency along the same lines, one that would provide the superb care that VHA provides, but that is adequately funded) and make it available as an alternative. Someone who wanted complete coverage could opt for the full-fledged “socialized Medicine.” Those who prefer fee-for-service, choose your own provider, traditional American medicine could go into Medicare. Then the two systems could compete, and executives could be rewarded based on their performance.
As it stands now, American private medicine, certainly including HMO’s, are hardly models of efficiency, even though there is a private, competitive, market. Thus, I argue that the basic question is rooted in a misunderstanding. It is framed around a set of incorrect assumptions: that competition always is better, that competition can exist only in the private market, and that competition is assured if only there IS a private market (especially with no regulation—I say regulation is essential or there CANNOT be competition).
Max
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