Tag Archives: American healthcare system

Are Free Market Forces Good for Healthcare?

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Contrary to popular belief, the problems with the American Health Care System are not the result of market forces run amok. In fact, just the opposite is true. The American health care system languishes because the forces of the free market are unable to exert their influence. Imagine, if you will, how our free market system would look if it functioned like our health care system.

Imagine that you are sitting at home, watching television, and something feels out of sync. You can’t put your finger on what it is you are feeling but it is nagging at you and keeping you out of sorts. After a few days, the problem seems to be worsening and you are really beginning to worry. Finally, you pick up the phone and place a call to your local retail professional and make an appointment.

On the appointed day you arrive at your local mall or shopping center and you describe your symptoms to your retail professional. Your retail professional listens intently, asks a few questions, and then diagnoses your problem and offers a treatment protocol to make you feel better. Your retail professional tells you that the problem is that your home entertainment system is not meeting your minimum daily requirements. As a solution, your retail professional tells you that what you need is a new home entertainment system with state-of-the-art technology.

Now, it just so happens that you retail professional has the perfect home entertainment system to sell to you and guess what? It’s covered by your retail insurance policy. In checking your benefits it turns out that you’ve already satisfied your deductible so your insurance is going to cover eighty percent of the total cost of your new system.

What your retail professional may not explain to you is that your home entertainment system exceeds the usual and customary charges for such items so the insurance is not going cover your retail professional’s full cost. She’s not worried, however, because there are a number of accessories she can sell to you that are covered and these will more than make up for the difference.

I know this sounds a little silly, but think about how our free market economy would work if the merchants with whom we do business would decide for us what we need and how much we are going to pay, and that we would be happy to accept their decisions without question because our insurance is going to pay for the merchandise, anyway. This is exactly how the healthcare system works today and we wonder why costs continue to rise at or above the rate of the Consumer Price Index.
The problem with the American health care system is not that doctors make too much money, the problem is that the incentives in healtcare reward the wrong behavior. The problem is not that health insurance companies, managed care, Medicare or Medicaid absorb huge chunks of our health care dollar, the problem is that these entities exist at all.

Think about it for a moment. If we really want to provide universal health care what value do health insurance, managed care, Medicare and Medicaid contribute? Don’t these entities exist to restrict access to care to only those who are eligible for coverage? Don’t these entities exist to limit care to only those services that are covered by our schedule of benefits and for which we have paid?

If we want to provide comprehensive health care to all Americans we have to change the way we think about our health care system. There is a solution but it resides outside the boundaries of conventional thinking.

Visit my website atwww.melhawkinsandassociates.com and check out my book, Radical Surgery: Reconstructing the American Health Care System. In fact, tell all of your friends about it.

ObamaCare Approval Rating Continues to Fall

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Over the last few months there have seen and heard numerous reports that the public’s approval rating for ObamaCare, more appropriately referred to as the Affordable Care Act, has been falling steadily and now rests well below forty percent.

This should come as no surprise. Attempting to fix the American healthcare system by relying on the health insurance industry is like trying to fix Congress by making it easier for people to get re-elected.

The best we can say about the Affordable Care Act is that it was a nice try but one that was doomed to fail because its design was driven more by political considerations than by an understanding of how the healthcare system actually works. All ObamaCare really accomplished was to add another layer of complexity to a system that was already unimaginably complicated.

Until we are ready to acknowledge that health insurance is one of the biggest reasons why our healthcare system fails and, of course, that human beings actually deserve medical care when they are ill or injured, our tinkering with the healthcare system will only make it worse.
Focus on health insurance, if you will. Imagine for just a moment that we all could agree that there ought to be a way to see that all men, women, and children have access to health care when they need it.

Now, think about what health insurance actually does. The health insurance industry restricts access to care to only those people who are covered by a health insurance policy and it limits care to only those services that are specifically covered by that policy.
Assuming, again, that we want everyone to have access to healthcare, why would we be willing to pay the health insurance industry hundreds of billions of dollars to restrict care to a special few individuals and to limit care to only services that have been specifically identified?

And, yes, I’ve heard the argument that we over-estimate the amount of money siphoned off by the health insurance industry. Just the opposite is true. We grossly underestimate the degree to which the health insurance industry contributes to the rising cost of healthcare. The cost of health insurance is not just the result of that portion of our premium dollars that are retained by the health insurance industry after payment of claims to providers.

The cost of health insurance also includes every dollar that is spent by doctors, hospitals, nursing homes, out-patient surgery centers, rehab facilities, lab and imaging centers, home health care providers, and hospice providers to manage the process of filing insurance claims and fighting to get the paid what they are rightly owed.

We could also add the expenditures by employers as they manage the process of selecting health insurance or managed care providers, managing the enrollment process, and mediating grievances when their employees are unfairly reimbursed for care.

And, we could factor in how much the health insurance industry pays to influence legislators. And then, of course, there is Medicare and Medicaid.

If we could recoup every healthcare dollar expended by people like you and me, and also by our employers, that does not end up in the hands of actual providers of care we could afford to provide comprehensive healthcare and prescription drugs to every American man, woman, and child.

And, if you want “to hear the rest of the story,” as Paul Harvey used to say, take a look at my book, Radical Surgery: Reconstructing the American Health Care System Continue reading →

Act Now and Save $15 Trillion ($15,000,000,000,000)

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Let us forget, for just a moment, the debate about the Affordable Care Act or, as most of us would call it, the Obamacare Act, and focus, instead, on the issue of providing universal healthcare (translated to mean comprehensive healthcare for all American citizens and legal aliens).
No matter how we feel about Obamacare, we certainly would agree that the Affordable Care Act will not provide access to healthcare for every single American. The absolute most the Affordable Care Act will do is to make it easier for more Americans to purchase health insurance coverage. There also seem to be few illusions that Obamacare is going to cost less than what healthcare in America cost before implementation of the Affordable Care Act. Many will suggest that it will, in fact, cost more than what we have spent in years past.
The real question we should be asking, however, is “why are we unable to provide comprehensive healthcare and prescription drugs to every single American Citizen and legal alien?” In other words, why are we unable to provide universal healthcare?
For the moment, I want to forget about all of the altruistic reasons as to why the richest and most powerful nation in the world should have a healthcare system that meets the needs of all Americans, like virtually every other developed nation? I want to forget about these things because no one really seems to care.
We seem more concerned with rejecting the concept of socialized medicine than we care about all of the men, women, and children in the United States who are unable to gain access to and afford the medical care they require.
The fact is that the vast majority of Americans are unable to distinguish between the concepts of universal healthcare and socialized medicine. These to concepts are, in the minds of these people, synonymous. I suggest to you that it is this inability to differentiate the concept of universal healthcare and socialized medicine that is at the root of the entire problems with the American healthcare system.
Since no one seems to care about the suffering that so many Americans are made to endure, let us focus on the one issue about which everyone seems to care and that is the cost of health care in America.
From 2001 through 2011, the total annual healthcare expenditures of the U.S. grew from $1.2 Trillion to $2.8 Trillion. This represents an average increase of 8.8 percent per year. If that trend continues from 2012 to 2022, our annual healthcare expenditures will increase from $2.8 Trillion in 2011 to just under $7.1 Trillion in 2022. For the eleven calendar-year period from the end of 2011 until the end of 2022, we will have spent just under $56 Trillion on healthcare. Mind boggling, is it not?
In 2001, I wrote a book entitled, Radical Surgery: Reconstructing the American Health Care System, in which I proposed a healthcare solution that would provide universal healthcare without socialized medicine. In other words, I wrote that we could provide comprehensive healthcare and prescription drugs to all Americans and legal aliens without relying on government. Let me say it differently in order to alleviate any confusion. I proposed a way in which we could give every American access to whatever healthcare they required but that would involve neither federal nor state government in the healthcare delivery or decision-making process.
One of the features of this new system was a mechanism that would allow us to control the increases in the cost of care so that costs would rise no faster than increases in the Consumer Price Index (CPI). At that time I projected that the CPI would grow at a rate of 5 percent per year. At that rate, I suggested that healthcare expenditures would have risen to $1.86 Trillion by 2010. Had we been able to hold the increase in annual healthcare costs to 5 percent per year we would have saved an aggregate amount of $3 Trillion over the ten year period. Pretty significant savings, wouldn’t you say?
In fact, the actuall CPI growth during that same period was an average of 2.7 percent per year. Had we been able to control the rise in healthcare expenditures to actual inflation rates, costs would have grown only to $1.55 Trillion resulting in an aggregate savings over the decade of just under $4.5 Trillion. Even more impressive, don’t you think.
Now, let us assume that the actual rate of increase in healthcare costs between now and 2022 would remain the same as the previous ten year period (8.8 percent). In that case healthcare costs will rise to a staggering $7.086 Trillion by the end of 2022.
If, however, we were to implement the healthcare proposal presented in Radical Surgery: Reconstructing the American Health Care System, and inflation would continue to increase at the rate of 2.7 percent per year as it did over the last decade, our annual healthcare expenditures would rise to only $3.9 Trillion. Under this scenario, the aggregate saving in healthcare costs over the ten year period from 2013 to 2022, compared with the projected 8.8 percent per year increase, would be $14.9 Trillion dollars.
Forget altruism, just give me the money!
The question for the reader is a simple one. Can the American people afford to spend an extra $15 Trillion over the next decade for a healthcare system that will continue to leave a significant percentage of the American population with inadequate access to healthcare?