Monday, May 11, 2009

"Free" Healthcare or "Raise Taxes?"

Obama says that 45 million Americans are without health insurance. Just tragic! Right! Is he talking about the 60 million kids under the age of 15? Or the 80 million people between the age of 15 and 34? Then there is another 100 million are between 35 and 59.

This number of people “neglected by our health care system” is probably severely mis stated. I assume that they can’t pay for it themselves. In order to cover them, those of us that pay for health care insurance must pay more since they can’t.

Add it up; there are about 140 million people under the age of 34 that really don’t need health insurance. Why not? They are healthy. Health insurers give them a very good rate on insurance. This is called the gravy boat, money coming in and very little going out. Under Obama’s plan, their rates could triple.

Have you had two heart attacks, want health insurance and wonder what your rate will be? I don’t, we know you can’t pay it.

Just been in a shootout with the police and have critical wounds and no insurance, who pays the bills? By god these people need health insurance, 300K to 400k worth just this week alone.

From an insurance concept, you build up an actuary table and figure out what everyone has to pay to get health care over their lifetime and charge accordingly. Presently it looks as if we need about 200K to 600k just for an elderly person. We are not talking rest home here, that’s extra. So if you work 40 years, that amount to about $5,000 to $15,000 per year in health care taxes. Since we have to cover those already old, double the amount to say $10,000 to $30,000.

Right now, everyone over the age of 65 has a blank check for health care and they never paid a dime for it.

People that end up in the emergency room are also entitled to free health care (they don’t have to pay for it). This concept of free care is about to shut down emergency rooms nation wide.

Then we have people on Medicare. The government pays $2,000 per day in Chemo therapy for people dying of cancer. Price is no object.

Currently we have a budget that needs more tax revenues. The country will not stand for a tax increase. Well, let’s give the masses free health care. That means we can take the 180 million people between the ages of 20 to 59 and charge them for this added benefit. $5,000 per person per year for health insurance would raise about 1.8 trillion dollars per year. And the employer pays half—oh goodie. That way, we can pay for the 48 million people already eligible for Medicare.

The question arises, does government need money for health care or for operating expenses? It’s kind of like hiring a hooker to solicit customers at a blood bank. The bank takes a quart instead of a pint. And you’re now more worried about making it to your car without collapsing, rather than the good time you had in mind. There is a fine line between what a hooker does to you and what the government does to you. The results the same, but only one will leave a smile on your face.


Sackerson said...

I think we need a health strategy, not healthcare; i.e. an ounce of prevention... How to reduce the destructive temptations of alcohol, and Garfield's diet? When cars get too expensive, at least people will walk or cycle more. Maybe the economic crackup, if it takes us back to the 50s, will improve our health, as (reportedly) a degree of wealth reduction for the richer types increases happiness scores.

I do hope that not every attempt to help those in need will be attacked as covert communism. 82% of Americans are Christian, and look at Acts 2, vv 44-47 - sharing is a Christian concept.

Socialism's horrible mistake is to think you can do without the socially unifying spiritual aspect - all that does is let in the cynical power-seekers. Well, we've seen that happen with wealth accumulation. What do you think Paulson, Goldman Sachs and the rest of the wrecking crew really believe in?

Jim in San Marcos said...

Hi Sack

Welcome back

I agree government should stay on the sideline.

The main point that I failed to cover in that article is the fact that we have to set limits on what each individual can draw on these government health care plans. When cost is no object, you want it all.

It reminds me of the neighbors dog who got hit by a car, do you pay $2,000 for surgery or get a new dog? If you have insurance, you don"t have to make the decision.

If you eliminate price out of the equation, you have in fact guaranteed unlimited medical services which is not a sustainable government budget item.

We do have free health care here, you go to the emergency room and wait 5 hours to be treated, whether or not you have insurance. And if you are really sick, 5 hours is a lifetime.

Things will change. I just wonder if it will be for the better.

Take care

dearieme said...

Sack's hope that the circle can be squared by "prevention" is probably wishful thinking. The tactic that might work is perhaps politically impossible - just deny treatment to people where the cost:benefit ratio is too small. It's hard to see how that would work in the nationalised British system or the lawyer-plagued American one.

dearieme said...

Oops! Benefit:cost too small.

Joseph Oppenheim said...

Gee, in 2006, BusinessWeek Magazine called the single payer government financed VA medical system, "The Best Medical Care in the US", with both "lower costs and higher quality".

If the link doesn't come up correctly, then just Google "the best medical care in the us" and go to the link there.


Sackerson said...

Prevention wouldn't solve eveything, but we could challenge the Drugs/Alcohol/Tobacco lobbies and the Sugar/Fat/Salt lobbies. Also, the NHS may spend too much on elective surgery; and oldies cost too much.

Ares said...

Free health care is the only way to go. People should not get a level of health care based on income. This violates a basic human right, and denies a basic human need. Heartless people profit from the sickness of others. Too bad most of them are admired by our scared society.

Jim in San Marcos said...

Hi Ares

There is no free health care, the concept is impossible. The government will take it's health care cut before you get your paycheck with the proposed plan.

On top of that the money collected won't even go toward health care, it is just a way of increasing our taxes with the appearance that we are getting something in return.

Congress claims they tax the rich. Social Security and Medicare are not considered as taxes. The Supreme Court has ruled otherwise, they are taxes and can be spent by government anyway they choose.

Since Congress says they are not taxes, you can't fiddle with the amounts at tax time. You and You(the employer) pay the tax as a percentage of earned income 15.3 percent. Government health care could raise that figure up another 8 percent. One fifth of your wages would be for future promised benefits that are being used to fund the present budget.

Once you realize that the health care plan has nothing to do with health care, it is a tax increase, you'll understand what sort of future benefits to expect.

No lawsuits for mal practice. A skilled heart surgeon will get paid the same as the heart surgeon with no experience. And if it's prostate surgery, you may end up with free diapers for life.

This is a very big tax hike, and you have to be able to read between the lines to see it.

Don't get me wrong Universal health care is a desirable goal. That's what makes the proposal so enticing--it's just bait on a hook.

Jim in San Marcos said...

Hi Sack

I agree "The oldies cost too much."

Unless you have parents in a rest home, you have no idea of costs that are incurred that are not even health related. My grandmother lived to be 98 and from the age of 85 on, she was in a rest home. The minimum cost there per year was 30K. And we are not even talking about getting sick.

One time the rest home called me and informed me that Grandma was dying. I went there and called the hospital and asked to have her admitted and they told me that they wouldn't admit someone dying of old age. Heart attack yes but old age no.

As a post script, since Gma was so sick, I asked the doc if it was OK if she stopped taking all of the daily 30 prescribed pills she was suppose to take. He said yes, and Grandma recovered fully in two days, and outlived all of her friends in the rest home that came to see her off.

After that, the only pill that she would take was a sleeping pill. She lived another 3 years.

Sackerson said...

Hi Jim - that bit about the pills really rings the bell. My mother-in-law was tyrannised by a regime of pill-taking and I think a nightly sherry would have been better than all of them together. I think half the pills were to counteract the side-effects of the other half.

The pharmaceutical industry is another lobby overduw for a major sorting-out. (a) Drugs should only be prescribed/taken when they are clearly better than alternatives, including doing nothing, and (b) we should use cheap out-of-license drugs first, before the expensive new versions.

Next, families need to accept the responsibility of taking care of their own. Involving seniors in family life might mitigate/forestall old-age depression and dementia.

Once we've done both those things, we'll find that "healthcare" for oldies doesn't cost so much, after all.

Joseph Oppenheim said...

I went there and called the hospital and asked to have her admitted and they told me that they wouldn't admit someone dying of old age. Heart attack yes but old age no.<<<<<

That's because Medicare wouldn't pay for her stay there. It is limited to about 90 days at a time for a medical condition which requires "skilled" nursing after a hospital stay, not just because of old age.

However, even if she had to pay out of pocket, it can be up to fully tax deductible depending on how mobile she is, that is if she needs the care. But, Medicaid will pay everything (if she doesn't have the assets/income to pay) at a home which accepts Medicaid. Yes, there is free care, government paid, if needed.

Long ago, people had legal financial responsibility for parents who needed such care. Americans decided they wanted the government to be responsible for them.

It is a complicated situation, many people are more self-centered, now. But, also, it can be more efficient to have such specialized facilities. Plus, that it is so complicated, really shouldn't be, in my opinion.

The bottom line, though, is that care is available for free now, by the government, if needed. And, if needed, but the person has assets and income, there are tax deductions, including for such things as restaurant- style meals and other, even recreational activities.

But, again, everything related to that, is overly complicated, unfortunately family or such individuals really have to be sophisticated, and learn, to find the right path.

By the way, there is a massive demand for such health care workers - administrators, care givers, and support personnel, even now, as the economy is hard pressed in other employment areas. That's the good side of "old age" for our society.

It is one part of our economy which is growing quite well. And Americans, including the elderly, are more affluent, than back in the 30's, etc.

Same with medical care for anyone indigent, but it is so inefficent, tax payers paying for emergency care at hospitals when not needed, etc. That is why, a streamlined national health care system is needed.


Jim in San Marcos said...

Hi Sack

I don't think that you can blame the Pharmaceutical industry. It's the rest home or the health care provider. They get paid for basic services provided. Each extra prescribed pill can add a dollar to your bottom line. In my grandmothers case, it was about $120 a week for medication and the government paid it.

Health care is a business and believe it or not, it is usually the patient that wants all of the medicine, it's free.

Jim in San Marcos said...

Hi Joesph

I agree it is a complicated mess. Health care and retirement homes are separate issues.

The only way the government could afford to pay for all of this is to shoot people when they reach their 70th birthday. The actual costs are mind boggling and will probably bankrupt this country in the next two years.

Right now the government can't pay the bills. They have to pass the health care just to raise enough tax money to cover current spending which has nothing to do with health care.

Jim in San Marcos said...

Hi Sack

Another thing just came to mind. Most doctors have no idea of the cost of what they are prescribing. I got bit by a dog and the Doc gave me a prescription for antibiotics. When the pharmacist said the bill for 8 pills was $150 I hit the ceiling. I was advised that this was the latest and greatest.

The same thing happen to me when I went to the doc for poison oak. Since I had had it before, I knew that the 15 day cortisone treatment of 30 pill is about $12. The bill for the doctors visit was $95 and when I hit the prescription counter I went ballistic when told that the prescriptions would cost $140. I called up the doctor and reviewed her bill asking why I needed to have a culture tested for infection. She agreed to drop that. Then I asked her if she knew the cost of the drugs that she had prescribed and she said "no she didn't." Her truthfulness earned my admiration. She agreed to write me a prescription for the cortisone pack.

When the money comes out of your own pocket, you think twice.

I don't blame the drug companies for trying to make a profit. But if the consumer of health care doesn't have to worry about the cost of what is being consumed, we are doomed to bankruptcy.

Joseph Oppenheim said...

Health care and retirement homes are separate issues.
Right now the government can't pay the bills.<<<<<

Yes, Jim, but they have something important in common, that they both have a private economy and a government component to them. Likely, changes in most programs will balance public-private combination solutions, to win enough middle of the road support. Plus, I do think the new operative term is "libertarian paternalism", where choices will be available to people, but the default options well thought-out with one option to continue using whatever one already uses. I also see such a tactic with SS reform, some options for part of SS to be invested in stocks like indexed funds, and a few other options - maybe money market funds and bond funds, but still the ability to stay with the same option - basically US Treasuries as it really is now.

Remember, too, that Medicare is a public-private combination where the government only picks up about 80% of costs plus certain deductibles. That is why there are Medigap private plans and Medicare Advantage plans, with private companies participating. Personally, I would like it if Kaiser is one option. Two advantages, one, it is a fine HMO, two, it is non-profit.

Also, you will notice credit unions haven't been having as much problems as banks, though not non-profit, they are similar not-for-profit. I really don't trust full-fledged for-profit financial companies in the mix. Remember, it was the insurance industry which brought us the "wonderful" AIG and almost tanking the entire world financial system in one day.

Plus, yes the government can pay the bills, just not forever, thus there will be changes.

As for your comment about doctors being oblivious to drug costs, one thing I always do is make it known up-front I am cost-conscious, plus one reason I prefer to stay away from new expensive drugs, is because generics usually have a longer period of observing side-effects, etc, so I think that is a safer course.


frakrak said...

The recently touted health care reform in America is just another smoke screen, just another adventure into “diversional therapy” by your president. Anything to avert the attention from the fiscal brokenness of the world economy …. swine flu … health care reform … I am sure that your population will be kept debating an endless cascade of issues generated by your current administration. Isn’t America broke? We’re broke, so shouldn’t we be talking about what we actually can afford to do?

However, I am happy to add to the debate by giving the Australian experience here, as I think your administration thru Hillary’s influence will be looking closely at the Australian health care model. Don’t buy it!!

Governments should regulate and not become business owners, if they don’t regulate self interest, the general populace pays, case point would be your banking industry.

My father suffered for seven years with poor health, and as a dutiful son I spent many hundreds of hours at hospital appointments with him. It became a coal face view at what happens when governments throw many at health care. I can remember one instance of begging a nurse to show me how to insert a drip into his arm before she went on her much needed tea break. It is a bloated, fat assed organism that demands to be fed ever increasing amounts from the public purse, don’t go there!

Positive points seem to be the government has got a good mix with grants for medical research that are linked to outcomes and innovation.

Training doctors in this country is controlled by “the royal college of surgeons” that have constantly reduced the “real” quota for training doctors, as a result we “import” doctors from Sri Lanka, India to make up the short fall. If you need to socialize anything go down the training college route!

Public hospitals in this country kill 25,000 people annually with preventable misadventure! Your five hour wait would be 8-10 hours here. I would agree with the other comments re drug companies. There is a need to regulate the unbridled self interest. There are research institutes in this country that are funded by the government that compete in markets of the major drug companies. They create patents and sell the rights for manufacture.

Jim in San Marcos said...

Hi Frakrak

It's refreshing to have a view from another part of the world.

Your observations on the delivery of socialized medicine pretty much agree with what Rob from Nova Scotia was saying about Canadian health care.

It seems, once you embrace universal health care, you can't go back.

I do think as you suggest, universal health care implies lesser qualified physicians practicing medicine. The pay scale just isn't there. In GB the doctors were so overworked that the government gave them a pay increase. The net result doctors started taking more time off which made things even worse.

You have to laugh when you see how we too are going to paint ourselves into a corner.

Thank you for your comments