Tuesday, March 24, 2009

Letter from Reader

After a couple weeks of break for finals, FMP is back online. We thank Nathan Reed for this submission, with which we wholeheartedly agree.

I've been pretty outraged on a daily basis since January 2009 about the happenings in Washington D.C. Now I'm just sad for our country. What is happening now is the death of the chance for success. That is the “American Dream”; the CHANCE (not guarantee) to raise your lifestyle through dedicated hard work and innovation in any field of your choosing. The “American Dream” is NOT entitlement to free healthcare, housing, etc. It is NOT allowing congress to choose which companies must be saved, which the government should take over, and which companies and EVEN INDIVIDUALS to tax at confiscatory rates. This country is currently on a path that Ayn Rand depicted decades ago. A 90% tax (that members of BOTH parties voted for) on a select few individuals! A confiscatory power that president Obama is now seeking to extend to anything/anyone that our D.C. prima donnas don't like. After legislators ENABLED the behavior they feign outrage about by saving these failing companies in the first place! They are KILLING the wealth, dreams and motivation for anyone aspiring to be more and do more with their lives than merely subsist. Anyone that manages to make a good living is suspect.

Liberals and socialists would like to assume that most people operate from purely humanitarian motivations – that this is how it should be, but our country has proven in the last 230+ years that self-interest is the greatest motivator of the human spirit. This country rose to relative success in the world by refusing to deny that universal truth. Furthermore, self-interest is individual, and the freedom to pursue the goals that tickle our self-interest is another bedrock of our past success. Society cannot reasonably expect an individual to put their all into any task when the effort of their work is not met with some form of compensation that the worker finds acceptable. That is the beauty of money – its buying power allows you to reward yourself in an acceptable way for the job that you completed.

To change tracks due to personal interest, I’d like to predict the consequences of universal healthcare provided by the government. Like with government subsidized housing, costs will inflate as demand increases because going to the doctor is “free”, or at least “cheaper” after D.C. picks up some of the tab. Why go to the family physician in the morning when it costs the same to get fixed right now at the ER? Doctors will be expected to pay off hundreds of thousands in student loans in a payout system that doesn’t rise with inflation, but actually decreases from time to time because government has to squeeze them to help control costs. There will be fewer people that train for the minimum of 11 years to become physicians due to the lack of benefit from that training (that dirty self-interest thing again). After some years comes rationing of care. No, the legislators (not doctors) in charge of deciding what kind of care you can receive won’t come out and say that you’re too old, or the therapy you require is too expensive to be worth saving your life. Instead, they will make people jump through hoops to get their care. You can’t get your lung cancer treatment unless you’ve stopped smoking for at least a year. You can’t have more than one heart surgery every 10 years because it’s been “proven” to congress’ standards that you should be able to go at least 12 years if you had eaten right and lost that extra weight. I know that there are people that don’t believe me, but just look at some of the news coming out of the U.K., our “model system” as touted by Tom Daschle. Good thing he didn’t get the Health and Human Services secretary position he was offered (tax cheat writing/voting for taxing legislation), but do you think the model will change? Yeah, let’s be just like the U.K. because they should be our model, not the other way around? Oh, and throw a little Chavez in there when we don’t like your business.

It’s all just so sad, as well as stressful that I’m going to have to find some place in the not too distant future to make a living doing what I love, and to MY standards. Hopefully it’s here, but then again, who is John Galt?

Nathan Reed


Pastor said...

An alternate approach to Universal Health Care and the need for a fee for service system:

The Problem: medical expenses are more than many can afford. This is due to many reasons, but the fact remains that it is a problem.

The Debate: free market proposes fee for service options on one hand and current government proposes universal health care.

Can the two co-exist? Not in the purest form of either model or current debate. I propose that the excessive nature of universal health care needs a free market solution for a moderately successful outcome.

The Proposition: Universal catastrophic care only. This simple modifier to the universal care system will save the US billions to trillions of dollars.

How it Can Work: The tax payers pay into a universal care system that begins at health care costs of $10,000 and above.

Traditional insurance models will provide coverage for clients up to that point which will decrease the cost of insurance.

People will look for lower cost health care due to paying either out of pocket to fee for service health care (HC) and submitting their bills to the insurance company or by just paying out of pocket to the HC provider.

This model deters the masses from overcrowding the ER and having elective procedures on Uncle Sam's dime. Cost sharing for health care will remain intact.

Why $10,000 dollars? This amount is debatable. It may lower or raise with inflation. The point is that it is a large enough sum of money that it will deter abuse and over utilization of HC.

What if the masses don't pay for the ER visit they insisted on? Their wages are garnished. Why should you buy a new ipod or blackberry when you owe thousands of dollars to the health care providers.

What about the non-compliant patients that have preventable diseases? They are also taxed more heavily if evidence of lifestyle choices make hospital admissions frequent.

What about the general population?
Governmental employees will participate in preventative medicine screenings including fitness screenings, and dietary screenings or their wages will be garnished. This may encourage increased brain power in Washington D.C.. Private companies may offer incentives for healthy lifestyle choices that will promote productivity and decrease medical expenses due to time off work for treatment.

Flaws: Too many to list, but it is a ground for discussion. We are facing a government that is taking action toward universal health care. The time to provide alternatives is now.

LLTN12 said...

I also feel that most people would benefit from leaving the insurance system other than for catastrophic coverage. People do not realize how much money is collected vs paid out in most cases. What I don't like about your plan is the idea of increasing taxes on noncompliant people. I prefer an incentive approach, for example - that $10000 (or other feasible number) deductible is decreased in people that are up to date in health screens and other forms of preventative medicine.

Rather than being punitive in a fashion that can only be regulated by increasing government tax bureaucracy, this allows people who prefer not to follow provider plans (in other words some freedom of choice as I'm against anything compulsory) to pay for the privilege should they need extra care. I think a somewhat hefty deductible would serve in itself to promote better lifestyle choices and and adherence to treatments prescribed, without the need for mandating policies through taxation.

Actually, I think a little education and an increasing percentage of the general population on catastrophic coverage alone (as discussed above) would serve much the same function as your deductible idea. Less is more. People remaining on high-cost plans will often be doing so due to chronic illness states. Seeing others paying less would likely promote the same behaviors as the above outline. Still not perfect. There's always that pre-existing and/or incurable condition problem where I cannot find an answer that I agree with completely. There are many mechanisms that are left out in these discussions too often, however; we ARE the most charitable country in the world, especially to those that demonstrate true need. There is NO SUCH THING as government charity though - something I've heard people speak of that makes me sputter. If it is not voluntary it is merely redistributionist; one person slaving-away (yes, the correct word) for another's benefit.

-Nathan Reed

Rusty Scalpel said...


I likewise think that your idea is a step in the right direction.

You used the term "Universal" catastrophic care. I don't see the point of a universal catastrophic care policy. Do you mean a common policy that all Americans are a part of? Could you accomplish the same goals by providing federal funding to buy policies for those who can't afford them?

I would be more in favor of the second option (although the first option is infinitely better than anything on the table right now). The cost of catastrophic policies is so much lower than that of comprehensive policies that only a slim percentage of Americans would find themselves unable to afford them.

If this approach was THE American approach to social health care, it would also reduce federal funding for health care by billions as medicaid was axed. Of course, I don't know if you intended suspend all federal funding for primary care and I'm certain that the House and Senate are not thinking along those lines.

Rusty Scalpel

Pastor said...

Rusty Scalpel,

The approach I would like to see in a health care reform (if it has to be a universal plan) is one that encourages consumer frugality.

Current government programs for health care pay out well for some tests and procedures with little regard for consumer compliance. The non-compliant consumer will use more resources for the same result or may not even achieve the desired level of health and then require additional intervention. If the HC plan was a government provided catastrophic care plan, then we decrease the cost of HC and we establish "fiscal responsibility" of the consumers.

The private insurance companies would be able to provide lower premiums for the consumer to cover costs below the catastrophic care plan.

In response to Nathan, I agree that incentives would be the better option to encourage increased compliance.

I don't know how this would work with the existing Medicare/Medicaid entities, but I would hope to eliminate the excess paid in both programs by this one. One of the key questions: Is health care a right or a privilege?