Friday, July 3, 2009

McMorris Rodgers' Invisible Health Care Solution Made Clear

I was unable to take part in Cathy McMorris Rodgers' TeleTown Hall meeting last Wednesday evening, but a recording of it is available on her web site so I listened to it. After leading off with a prepared statement repeating the government control of health care canard she is so fond of, she took questions. The inaccuracies and incongruities were many.

One of the main themes was the effect of illegal immigrants getting health care and raising the costs for all of us. Our congresswoman said that of the 40-45 million Americans without insurance, 8-10 million of them are illegal immigrants. Illegal American immigrants?

Another theme was how bad government control of health care would be for us, mainly because of the lack of choice of health care providers and waiting lists that would result in order to keep costs down. Also, McMorris Rodgers is concerned that Obama's public option could be forced on people who already have private insurance.

When the subject of her medical insurance came up, McMorris Rodgers clarified that she had the same choices as every other federal employee but added that it was a pretty good deal. She complained about using her husband's TriCare coverage for their son because she couldn't choose her pediatrician. So she switched her son to her Blue Cross/Blue Shield. Having been a long time TriCare user myself, I have few complaints about it.

A small business owner said he didn't know how much longer he could provide health insurance for his employees because it costs so much. Then he segued into complaining about illegal immigrants which was completely unrelated to his problem. Nobody addressed the issue of why the cost of the insurance keeps rising.

One person asked why the hospital accepted $3,000 from his insurance company when his bill was for $15,000. She said the low reimbursement Medicare and Medicaid rates force private insurance companies to accept lower rates and forces hospitals to try to make up the difference by trying to charge people more. She also said that Medicare will go bankrupt in 2017 but did not say that it's because of the rising hospital costs forcing it to pay out more than it collects by then. Are you following this?

Overall, McMorris Rodgers succeeded in keeping the issue murky. At no time did she provide a clear strategy for dealing with health care other than saying no to government control. On a related note, although she would like the Shriners Hospital to stay open, nothing she proposes would have any effect.

Most inane moment: An elderly caller complained about the "donut hole" (Medicare Part D) that forces her to pay full price for her prescriptions. Our congresswoman said that not all plans have donut holes and suggested she talk to someone about switching plans. Hmm, but not addressing the cost of those plans. Anyway, that must be how choice works.

Most bogus poll: She asked, What is your biggest concern of the proposed government insurance option?

49% - Fear it will grow the size of government
21% - It will take longer for a medical test or procedure
13% - It would be harder to see you doctor
17% - Favor this type of option

It's so easy to craft these so you can get the answer you want, especially when people have little or no knowledge of a subject which is presented ambiguously anyway. I thought I'd make one up of my own as an example.

What is your biggest concern of the proposed lengthening of home-use chainsaw blades?

- Fear it will increase injuries causes by kickbacks
- It would require more maintenance
- The increased weight would make it awkward and uncomfortable
- Favor this type of option


justin said...

Healthcare is expensive. And for some reason democrats want to give everyone all the healthcare they want.

There isn't enough money, unless people without private insurance are willing to accept lesser government healthcare. No CTs, no new medicines ($4 generics only), only basic surgeries, no $$$chemo/radiation for cancer, etc. It's the only way to make the dollars stretch.

I think this is the best way to provide basic healthcare for all americans. But people scoff at this idea of a "two tiered" plan.

Lucas said...

We already have a "tiered" plan - people with insurance and the indignant who are forced to use the emergency to treat problems that would have been easily prevented had they had access to preventive care.

There are a lot of reasons health care is expensive, part of it being the incentive structure for health care providers. My wife's uncle is a cardiologist. After he finished his fellowship in cardiology he accepted an insanely lucrative offer to join a cardiology practice down south. After less than a year, he left the practice to move back to Montana and take a HUGE pay cut to practice medicine there. The reason? He was tired of sitting in meetings discussing why he had not referred more patients to the diagnostic lab the practice owned. He felt there was no reason to subject a woman in her 30's with no history of heart trouble and no family history to get a very expensive and unpleasant dye test just so it would increase the bottom line of the practice. That was not why he became a doctor. So, if you think that profiteering is not one of the driving factors in the cost of healthcare, you are sadly mistaken.

Saying that we can't find a way to give universal coverage to everyone is to say that we are not as smart or inventive as other industrial nations, like England, France, Canada, Germany, Japan, etc. Also, many pharmaceutical companies spend a lot of money to slightly alter their drug compounds to keep them under patent protection longer, which keeps the prices high.

And there is enough money to pay for it, if you look at the cost savings of a not-for-profit federal plan when all is said and done total spending on health care in the economy will go down, freeing the extra cash to be taken as profits by companies enjoying lower costs or given to workers in the form of higher wages (though I think the first option is more likely).

There are a lot of scare tactics out there to discourage people from pushing for a single-payer system, but if you look at the other countries around the world you will not see that they have worse results in terms of health outcomes. Don't believe the hype - take a look at the facts and make a decision.

justin said...

Some doctors, like cardiologists, are often in unique positions to refer pt's for procedures that they will directly be paid for. That is incredibly atypical, mostly thanks to Stark laws that try to prevent such unethical behavior.

Any "federal insurance" that people think is going to save piles of money is a pipedream. Look at Medicare right now. Doctors (and midlevels) don't get paid enough by the federal plan so they are refusing to accept it. Because it is too expensive to cover everything for everyone, the federal gov't decreases payments to doctors to stretch the money. If you want such a plan to work you will have to pay doctors more than current medicare rates, with cost of living increases (which I think is reasonable since every other professional I talk to gets this), and expected savings will be lost.

As far as a current two-tiered plan existing with pt's who have insurance and those reliant on the ER/county hospital's to provide indigent care, what a joke! I'm talking about a true plan where people are covered for basic healthcare(preventive care which is cheap)/surgeries/medicines and they don't have to file bankruptcy when they need to have their appendix removed. A plan like this is the best I think we can do. You can't provide all care for everyone on the taxpayers dime. Their is not enough money. I think that is fairly obvious.

And US healthcare outcomes are bad because we are fat, lazy, and fat. We are the fattest country on the planet. So we all end up with diabetes, high blood pressure, and heart disease. No wonder are life expectancy is less.

I'm not advocating for the status quo. I think the current situation is not working well. Though I'm against an all encompassing federal plan. I support a basic government insurance for all with extra private insurance for those who choose to buy it. I don't understand why people get upset when the two-tiered plan is suggested.

Lucas said...

Heathcare doesn't have to be AS expensive. Read this piece from Ezra Klein

The incentives behind health insurers are all wrong. When we are only concerned with stock price and returns, we are not focusing on making people healthier. We are focused on making money, at the expense of individuals health and well-being. There are only two ways to change this, mandate health insurers provide a specific set of medical outcomes or go single-payer. Either option will be a necessary intrusion by the federal government into private industry, but if you just go single-payer it will be easier to administer since you won't have to deal with push-back from the insurance companies.

There is no easy solution to this problem. If you provide a government option, some employers are going to dump their private plans and push their workers onto the government plan to save money. Once this chain gets going market forces will push other employers to do the same, or risk being unable to compete. This is one reason American car companies make cars in Mexico and Canada, national health care in those countries reduces costs for the auto makers. If we could reduce the cost of health care for auto makers in this country we could return some manufacturing to our shores, where the money earned by the workers will at least get dumped back into the economy it came from. It is a basic principle of economics that putting a cheaper alternative on the market will drive people to it. Again, we can find a way to do it better. We are the most advanced nation in the history of the world. We are at least as smart as France, right?