Health Care Crisis Redux

I recently made a post on Facebook about my frustration with the 45% rise in my family’s health insurance premiums which I blame in part on the new Patient Protection and Affordable Care Act (PPACA) legislation called Obamacare by many including President Obama.  I was surprised at the number of people who chided me about it either in the comments or privately.  Since many of them apparently didn’t want to discuss their points openly, I’ll respect that and post here a response based on what I sent to them directly.  I certainly understand their decision to support Obamacare, and many of them had very well laid out reasons why it was the best option.  I have much less problem with the particulars of the bill we’re now feeling the effect of and more problem with the entire approach that was taken to the health care situation.  I had similar thoughts way back in 2008, but I wasn’t called to Washington 🙂  I have two big issues with these new health insurance legislations.

The first issue is not with the bills themselves at all, but that the solutions they implement are being sold as a panacea.  That only rich people will bear the cost, and the vast majority of people will be better off.   I am by no means rich, and yet we are now seeing a dramatic rise in the cost that we pay for health insurance, in part, because of these new rules.  So, regardless of what the legislation says, the way it has been presented is disturbing to me.  No less disturbing is the way the American people have accepted this presentation as plausible.  Do we honestly think that by forcing insurance companies to extend “risky” people that they didn’t insure before, however good and noble that sentiment may be, that it will not raise the cost of covering the rest of us?  And do we think that there are enough “wealthy” people to bear the brunt of this?  It costs just as much to treat a rich person as a poor person, and the extremely rich are able to “self insure” to avoid many of the pitfalls the rest of us must navigate.

My second problem with Obamacare is that it doesn’t address the real reason that health care is such a problem for many people, and that is the rise in the actual cost of being treated.  While our ability to treat diseases, infections, and all manner of maladies has been dramatically improved over the past 50 years, the cost of those treatments has continued to rise.  The assumption of the necessity of health insurance further distances both patients and doctors from the true costs of health care making both sides ignorant of the magnitude of the problem.  Instead of enshrining the position of the insurance companies in law, I would have much rather preferred that laws been passed that restricted the influence of drug companies over doctors, freed up research that was done on public money to be made available to the public, and encouraged research to be done in areas that will provide long term cures for people and not just costly and never ending drug treatments that are a boon to the large drug companies.

Several of the people that contacted me appealed to my Christianity and the need for us to help the poor.  I am a Christian, and I do believe in helping people less fortunate than I, but I would prefer that Christian charity come from churches and people and not be filtered through the government.  That approach, however, seems to be under attack from the Obama administration as well, as seen in the case of the constraints being placed on religious hospitals and charities, to the point that we may have no choice but to run all future charitable actions through the government, which will decide who and what receives the aid while being heavily influenced by lobbyists and special interest groups.

I was also told that I didn’t understand people who had terrible times finding and paying for health insurance.  My family has been on many different health insurance plans over the years, from the, relatively, cheap and good coverage that we have now through a large employer, to poor coverage when I worked for a midsize consulting company, to no group coverage at all when I worked for a two person shop where we had to pay very large amounts that we researched and found ourselves on the open market.  While we didn’t have pre-existing conditions to deal with, we do have a tendency to get pregnant every couple of years, and that added to the expense of the coverage we needed.  Each of these different types of employers have their pluses and minuses, but ultimately that is the choice you make by choosing those positions.  While I may not be able to put myself in the position of someone with a lifelong and costly condition, or someone unemployed and bearing the heavy burden of health insurance, I refer back to my original point that a health insurance law does not address the root of that problem.

If I had my preference, we would have a system where providers and patients alike could see a closer connection between the costs that they pay and the benefits they receive.  In that environment, the incentive for innovation would be driven by market demand and a desire to provide better, cheaper and more convenient care, the same motivations that have driven advances in technology and many other areas of the economy.  To my mind that is a better way to improve our situation and not by cementing the relationships between powerful insurance companies and powerful hospitals and clinics who then fight over the right to take the largest amount of money from use the patients who can’t live without their services.

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