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March 20th, 2009
How to Fix the Health Care Industry
photo credit: That Other Guy
The health care industry has a large target painted on its back, drawing ire from frustrated individuals and scheming politicians alike. Public anger towards this market is certainly justifiable, given how expensive things have become. Basic care now requires both your arm and your leg as payment, causing penniless people to clamor for somebody who will fix the system, once and for all. The cries for “change” amid an imploding economy will, no doubt, lead to further government intervention and regulation—effectuated with the noble intent of solving our problems, but only resulting in further complications and rising prices.
There are a number of things that can be done to improve the cost and quality of health care in this country, and they all revolve around one basic concept: allow the free market to work. This maxim, if implemented, will dramatically improve things in rapid fashion. Doing so, however, is politically unacceptable by most, as it requires government to step out of the way to large degree, and allow the consequences of freedom to be carried out unabated.
I believe that there are two important steps that can be taken to immediately and substantially improve the health care industry. First, individuals should only use insurance for large, costly, and unforeseen medical needs. Second, prices for all medical services should be advertised up front to the potential patient.
When to use insurance
To illustrate the concept behind this recommendation, we can look at another form of insurance. Chances are you have automobile insurance, which in many locations is required by law to have. Now, imagine yourself using your car insurance when filling up your gas tank, changing your oil, rotating your tires, or going through a car wash. These laughable scenarios clearly show that insurance is properly intended only for large, costly, and unforeseen problems. If you are involved in a car accident or your vehicle is stolen, that would be a good time to use your insurance. Anything short of something drastic and rare like that would only serve to inflate everybody’s premiums, since the menial tasks listed previously occur quite frequently. Other forms of insurance, such as home or life insurance, are equally understood to be only used in extreme situations.
This principle is well accepted when applied to inanimate objects that are easily replaced, but when you involve a person’s body and health status, the situation changes. Routine medical exams and procedures—basic and frequent services—are now part of any comprehensive insurance package. This, of course, nullifies the true intent of insurance, and instead turns it into a pseudo-insurance system of prepaid consumption. The end result of this (government-enabled) practice is the overuse of services which drives up costs for everybody; any subsidized service in demand will lower costs in the short term, increase consumption and demand, and in the long run ultimately increase costs and decrease quality across the board. Thus we see the net result of socialized medicine and government intervention into the (health) marketplace.
Removing government regulation and subsidization of insurance packages and premiums would be an important first step towards inducing people to seek out personal policies that would cover only large, costly, and unforeseen medical needs. A reduced general insurance coverage would lead people to more judiciously use the health care system, and this decrease in demand would inevitably lower prices for everybody’s medical care.
Where’s the price tag?
When was the last time you were told how much a medical procedure would cost? While some proactive individuals do the necessary research and inquiry to determine what their medical care will cost for each service rendered, the vast majority of people have no idea until the bill comes. Nobody in their right mind would fix a broken furnace, for example, without having a clue about the costs involved. Since the marketplace is largely intact in most other spheres of economic activity, you can shop around, view prices, look for discounts, and haggle with somebody on price. When does this happen with health care?
The day you see a price menu at your local doctor’s office is the day the health care industry self-corrects through free market forces. Today, health care is burdened with all sorts of hidden costs, astronomical hourly fees, and a veil of economic ignorance that suppresses any ability for market principles to improve cost and quality. The competition for business created by mutually understood prices and corresponding services rendered would cause health care prices to plummet overnight. Each doctor would be forced to lower prices and improve care and customer service if they wanted to retain business, whereas right now patient retention is largely shielded from the doctor’s hourly rate.
In the first suggestion, government should get out of the medical insurance regulation and subsidy business, and allow insurance companies and individuals to find the same equilibrium other forms of insurance have for so long. In the second, government should enforce contract law by requiring health care providers to publicly disclaim the terms of their services, which includes prices of all services offered.
These two actions, if implemented, would far exceed anything else the government has done or is currently trying to do to allegedly improve the state of our health care industry. Further regulation is not the answer, and less government—not more—will allow market forces to both improve quality and decrease prices, as occurs in so many other types of markets. How do we fix the health care industry? We start by an annulment of the marriage between the industry and “do-good” government.
The lesson is clear: when government and other third parties get involved, health care costs spiral. The answer is not a system of outright socialized medicine, but rather a system that encourages everyone — doctors, hospitals, patients, and drug companies — to keep costs down. As long as "somebody else" is paying the bill, the bill will be too high. (Dr. Ron Paul, Lowering the Cost of Health Care)
35 Responses to “How to Fix the Health Care Industry”
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Recently, my wife had her eyes lasered. As you know, such procedures are not covered by insurance. These businesses run completely on the free market. It was refreshing to see what medicine could be like if not inundated with strings attached by government or insurance requirements.
The place was spotless. There were couches in a lounging area with movies for the kids to watch while we were waiting. Everyone was part of the customer service department from the receptionist to the doctors (even ones not in charge of your surgery). They took the time to get to know our names instead of our patient number. It was all very personable.
I believe the new “boutique care” facilities are going for the same thing. They don’t accept any kind of insurance — even the government kind. And they do fine. If it is catastrophic, they don’t take those cases.
However, the costs are raised by three issues (these are things that the eye company stated in our interview).
1) Liability. ANY medical center has to pay through the nose for liability insurance because we live in a litigious society.
2) Regulation. While there are many safeguards that any doctor with sense would put in place, the government goes overboard where a 1% increase in safety ends up increasing the cost by 100%.
3) The rest of the medical industry has grown too expensive. Because of insurance and govt programs, the medical industry has increased in cost compared to constant dollars through history. Doctors and nurses in general make tremendous salaries. Thus medical school costs an arm and a leg. So, ANY doctors and nurses must make enough to pay back their student loans or get a proper return on their investment.
So, while the free market process would help, it appears that there is such a mixed bag that it would be impossible to convince someone not already open to the idea.
We also live in a society where medical care personell kill upwards of 80,000 people a year thru errors in practice according to a Harvard study a few years back. I suppose there has to be some sort of protection for patients.
My husband has been self-employed for most of the 30 years that we have been married. Due to the cost of medical insurance, and the need to provide our own plan, we have been using it exactly as you have suggested, here.
We have always HAD to choose a plan with a high deductible, but that IF something catastrophic, such as cancer treatment, ever became necessary – we would be covered. Rarely did I ever have the luxury to run to the doctor’s office for every little ear infection, runny nose, etc…
I have always considered ourselves very fortunate, to have raised such a healthy family – considering our health insurance situation. So, I agree – in the long run I think we did it right. Most general illnesses that people suffer – really do not require them seeing a doctor. Shocking as that may seem!
However, because of the extreme high cost of insurance, even for those of us in my type of circumstance – we are all vulnerable for allowing the government to come in and save us! This, is what we MUST not allow to happen, else we will ultimately find ourselves in BONDAGE.
It is astounding how difficult it can be to find out how much a medical procedure will cost. When a friend recently asked a doctor’s staff point blank what a procedure would cost, he was told that per their contract with his insurer, they were prohibited from disclosing that information.
My furious friend called the insurance company. He was tenacious enough to go through three levels of supervisors, where he was told that the doctor’s office was indeed correct. He was appalled when the insurance company explained that the contract also forbade them from disclosing this information, since the pricing for each procedure is individually negotiated between the insurer, the provider association, and the group (i.e. my friend’s employer). If that information got out, the rep said, it would jeopardize the insurance company’s ability to negotiate competitive rates with other employers and medical practitioners.
In other words, the cost of just about any medical service or good that is nominally covered by insurance is an industry secret that you are prohibited from knowing.
Imagine going to a car mechanic and getting that kind of song and dance. Well, it turns out that the auto repair industry used to work something like that. People got upset about it. As a result, auto mechanics are required to provide you with a fair estimate prior to performing any work on your vehicle. Apparently they didn’t have as much lobbying power as does our health insurance industry.
Actually, the health insurance industry used to work much as you suggest — only for catastrophic issues. Activists argued that this led to higher costs because it incentivized people to avoid early or preventative care that would have kept them from getting so bad that they needed major care. We bought into this schtick, and continued to do so over time, until we have ended up with the messy quasi-public/quasi-private socialized medical system we have today.
No matter how bad the problem is or what has caused it, there are those that claim that increased third-party involvement is the answer. Somehow, a large portion of our population always buys this argument. I guess that’s why it continues to be pushed: it is such a successful tactic for amassing power.
I don’t think the free market fetish is going to help this situation.
Market goods respond to market forces because there are alternatives. When you go to buy a toaster, they tell you how much a toaster will cost. If that’s too much, you can go somewhere else and buy a different toaster, or just not buy one. You can do donuts for a while. But when you’re sick, not getting better isn’t really an option. Your ability to get information will also be limited.
Another reason health care doesn’t act like a free market good is that there are externalities; that is, treating sick people benefits not only the sick people themselves, but also the whole community.
Health doesn’t really act like a free market good, and we shouldn’t treat it like one.
The cries for “change” amid an imploding economy will, no doubt, lead to further government intervention and regulation—effectuated with the noble intent of solving our problems, but only resulting in further complications and rising prices.
Can I remind you that Americans pay a lot more for health care? In other countries, where the government plays a larger role, more people are covered, and the costs are lower.
I think one problem here is that we’re mistaking health insurance for health care. Health insurers are a problem (IMO) because they make more money when they deny people health care. They eat up so many resources. I’d like to see that whole sector gone. I agree that the government shouldn’t be involved in health insurance. We’d see arguably better results if they were involved in health care.
One problem with insurance for catastrophic or expensive care only is with diseases such as asthma. Asthma is a huge problem among inner city kids who don’ t have the insurance to pay for their care. Therefore, their care comes in the form of ER visits and costly hospital stays and sometimes ends in death. Of course, the parents can’t pay for this expensive treatment and the hospital has to write it off and it ends up with care for everyone else becoming more expensive.
On the other hand, what these kids really need is good preventative care, which their parents still can’t afford, but which would be much less expensive for society than the hospital stays. It would also be much better for the kids if their treatment was aimed at their long-term care rather than the acute asthmatic attacks which can end up killing them.
Good primary care would be a heck of a lot cheaper for society on the whole for a lot of disease processes, than insurance for expensive procedures only.
How can we achieve the two goals above (transparency in pricing and responsible, moderate use of insurance) without regulation? The “free market” creates incentives for insurance companies to encourage rampant insurance use (and for people to cushion their medical costs through higher premiums for lower copays) and for medical professionals to lie about prices and hidden costs.
On a related note, we don’t need the government to get involved in the military! All we need is for people to stop attempting to take the property and resources of neighboring nations. QED. If we assume that people will take care of the problem by themselves (and I agree with your solutions), there’s no debate about government regulation in the first place.
@Daniel: what about buying food? What’s you’re best alternative to negotiated agreement if someone decides to charge you an arm and a leg for food?
Connor, you’ve identified the principles that I’ve been scratching at for a long time as a solution to this problem. Thank you for this insightful post
No offense meant, but such “solutions” remain naive and necessitate an unrealistic oversimplification of the challenges many Americans face when it comes to health care costs.
And two points: Gas prices are clearly displayed when you pull up to the pump. It has nothing to do with what that price is… not even remotely. And give your “use health insurance sparsely” speech to the self employed man who is broadsided by an uninsured motorist and hospitalized for three weeks, see what kind of response you get.
First of all, the point was that catastrophic events (like a broadsiding) SHOULD be an insurable medical issue.
As for the challenge: I was a self-employed businessman that had a catastrophic even happen (not a broadsiding, but forgive me if I choose not to share my medical history with a public blog).
I made too much money for public assistance. But I didn’t make enough to be able to afford medical insurance while still paying the bills. So I had no insurance. And I certainly didn’t have enough money saved to pay for all the bills that came in. I’ll just let you guess for a while what happened.
But even after that event, and in some ways because of it, I support Connor’s position even more.
I agree with Daniel that there is a difference between health care and health insurance. This is actually part of the differentiation that Connor was making. Doctor after doctor that I’ve spoken with have told me that the entire medical industry would be better if people only had catastrophic care.
Yes, there would be trade-offs (such as the asthma case that Curtis brings up) but no system will be perfect. This is why the medical industry will always be an area of controversy. We’d all like to have everyone taken care of for all conditions. But reality needs to be addressed. How are we best going to address it?
Most of the posts here (on all sides of the argument) make some very good points. It is not that anybody is wrong about their points. It is a question of judging what trade-offs we’re willing to make. I’m not willing to trade off my freedom to choose to help someone for the government forcing me to. And I have done my share of helping people out (even in catastrophic medical cases).
“And give your “use health insurance sparsely” speech to the self employed man who is broadsided by an uninsured motorist and hospitalized for three weeks”
Which is why you should carry Uninsured Motorist coverage on your auto policy.
@Daniel: what about buying food? What’s you’re best alternative to negotiated agreement if someone decides to charge you an arm and a leg for food?
Not a good analogy. The demand for food (as a category) is of course inelastic, but there are many different kinds of food that would satisfy your hunger. So there are alternatives.
When you have a broken leg (say), there’s only one kind of remedy: broken-leg-fixage. No alternative.
Daniel, I think you are over-generalizing. Yes, a broken leg can only be fixed in pretty much one way–but there are many doctors which can do it. In a free market system you could choose a more experienced doctor that charges more, you can choose a doctor right out of med-school that will charge less. You can go to a hospital that specializes in rehabilitation so that you not only fix your leg, but regain movement as quickly as possible. You could go to a hospital with hotel-type accommodations and pay more, or go to one much more simple and pay less.
A “broken leg is a broken leg” is only true in a tightly government regulated system. People get creative in the free market–that is how you survive and thrive. Government is notorious for robbing the incentive to excel.
Differing opinions are a dime a dozen, especially when it comes to heal care reform.
Not true. Insurance companies pay for this sort of thing, for the same reason that dental insurance will usually cover routine checkups “An ounce of prevention is worth a pound of cure”…..to borrow a phrase from Ben Franklin himself. They do it because it’s worth the investment-it just makes sense. The problem in the US is hardly an overabundance of routine checkups, but a LACK of them…. Discovering a disease early, in most cases reduces the potential costs and vastly improves the prognosis.
This isn’t an accurate comparison. Car insurance doesn’t pay for these things, because not doing so poses no risk for them in the future. No reasonable company would buy you a new engine because you forgot to put oil in the old one. Undiagnosed illnesses are a BIG risk for medical insurance companies…The point of insurance is to protect us from risks that we CAN’T control.
In response to Reach Upward:
In my own opinion, you’re confusing a lot of interwoven factors.
This might be true in a superficial sense. Back when health care only for catastrophic illness was the norm….say, the 50’s and earlier, people certainly WEREN’T healthier, on average. Respectfully, costs were low because people simply weren’t getting care, and even those that did were more likely to die anyway. No matter how you feel about it, death does tend to reduce health care costs….
Access to health insurance and health care directly correlates with reduced mortality and morbidity, and increased life expectancy. You’re going to have a hard time debating otherwise.
Likewise, the percentage of uninsured people in the US bottomed out around 1988, then began to rise, and i think the US has seen an unprecedented decline in life expectancy as a result.
Health care and health insurance are certainly complex issues.
I have some background in health care, having worked in Medicaid consulting, as a health insurance agent, and as a benefits analyst. I have heard proposed solutions from the government perspective, from the corporate perspective, and from other perspectives. Everyone has some idea on how to fix or improve our health systems. Most of them simply shift costs or responsibility from one party to another.
I have come to believe that the best solution is the one that seems the farthest from current discussion. That solution is for the federal government to move out of the health care arena, and for individuals, families, and communities to take back responsibility for their own health and health care. Connor’s ideas in this post fit in well with this solution.
This isn’t an accurate comparison. Car insurance doesn’t pay for these things, because not doing so poses no risk for them in the future. No reasonable company would buy you a new engine because you forgot to put oil in the old one.
Actually, I think that not changing your oil and not rotating your tires do increase risk of car accidents or other problems. The comparison may not be perfect (few are in economics), but it illustrates the point that health insurance today pays for things that are not included under the classical definition of insurance. Your own definition, Josh, is a pretty good component: “The point of insurance is to protect us against risks that we can’t control.” In addition, insurance is protection against circumstances that are unlikely, but that would strain our own resources if they came to pass. A house fire is a good example.
Likewise, the percentage of uninsured people in the US bottomed out around 1988, then began to rise, and i think the US has seen an unprecedented decline in life expectancy as a result.
Actually, life expectancy has continued to rise since 1988.
Dima: It is revealing that you do not see anything wrong with a hypothetical system where someone with a broken leg needs to ring around for information as to who would do the best job for the best price.
I know some people here can think through the consequences of their statements for more than like one second, but you’re obviously not one of them.
Daniel: Yeah alright, I concede that if you have a broken leg you aren’t going to be in much of the mindset to shopping around for a doctor. But I think you get my point. In cases in which you weren’t bleeding to death and actually had time to make a decision–you could choose between different doctors, accommodations, and prices. You already can–I live in Utah, most hospitals are under the IHC umbrella, but there is a independent hospital close by that I go to for any planned procedures as it is less expensive (I don’t have insurance so I actually look at the price tag).
Do you really believe that a highly controlled government system is going to help health care? I don’t know your political persuasions–but do you trust the Defense Department and the big dollar contracts they hand out to their friends? Do you trust that the CIA is squeaky clean? Why do we distrust a chunk of our government, but then when it comes to national health care we just throw our arms up and start cheering?
I know that the last thing we should do is compare our health care to other countries that have nationalized the industry…but lets do it anyway. I’ve lived most of the past 6 years in Russia. You can cite other problems that plague the country, but let me tell you, they’ve got a great nationalized health care industry. I had to get an X-Ray once–they did it for free. I had to get another one a little while later and this time the charged–it was about $3. I was happy. But this particular hospital didn’t actually have toilets. Yes, that’s right, this is a hospital–hundreds of patients, and they’ve got a couple open pipes to serve their sewage. Hospitals have been improving in Russia…but if you want good treatment, you had better go to one of the ever growing PRIVATE hospitals.
I’m not saying that if we nationalize our health care we’ll soon be using open pipes for toilets–but I think lessons from the rest of the world show us what type of system really encourages innovation and will actually reduce the real prices.
Some have been beating around the public good bush, more or less directly. So here goes.
Fact, free markets do not work in all cases. They break down in specific situations. The case where markets are worst is with public goods. National defense is a public good. If defense was privatized, then say I pay a firm to defend us from Cuban missiles. Cubans fire missiles and my firm stops them. Happy day! But my money stopped the missiles from hitting you, too. Shouldn’t you have also paid? You won’t though, because I’m already paying. I feel cheated, so I pay less, so on until not enough is spent on defense.
This brings up the two criteria for something being a public good. Non-exclusive and non-excludable. If defense is enacted one person benefiting from that defense doesn’t lessen the effect of defense on another. The defense is non-exclusive. If defense is enacted it is impossible to keep someone from reaping the benefits of that defense (short of moving the defense away from the coast, and letting CA fend for themselves) so defense is non-exludable. This makes defense a public good.
Now let’s look at health care. If public health care is enacted, does my use of the program lessen the effect on someone else? Yes, absolutely, a doctor treating me can’t treat someone else. Medicine I take can’t be taken by someone else, Money I use out of the system is not available to be used by someone else. Health care is exclusive, already not a public good.
If I pay a doctor to treat me, I can keep him from treating someone else. Medicine I take for myself I can keep someone else from taking. Money I set aside for my own health care I can keep from benefiting anyone else. Health care is excludable.
Thus health care is not a public good, and should never be treated as such. The comparison to national defense is null and void. Now someone said that health care brings externalities. While that may be true to some extent, it’s a fairly weak argument. If there is an externality then it is so indirect as to be impossible to pin down. To be clear, an externality is when the use of a good effects someone external to the market scope of that good, in a positive or negative way. Likewise, the extend of the use of the good directly correlates with the extent of the external effect. You might argue that the more health care is consumed, the healthier people are, and therefore the more productive they are, and therefore the more our economy produces, and therefore the cheaper you can buy oranges. You can begin to see what I mean with the indirection. If one could indeed pin down the exact extent of the externality, the proper action (in this case with a positive externality) would be to subsidize the good at the exact amount of the externality. This is not health care for all, this is not nationalized health care, so even if the externality argument holds any water, it is not a valid argument for public health care.
Actually, life expectancy has continued to rise since 1988
You’re right. Thanks for correcting me, forgive me for perpetuating another flagrant media myth.
It should be noted that US life expectancy still significantly lags behind Western European countries which have some form of national health insurance or national health care.
I personally favor the Swiss system…….That is, the government legally sets a minimum level of coverage, that all insurers must provide-they cannot sell anything less. They also can’t make a profit from selling basic insurance, only by selling additional coverage. In turn, legally, everyone has to buy insurance, the government pays a certain part of the premium if you cant afford it.
There are strong moral arguments that can be made for all of these criteria, against the moral hazard of government interference.
Most Swiss buy their insurance individually, like they would car insurance, not through their employers. They have no reason to do otherwise.
I have read through all these posts and one BIG part of this subject is not being discussed: Alternative Health Care. This needs to be put on EQUAL GROUNDS legally and ethically and technologically with MD’s. For instance, If present day herbalists were allowed to legally practice, diagnose and treat diseases, and had equal access to all the technology the MD has, you would see them BEAT them all in the curing and preventing of disease HANDS DOWN!!!! Give the MD’s some REAL competition
Recently my wife had her eyes lasered…..
How much did all that cost you Corborendum?
Simple eye exercises cured and I do mean CURED my nearsightedness and astigmatism. I am 53 years old and will never again wear lenses for any reason. My vision is now 20/5 and I am the only person my age I know of who does not need glasses to read.
This is just one example. I am also a cancer survivor, no thanks to chemo.
The food analogy was actually a very good one, since food is the only real medicine.
And about the broken leg example, we had choices of a new MD, and old MD, basic service, country club service brought up here. How about the broken bone cures of the Nez Perce Indians? They will have you back up and running in less than 3 weeks for nothing but the price of some plants.
No traction after an accident. No death dealing pain killers.
But you don’t know you have other choices, do you? That is because the current medical system is a government approved monopoly already, who do not intend that you should have any other choice but them.( and how that happened is quite an ugly story)
Alternative medicine is HUGE in this country because it works and it cures.
I certainly do not want any of my tax dollars paying for lasik surgery, chemotherapy, prozac, vaccinations, etc when I know there are superior alternatives.
Yes, life expectancy has risen, but have you been to a nursing home lately? Quality of life has gone way down.
And Curtis, as far as the poor inner city kids with asthma, that ‘disease’ is simply cured through purely natural, inexpensive means. But that would stop Big Pharma from profiting from their problem, wouldn’t it? so please keep taking them to those clinics so they can inhale those drugs for the rest of their life, and at taxpayer expense. What a deal.
Sorena, I would be very interested to take on any reading about that ugly story you mention, and those eye exercises (even though my vision is good, prolly 20/22 or so).
I too am a fan of alternative medicine. All growing up I was _very_ reluctant to take any medicines. When I was a teenager I would rather stay up half the night with a splitting headache finally falling asleep in the wee hours than pop a pill. Unfortunately I’ve become softer over time 🙁 but I still try pretty hard to avoid it. All too often I think the whole thing gets a bad wrap. All it takes is one really crazy story and the whole of alternative medicine is bagged as wacko. Talk about throwing the baby out with the bathwater.
You know what they call alternative medicine that works?
Alternative medicine that works is good, but an unregulated alternative medicine system would be a disaster. There are so many quacks out there. I’m a pathologist and I just saw a great example of this. I got a colon biopsy from a 6 year old autistic kid who had a rip-roaring colitis with huge numbers of eosinophils causing bloody diarrhea. Eosinophils react to allergic stimulus or to parasites among other stimuli. I assumed that it was an allergic issue until I heard that the parents had been giving the child parasite eggs as an alternative treatment for autism! This sort of quackery is a lot of the alternative medicine I see. Not to say there isn’t some good stuff out there, but it needs some serious regulation.
If alternative medicine wasn’t marginalized to quackery, then there would be more non-quacks engaging in it. That is to say, people could actually have honest conversations with eachother about what works and what doesn’t. Right now, a person who wants to try alternative medicine is written off, they are immediately part of the ‘wacko’ group and we wonder why some of them fall for wacko ideas? If alternative medicine were allowed to mainstream, then we would _all_ be able to see what works and what doesn’t.
How much did all that cost you . . .
It only cost an arm and half a leg 🙂
Simple eye exercises cured and I do mean CURED my nearsightedness and astigmatism …
I’m familiar with the eye exercises you mentioned. I’ve used them myself and I’m almost back to 20/20. But they will only work so well with limited time. My wife is (was) legally blind without glasses. Situational issues motivated us to do something more immediate. And all the reading I’ve done on the subject indicates that it only helps so much. When you’re up as far as my wife was, it wasn’t going to cut it.
I view alternative medicine as exactly what the name implies – an alternative. There are good things with mainstream medicine and good things with alternative medicine. I study each issue out for myself and I pick and choose with each issue. There are herbal remedies I’ve found have no basis in fact. Others make me wonder why doctors don’t use them more.
Regarding mainstream medicine vs. alternative medicine: My biggest problem is that pharmaceutical companies (and indeed much of the medical industry) focuses on treatment rather than curing. Why would a pharmaceutical company want to develop a cure that gets sold once when they could develop a treatment that will keep the patients paying more and more?
The only motivation for them to find a cure is if there isn’t enough money to keep people coming back for more. If the insurance industry keeps paying more and more, big pharma will be willing to take the money. If there isn’t enough money for life-long treatment, then patients will get wise and realize it is a scam. But if someone else is paying for it, they have no motivation to insist on a cure.
Alternative medicine has two very different spheres.
One sphere essentially takes the natural active herbal ingredients in medicine, emphasizes personal exercise and complete health rather than treating a limited range of symptoms from one condition. I respect this field, though their methods vary in individual effectiveness just like an MD’s. I know how well mullen, curry or garlic can help the sinus/throat system, and tea tree oil is useful for seborrhea. And muscle testing can be uncannily accurate though I’m still on the fence there.
But a lot of people make you repeat mantras, wave their arms in front of you or tell you to hum. Evidence may later suggest that some unintuitive procedures work, but I equate much of the “I GOT CURED!!!1!!” hysteria I see sometimes to people praying to saints or keeping lucky stones in their pockets (Note: Not you personally, Sorena.). I’ve been screwed over by enough alternative medicine practitioners my parents got some sort of placebo effect from and drug me to to have my skepticism. You know the people – they’re “cured” every couple of weeks until the problem comes back and they see a new doctor and get “cured” again.
Some topical humor:
I am late to the discussion here. I really enjoy your blog Connor because it seems that most people can calmly discuss their sides of issues. It is refreshing to say the least!
IF – and that is a huge IF your idea of free-markets running health care would work, that would be great. (I personally believe unregulated free markets often only benefit the gifted or already wealthy – but that is a-whole-nother can of worms) BUT – you say that it will never happen because of the country we live in. SO – how about trying to find a solution that WILL actually help people?
Should certain people be consigned to poverty simply because they were born with medical conditions that others were not? That doesn’t sound right. I don’t want to live somewhere where only the healthy and highly-intelligent people get to succeed.
I agree that people use doctors less when they have to pay out-of-pocket, but that is a big problem. Many people who make enough money they don’t qualify for current government aid can’t afford their own insurance (even high deductible plans – have you check the premiums for those as people age?) wait until they are very sick to get treatment. And then it is super expensive, they can’t pay, and the costs get distributed to those with insurance through higher overall medical costs.
I don’t know the best solution – I won’t pretend that I do. I do like the discussion here. Very open, honest, and beneficial. If only our representatives could actually speak like this (ahhhh we can dream). I do know that something needs to be done. There are a lot of ideas floating around. Maybe they aren’t perfect, but they could help.
Have you ever been truly sick? I mean truly ill where you couldn’t work for months or years, but you were too poor to see a doctor? This isn’t a catastrophic event, but it is nonetheless one that needs insurance. A measly $1000 medical bill here or there to someone with a good job is a nuisance, but not a burden, but give the bill to someone who is barely able to pull themselves out of bed to go to their menial job and it becomes a financial burden, an emotional burden, and the weight of the stress adds to the physical burden. Shouldn’t we try to help these people? Or are we too callous and feel that “their lot is their own”? I can not call myself a Christian and not try to find ways to help people get appropriate medical care.
Should certain people be consigned to poverty simply because they were born with medical conditions that others were not?
Absolutely not. We as private citizens can and should help them. Redistributive social government policies, though, are not the (moral) answer.
I don’t want to live somewhere where only the healthy and highly-intelligent people get to succeed.
I rarely think this is the case. Utopian socialists and closet Marxists often try to pain the issue this way (I’m not saying you fit either of those labels), pitting the poor, working class against the rich elites. But the fact remains that wealthy people create jobs, and poor people would have even less of a chance were it not for capitalists, investors, and wealthy individuals.
This isn’t a catastrophic event, but it is nonetheless one that needs insurance.
That depends entirely upon insurance companies choosing to offer this type of coverage, I think.
Shouldn’t we try to help these people? Or are we too callous and feel that “their lot is their own”?
Absolutely, but this question delves into the stark contrast between socialism (force) and charity (voluntary). By creating a system in which people are taxed to distribute wealth and create a system of entitlements, charity is discouraged since people defer to the existing (albeit corrupt and broken) system. I would wager a good sum of money that charitable acts and giving would skyrocket in this country if all forms of social welfare were eliminated outright.
NO SYSTEM IS WITHOUT PROBLEMS.
It is a question of which problems are more acceptable than others. If we had an abundance of resources in proportion to the demand, of COURSE we’d offer free medical care to all. But the reality is: WE DON’T.
I want to help the poor. And I recognize that I have been very blessed in my life, so I have. I give as much as I can. I’ve personally helped people I know directly. But I can only do so much. The reality is that all the rich people in the world cannot pay for all the medical demand there is in the world. Otherwise socialized medicine would not be hurting as badly as it is in the countries where it exists.
There are a few exceptions. But give it a generation or so, and it WILL devolve like it has everywhere else.
I called my German cousin who lives in Texas now. She said she loved the socialized medical system there. Germany was wonderful. (half our family is socialist, the other half libertarian–you can guess how we get along at family reunions).
But then I asked questions about the quality of service, length of wait times, emergency room procedures (she’s a nurse, and her mom is a nurse) surcharges, etc.
She said that the just recently started adding co-pays to their services because the system ran out of money and their taxes are already much higher than ours. The wait times for an appointment are about the same or longer than they are here under our “broken” insurance system. The biggest problem is if you have any women’s issues including pregnancy. It’s not unheard of to not have an appointment before the baby is born.
Once you have an appointment, your wait times are anywhere from a few minutes to longer than the horror stories we hear from England. It’s all potluck.
She told me that the extent of most dental appointments was,”So, you have any teeth that hurt? No? Ok, see you in 6 months.” Uhm?
So, on the one hand, she praised the system saying it was wonderful. But when I asked the details of this “wonderful” plan, she seemed to indicate it was much worse than our “broken” system here.
Soo… Why was it wonderful?
Don’t forget that the wealthy are only that way because a host of other people enable their lifestyle.
Don’t get me wrong. I am not against wealth and I feel that American’s general nature toward self-determination and entrepreneurship are some of our greatest qualities. I just think there can be a form of health insurance that helps more people. I am not for single-payer systems, I am not against doctor’s having incentives to go to medical school. I just think that realistically, the best we can do is help provide basic insurance to more people.
Don’t forget that the wealthy are only that way because a host of other people enable their lifestyle.
Yes, but through voluntary association. If they render me a good or service for a price I agree to, then I can’t complain that they’re becoming wealthy by taking advantage of me. Steve Jobs is making a good deal of money, but I have no problem with it; I like my iPhone and agreed to pay the price required.
I just think that realistically, the best we can do is help provide basic insurance to more people.
I think it would help, Amber, if you clarified who the “we” is in your wish for more widespread insurance. Do you think the government should subsidize insurance for the poor? Or are you in favor of charitable organizations that fill this need?
Again, I think it comes down to force or charity. If your “we” is you, me, and other individuals acting of our own accord and through free association, then I agree 100%. But if your “we” is the government, then I strongly disagree on grounds of opposing any and all forms of socialism and false charity through taxation and threat of fine and imprisonment.
Remember that when you say “unregulated free-markets” that is a socialism buzzword. I don’t think anyone in their right minds believes in unregulated free-markets. There will ALWAYS need to be regulations. Heck the idea of having a contract between parties is a type of regulation.
(BTW, I knew a guy who was for completely unregulated free-markets. But he really was out of his mind–on a number of issues, like keeping cockroaches as pets–dont ask)
The question is whether the regulations encourage the strengths of the individual or not. If you accept history, socialism may start out good, but it eventually encourages weakness rather than strength. Capitalism encourages strength. The appropriate regulations for capitalism will discourage ruthlessness and predatory practice.
Notice I used the words “encourage” and “discourage”. I don’t think any regulation that “requires” certain actions, behaviors, or attitudes is good ragulation. The only exception is that for capitalism to work, you have to have HONESTY. Or else it is fraud or theft.
Socialism encourages dishonesty and discourages freedom and innovation.
This article has a few good ideas, one of which I elaborated on in this post.
I was at a meeting with my State Representative last night, and this subject (naturally, what with ObamaCare in the limelight) was a major topic of discussion. He supports (as do I) opening up the system to market influences so that consumers become more involved and informed. For example, Health Savings Accounts empowers people to use their money more judiciously, and thus ask questions (such as how much a procedure costs). Additionally, when paying with HSAs (or cash), providers will sometimes offer steep discounts since they can then avoid all the insurance rigamarole that they would otherwise have to wade through.
I brought up my point above, that being that government should be able to enforce basic contract law and require companies to disclose prices for services offered. He countered and suggested that this would naturally happen if market forces were at play; if we reverse government micro-management and can find ways to empower citizens to be responsible for their own money, you won’t need legislation compelling companies to do this—it will naturally occur. I agreed.
I thought people might be interested in this article from the American College of Surgeons.
And you want this guy to guide our medical system?
Wow, what a discussion! Health care reform is a big issue on my mind right now because my family recently switched from being covered through large corporation health insurance to self-employed insurance. I am in a position of wanting health insurance (because I value the peace of mind and security it gives me) but not being able to afford it. I agree with Connor that the solutions should come [mostly] from consumer demand and not government intervention. However, in a complete capitalist/free market the big dogs can easily take over which is about where we currently are with health insurance providers anyway. Time to put those dogs on a leash.
Carborendum said it best”Capitalism encourages strength. The appropriate regulations for capitalism will discourage ruthlessness and predatory practice.” ie We succeed best under appropriately regulated capitalism. So what are the appropriate regulations that will still allow for competition? I don’t really know what would fit our country’s needs best and I’m interested to hear long term effects of ideas I’ve heard. It seems like open discussions like this are a place to find a well-rounded solution so I’m going to bring up one of the problems I see.
One of the items driving up prices is the necessary humanity of giving health care to those who can’t afford to pay for it and don’t have insurance to cover the costs. Obviously we don’t want hospitals just turning away somebody who needs a life saving operation because they don’t have the money, which is what would happen in a true free market. But these people are causing our insurance premiums to increase because hospitals/insurers simply spread the cost to their consumers rather than take the hit. I don’t blame them, they are running a business not a charity. Maybe it would help if everyone was by law required to have at least some minimal level of health insurance the same way we are required by law to have car insurance. This would bring up an entire new set of obstacles but would at least help to pay for some of the costs. Perhaps we should have both private hospitals and government hospitals where people who have insurance get the perks of being able to pay for good health care while the people who don’t have to go to crappy government run facilities, eventually anything provided for “free” by the government turns into crap. I can also see this suggestion ending with extremely high insurance premiums and centralized government health care. Or maybe to help decrease the costs of people getting “free” health care they should be required to pay enough to cover all or most or at least some of the real costs. I mean the basics like the two bags of blood they needed pumped into their systems, the seven stitches required to close their wound, and etc.
It’s only natural that if somebody can get it for less or for free they’ll choose that option. So we need to somehow discourage people from getting “free” care because they will and do take advantage of it. Then it increases overall costs and the number of people who require “free” care increases because they can no longer afford insurance. We also need the private insurance companies to compete with things like Medicaid. Currently I am struggling with the pure fact that I cannot afford to insure my children’s health with anything but Medicaid. I’m scared that if I put them on it then I will never have incentive to get off, will I avoid earning too much money to be covered by Medicaid and become trapped in poverty? I plan not to do that, but it will be hard to switch from free/cheap with great coverage to not so cheap with less coverage. However, if a private insurance company was willing to provide similar service for a similar price I would hands down choose the private insurance over government insurance.
Connor brought up the idea that health insurance be used to cover only the large and costly problems instead of all routine visits. This would probably help to lower the cost of premiums via lowering the costs insurance companies have to cover, but the problem which was also brought up is that then people wouldn’t take part in preventative care because they wouldn’t want to pay $70 for a check up. I don’t blame them! Connor, you suggested to me that we look into getting a Health Savings Account (HSA). I like the idea that I would have more control over where my health care money is spent. I think that having an HSA for routine care in addition to health insurance for more costly events would give people both security that they have the money available to cover routine visits and also make them more responsible in looking around for lower prices in non-emergency situations. This is actually what I am leaning towards doing except that at the moment I still can’t afford both an HSA and catastrophic insurance. It’s about the same as having a regular insurance policy.
It would probably be difficult to convince the large group of people who are satisfied with the insurance coverage they get through work to change to a system that requires them to think a little harder about where they get routine check ups. But, for those of us who are self-employed and getting taken for a ride or excluded by insurance providers we need that kind of a healthy solution.