William Thien

Recently there have been a large number of stories in the local media about people suffering exorbitant bills due to health care they have received and it seems to me that The Affordable Care Act may not be living up to its stated objectives. I don’t fault anyone for that, though I was pointing out the fact that the ACA isn’t socialized medicine when most conservatives had missed that point during initial debate on the legislation and were in fact calling it socialized medicine, when in fact it is merely a private health insurance gimme with a sensible tweak to it such as the “No exclusion of pre-existing conditions” clause.

And so I thought I would revisit one of my earlier observations on the state of health care in The US with a global perspective on socialized medicine. Here it is:

I participated in a healthy debate on an email list about socialized medicine versus privatized medicine in 2004 and 2005. A fellow conservative had remarked that Canada’s health system required long waits for substandard care and concluded that all socialized health care programs produced the same results.

At the time I was paying for my own health insurance to the tune of about $6,000 per year. But when I went in to have some blemishes removed from my skin where my backpack straps (I like to hike) rubbed them, which was painful, the health insurer said it was a “pre-existing condition” and refused to pay for the doctor’s visit. Upon discovering the greed of the health insurer I stopped paying the monthly premium and was in fact better off by about $6,000 the next year. But people need health care.

The online debate I had caused me to use my own situation as an example and to examine what indeed the realities of socialized medicine were in other countries and then make a comparison to our own.

The first thing I learned was at the time people in Canada lived longer than people in The United States. So, in order to begin a somewhat scientific study of whether or not socialized medicine is better or worse than the system we have here in The United States, I had to have a control, a reference point, something to anchor the discussion so that I could use it as an example as the discussion proceeded. I decided to use “longevity,” or how long people lived.

It was astonishing to me to hear all of the negative things about Canada’s socialized medicine and then find out that in fact Canadians live longer. How can that be, I asked myself? How can it be that a system which is supposedly less efficient, and less expensive than our own as you will see later, how can it be that such an inefficient system would help their population to live longer? I mean, you would think that something that doesn’t work as well would produce less effective results. People living longer indicates efficiency when it comes to health care I believed, better results. So, I chose from the get go to use “longevity” as the reference point to determine a system’s efficiency.

Then, I went to several web sites that list statistics about the various countries on the planet, and perused The CIA Fact Book as well, a book which compiles information about every country to include the size of the country, its population, etceteras.

What I discovered is that in many countries with socialized medical programs, the people live longer, not just in Canada. I was flabbergasted. I’d been hearing all of this negative political rhetoric about how socialized medicine is a failure, yet here it was that many countries with socialized medical systems had populations that lived longer, in some cases, close to a decade longer. A decade! That’s significant in terms of statistical observation. Remember, I’m trying to be a little scientific.

Then, I tried to gather as much information as I could about the cost to each person of the socialized medical programs in each country. This was more difficult, but I was able to determine that the costs ranged anywhere from $3,500 to $6,000. Again, complete surprise. I had the impression after hearing all of the debates at the time that socialized medicine would cost the individual $20,000 or more, much like it costs the elderly here in The United States. No such luck. It happens that socialized medicine is actually much less expensive to administer than our own system of medicine.

What!? You say WHAT?!

That’s right. Socialized medicine is much less expensive to administer than our own system of medicine where, by the way, many don’t even have health insurance in the first place.

How can that be, you ask? How can socialized medicine be less expensive? It involves the government. The government always costs more. True. But as you will see, in this case, there is somewhat of an exception due to the complex nature of our own system of medicine.

For one thing, we are actually paying for several types of systems at the same time here in The United States. In a socialized system, you are only paying for one system.

The bureaucratic mess involved in administering the variety of medical systems in The United States means that many more dollars actually go into the administration of the system instead of the administration of the medical care and medicine. In other words, you are paying bureaucrats instead of doctors.

Well, what do you mean we are paying for several types of systems here in The United States?

For example, let me use myself as an example, again. Today, my employer sends me a statement of benefits at the end of the year whereas before I paid for my own health insurance. Last year my employer paid $11,000 for my health insurance (quite a bit more than the $6,000 I paid several years ago, which means the costs are skyrocketing). But not only did my employer pay $11,000, I paid in to Medicare and Medicaid and Social Security as well. Social Security also has a medical component to it. So, not only does my employer pay for my health insurance, I pay for three socialized medical programs myself. And this is just at the federal level. My state has three socialized health care programs. Some say the cost to administer that bureaucratic mess is immeasurable. Needless to say, it’s huge! Gigantic. But more importantly, it’s inefficient, much more inefficient than say just having one system, or socialized medicine countrywide.

When I total up all of the input costs to my health care, the $11,000 my employer paid for my health care last year and what I paid into Medicare, Medicaid, and Social Security, the cost is approaching $15,000. Today, socialized medicine in countries that have it, where they often live longer, is about $4500 to $7000, or about a third to one half of what it costs in The United States. And I’m just summing up the federal dollars that I pay and adding it to what my employer pays to the private health care insurer, and not adding what I pay to the state. That may approach $16,000 to $17,000, or two and a half times what people in countries with socialized medicine pay. Wow! That’s a lot of money.

Does this mean that we should move to a socialized health care system? Not exactly.

One of the things that I noticed in my somewhat scientific investigation is that there is a big fat guy in there that, were he properly regulated, medicine in The United States would be just fine, much less expensive, much more efficient. That big fat guy is The Health Insurance Company. Here we have a big fat middle man between America and its health care, a middle man that often tells the individual who pays dearly for the insurance that they are not covered due to a “pre-existing” condition, or that procedure is not covered because it is new, or that the prognosis is that you will only live three more months so they have decided not to approve the surgery.

In countries that have socialized medicine they have discovered something about efficiency in providing health care. Get rid of health care insurers. If you have a business, everything you do to structure that business is designed to make that business more efficient. You don’t have a special division of your business that doesn’t do anything related to that business. In this case, that would be the health care insurers. One thing health care insurers don’t do is provide health care services. They don’t treat patients, they don’t administer medicine, yet they are enormously costly. Countries with socialized medicine have recognized that fact and removed health care insurers from the health care equation. And guess what happened? The costs dropped dramatically. You can still purchase your own health insurance policy. But it’s not a law that you have to do so.

Since we live in a free market economy, that is really not an option. Or is it?

One of the major problems with health care in The United States is that big fat guy, health insurers, is not properly regulated and his weight is unhealthy for America. What we could really use is proper regulation of health care. After examining the issue on both sides, I’m convinced that is the answer, along with a couple of other minor tweaks that you will discover later.

Health care is not like other things. If you don’t have your health, you don’t have anything, the saying goes. Perhaps that is true of a country and its health care. And maybe like the historical relationship of the church and science, maybe health care and profit don’t make for a healthy marriage. Maybe there is something diabolical about profiteering so thoroughly as health insurers do from someone’s sickness, maybe not. But it sure is big business, in fact, one of if not the biggest in this country. In the last decade pharmaceutical companies have often been the most profitable businesses. Guess what else is in the top ten? Health care insurers. Nothing wrong with making a profit, unless it is making everyone sick. And I’m convinced that is what is happening with health care insurers.

So, from my perspective, the one measure to come out of the current administration’s health care legislation, the result of that big all-consuming discussion we all had at the beginning of the current administration, the one element that is of any value is that health care insurance companies can no longer say something is a” pre-existing” condition. This is an excellent example of the proper regulation of an industry that has been acting like a anti-societal monstrosity.

Yet, from my perspective also, I don’t see any benefit to making it a law to have to purchase health care in the first place, which was also an element of the current administration’s health care law, especially now that doctors are starting to offer lower rates if you don’t use health insurance. See how the health insurers have wheedled their way into the health care equation for good. Now, by law we are going to have to buy health insurance. Clever bunch those health care insurers. Pulled the wool right over everyone’s eyes in Washington.

I am not certain when the term “pre-existing” condition came into being, if it was an invention of some clever business school graduate brought on at one of the health care insurers, but that one term has increased the profits at health care insurers dramatically, I am sure, while it has simultaneously brought down the quality of health care in The United States, brought it down to that of a third world country in many instances. At one point I heard that close to forty percent of the population did not have health insurance. Well, why not just scrap it altogether, then? Something obviously isn’t working. Quite the opposite.

Outlawing the “pre-existing condition” status was in my opinion the one thing to come out of the current legislation on health care in this country to be of any measure. And it is an example of proper regulation. When the law says a corporation “must” do everything in its power to increase its profits and satisfy its shareholders, you will get things like the term “pre-existing condition.” Therefor, you must properly regulate against such behavior, and in this case, you must properly regulate health care insurers in general if you want costs in The United States to come down.

Furthermore, in reference to tweaking the system that I mentioned previously, it used to be that health care providers could not advertise their services as they can today. Advertising is not cheap, it’s expensive. All of those costs are incorporated into what you pay for health care. Do you think providers just throw that money out the door? No, the health care industry transfers those costs to you. So that brings health care costs up incredibly. In a “one system” form of health care, privatized or socialized, you make the choice, you would likely remove that part of the cost equation as well.

Finally, and perhaps most importantly, it is much less expensive to administer one health care program in comparison to administering three or four programs at the federal level and then several again at the state level. One program for everyone and you will see the costs plummet. People will have more money for everything. The economy would likely flourish. Even major auto manufacturers and other industrial giants have said that health care costs are putting them out of business.

And, as a conservative I have to ask the question: Is having a government-run health care system comprised of multiple and perhaps likely redundant systems of care at both the federal and state levels actually better than having just one government-run system? The obvious answer is no. Having one system would be the better choice.

That is if a conservative can even accept having socialized or government-run health care in the first place? If in fact having one such system is much less expensive and more efficient than the multiple government and private systems we have today at such great cost, then of course the answer is a clear and definite yes, regardless of whether or not the system is totally government-run or private. It would be by default the most conservative system.

There are of course the questions which remain as to whether or not such a system could work in The United States. But we ought not to let the media front men decide that question for us.

In my opinion, if we want to lower health care costs in The United States we need to switch to one system and only one, whether it be private or public, into which everyone pays, and properly regulate that system. In that way, we will simplify and therefore decrease the administrative costs and insurance costs and everyone will likely live longer, as they won’t be sweating the cost of going to the doctor in the first place.

Copyright © William Thien 2011, 2105

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