With everything else she and my father were worried about last week, it's good to know that they're not going to have to pay anything out of their own pocket for the surgery or the before and after care. The government will pick up a good part of the tab via Medicare; the balance will be covered with the supplemental insurance policy they purchased.
I say that this is good because they're living on a fixed income, and the level of that income is fixed a whole lot lower than most of us would be comfortable living on. Though they've got savings, they consider those for emergency use only, so the bulk of their income is based on their monthly Social Security checks. Those checks are not large, and a goodly chunk is spent every month on the premiums for the aforementioned supplemental insurance. But they're afraid to be without it, and so they go without other things instead.
I can't blame them for worrying about the possibility of very large medical bills. I pay a ridiculous amount every month myself for the same reason. But the size of the premium payment checks pale in comparison to the bill I got from a hospital two years ago. I had some surgery myself then. Though it turned out to be outpatient surgery, it was just major enough that there was some question as to whether or not I'd be able to go home the same day. I recovered well from the operation, and so I did go home late that day only to feel truly sick when I got the bill: $26,000 and change.
Most of my bill was covered by insurance. The balance due was luckily within my means to pay (though it was painful, I managed). Although I still complain when I have to write a sizeable check for health insurance coverage every month, that $26,000 bill is always in the back of my mind and I grudgingly never miss a premium payment as a result.
Health insurance affordability is a big deal, especially among so-called political liberals. They've made up their minds that every American should have insurance. That's far from the case today. Millions of Americans don't; millions more children remain uncovered. Although these numbers vary from month to month let alone year to year, it's fair to say that the total number of uninsured Americans at any given point in time is significant.
Most of the time, it's said that those millions of people don't have insurance because they can't afford to have insurance. In some cases, of course, that's true. But there are other reasons that people choose to forego insurance as well, and among them is the fact that they know perfectly well they'll get treatment anyway should an emergency arise.
The reason people know they'll get treatment because hospitals will give it to them is that it's required they do so by federal law. But they comply with the law in the full knowledge that they'll make up the costs of providing the free care. One of the ways in which medical centers recoup their losses is through tax deductions. Another is the large bills they send out for those who do have insurance coverage (does $26,000 for outpatient surgery ring a bell?).
In my relatively eclectic employment past, I've worked both for the home offices of insurance companies and for the billing department of a chain of clinics. At the insurance company, people are employed full time to pick through hospital bills. Oftentimes they'll find mistakes (that's not a reflection on careless hospital accountants but rather a simple statistical probability for error when that many line items are involved with that many bills). Usually, they'll consider the rest for payment.
Medical personnel get involved. They look at the procedures performed and decide whether or not those procedures were medically necessary. They approve for payment the ones that they decide were; they deny payment on the others. Claims adjustors get back into the picture when they determine "usual and customary" charges for the region in which the medical provider is located. And then they approve for payment some previously contracted percentage of that.
Hospitals, meanwhile, are often the butt of late night jokes when they bill $3 for a single aspirin, or include multiple fees for a wide variety of blood tests to reach one simple diagnosis. But in the first place, many people don't consider that the aspirin may have only cost a nickel, but for the hospital pharmacy to store and dispense it, the doctor to approve it for a given patient and diagnosis, and the nurse to bring it costs a little more than that. Multiple tests are done — the kind that insurance company medical advisors often decide aren't medically necessary — not to pad insurance bills but out of fears malpractice suits will be filed if doctors miss even the most obscure health condition.
Insurance companies are in business to make money, and when they get very high hospital bills, they do their best to pay as little as legally possible. Hospitals are also in business to make money (or, in the case of public hospitals, to at least break even), and so they have to institute charges everywhere they can and at a sufficiently high amount so even after numerous denials and numerous non-paying patients they'll still make something.
Liberals often suggest that the answer to putting a stop to this vicious circle - higher doctor bills mean higher insurance premiums mean fewer policyholders mean lower reimbursement levels mean higher doctor bills - is to put the government in charge of health care. Socialized medicine, they say, is the only equitable way to go.
In 1994, then-President Bill Clinton gave his wife, Hillary Rodham Clinton, the assignment of solving what some insisted was a "crisis" in health care in the United States. Mrs. Clinton and the fellow members of the task force given the job came up with what was derisively called "Hillarycare." Not quite socialized medicine, it came close with its requirements that all employers provide health insurance for their employees, and mandating tightly controlled (effectively nationalized) HMO's to offer care.
The proposal was fought by both medical providers and insurance companies for obvious reasons: Neither would make any money under the plan. Many Americans not affiliated with either industry fought the plan, however, as well. They didn't like it because it would eliminate much of their freedom of choice in choosing their doctors and other health care providers.
Some on the left have not yet given up on the idea of socialized medicine. They conveniently ignore the shambles of the socialized system in Canada; disregard the crippling tax rate in some countries in Europe necessary to cover the costs of socialization there; and they pooh-pooh the effect of the free market on research and innovation. Though socialized medicine is obviously (demonstrably so) a bad idea, it's difficult for some Americans not to look at it a little wistfully as insurance premiums and health care costs alike continue to spiral upward.
What's the solution? There isn't one single answer to the problem. The healthcare dilemma is much like a series of dominos laid delicately in complex patterns. If one falls, much of the system collapses, and nobody in their right mind is willing to instigate that (which is why only some of the most leftward Democrats ever really consider it). But there are some actions that the government could take without toppling the system, and they include:
Getting our borders under control
Getting the FDA under control
Getting out of the insurance business
I don't pretend that doing these things will solve our problems overnight. They won't. The one thing everybody can agree on is that healthcare costs in America are a complex issue at best. But these ideas will, at least, be a step in the right direction. They also have the virtue of some consistency: Each and everything I've said involves less government intervention, not more. I'm pretty sure there's a lesson in that. Now if only the socialist-prone left (and frankly the regulation-prone right) would learn it.
you probably know, the United Nations is about to be very busy discussing
how it might rid the world of small arms. After a massive outcry from
US citizens, UN officials say they're not taking aim at legal civilian
ownership, but rather at illegal small arms. But when you take a look
at previously published definitions of small arms, and you consider the
scope of its proposed ban, well, it's tough to believe that legal firearms
are not next. Get
the T-shirt here.
Lady Liberty is a pro-freedom activist currently residing in the Midwest. More of her writings and other political and educational information is available on her web site, Lady Liberty's Constitution Clearing House. E-mail Lady Liberty at email@example.com.
"Eternal Vigilance: The Best of Lady Liberty 2002-2004"