What’s Wrong With the U.S. Healthcare System?

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The problem with healthcare is not the “uninsured” or that people aren’t getting the care that they need. On the contrary, people are getting care whether they’re insured or not. They are getting some of the best care in the world.

But our system has evolved in a way that hurts us all. It’s evolved in a way that causes consumers to be careless users of the system. And that careless use costs us all money.  Pair that up with the widespread belief that healthcare should be “free” for all, and you’ve got a recipe for disaster. Free care isn’t free at all. Someone has to pay for it, and everyone would prefer that someone to be someone else.

Then of course, there is government involvement. Please show me an example of government intervention that isn’t costly and inefficient. Our government is ineffective at almost everything it does, so it’s no wonder that when our government gets involved and starts making all sorts of mandates about health care and insurance, the result is horrible. (Ususally higher costs, lower efficiency, and less effectiveness.)

DownsizeDC.org offers a wonderful analysis of our current healthcare system:

A survey by The Physician’s Foundation finds that nearly HALF of primary care doctors plan to reduce or eliminate their practices in the next three years!

The survey also gives the reasons . . .

* Too much non-clinical paperwork
* Difficulty getting reimbursed
* Too much government regulation
* Lack of time (caused by the above problems) to form patient relationships

These problems exist because the government has corrupted the nature of health insurance.

* Insurance is supposed to cover rare but expensive procedures
* But various government policies have made health insurance cover the medical equivalents of oil changes and tire rotations
* This means that most medical care is paid for by the government, or by insurance companies, and not by the people actually seeking the care
* This causes people to over-use medical services, and doctors to order questionable procedures
* That causes both insurance companies and the government to limit their costs by second-guessing every decision your doctor makes
* This burden of regulation leads to piles of non-clinical paperwork and difficulty getting reimbursed

But it gets worse. Health care prices are actually set by the government . .

* The government funds HALF of all medical care
* This gives the government huge clout as the largest purchaser of health care
* The government uses this clout to limit what it’s willing to pay for every medical procedure
* The insurance companies use these government prices to set their own prices
* If these fixed prices are too low, shortages result, AND DOCTORS VANISH!

But that’s only the beginning . . .

If your health insurance is tied to your employer — if you risk catastrophe because losing your job means losing your health insurance — you can thank the government for that. Federal tax policies created the incentives that caused your health insurance to be tied to your job.

But if you don’t have employer-provided health insurance, and find coverage too expensive to buy on your own, you can thank the government for that too. State and federal laws mandate that insurance policies cover everything under the sun, making it hard to buy affordable major medical coverage.

The politicians could easily fix these problems by . . .

* Providing tax refunds for all health care expenses, including insurance premiums
* Allowing insurance companies to compete with different policies at different prices by ending mandates on what all health insurance must cover
* Funding Health Savings Accounts for Medicare recipients so they’ll have more incentives to be frugal

The solution to our health care problems is less meddling by the politicians, not more. The case of the vanishing doctors isn’t mysterious. The politicians did it, and they want to do more of what caused it!

And in case you’re still not convinced that we should just “give government-run healthcare a try” and see what happens… (After all, what’s the worst that can happen?)

Remember that we have given it a try. It’s called Medicare. It sucks. For consumers and for care providers.  I’d even go so far as to deem it a massive failure. Why add to the failure? Why allow our government to further destroy our healthcare system. I want good care, and I want it for decades to come.

Let Obama run it all, and you might be surprised at how bad things will get. There will be no incentive for innovation or the development of new treatments. You’ll be lucky to get the basic care you need in a timely fashion. Stand up against the government officials who want to take over yet another aspect of our lives.

10 thoughts on “What’s Wrong With the U.S. Healthcare System?

  1. Chris C

    Thanks so much for publishing this, and for highlighting the great work of Jim Babka at Downsize DC!

    By any chance do you have a list of references for the stats you list above? I think it is important to have backup data to go along with the assertions.

    It’s going to take a mammoth effort to push back against Socialized Medicine.

  2. Ed Sommers

    I’m reading this blog today for the first time. I appreciate the insights provided into the MLM companies you reviewed. I was disappointed to read the “hit piece” on health care. Apparently, you and I live on different planets. On your planet, everyone can afford health care because there is full employment, everybody is making great money, driving Lincolns, and having annual physicals, paid for by private insurance. Everybody votes Republican. The USA always wins wars, and we always fight in them. On my planet, many folks are underemployed or unemployed. Foreclosures are common. House prices are dropping and health care costs are out of control because of the influence of pharmaceutical companies and insurance companies who refuse to pay claims based on pre-existing conditions. In my world, some government is better than no government. “The market” needs to be regulated to prevent the raping and plundering of the general public that always occurs when regulations are removed. Obama, as it turns out, is a rational, smart, moderate leader who will insist that the government provide US citizens with access to health care, so that folks like you are not the only ones that can arrord to be healthy.

  3. Tracy Coenen

    Obama is neither moderate nor rational. Smart, yes. What he will do to the healthcare system will harm all of us. Health insurance as it stands today is not considered “affordable” because government involvement has made it (and health care in general) more expensive than it needs to be. More government involvement will only raise those costs further.

    And when those prices go up astronomically, I’ll still be able to pay for whatever I need or want. Many people will not be so lucky. They’ll be stuck in a health system in which they’re limited in what services they can receive, and they’ll spend time in life-taking lines trying to get services.

    God help us all as Obama ruins our economy, our nation, and life as we know it.

  4. Bill Davis

    I have to say, this is very bizarre, coming from someone that spends an inordinate amount of time uncovering MLM scams. The biggest pyramid scheme out there is our so-called healthcare industry. Surely you could have just come out and said, in boldface type, that you don’t want to pay for poor/old/sick people’s healthcare (you did, but you were rather sneaky about it), and left it at that. That at least would be more honest than resorting to a blizzard of arguments, facts, and statistics that go a long way toward distorting the ideological underpinnings of your argument, which is free market good, government bad. Some of your readers might be easily taken in by this belief system, but unfortunately it betrays your naivete about how government works, and who pays the politicians salaries. (It isn’t the taxpayers, trust me.) The present system has been largely shaped by the forces that stand to gain the most, profit-wise. It’s the reason that they helped defeat Clinton’s healthcare reforms, and the reason they have such a large hand in shaping whatever comes out of Congress today. Did you think that campaign contributions don’t buy you nothin’? Beware of anyone prescribing “easy fixes” for complex problems that are largely created by the people themselves. If the reforms you suggest don’t (and won’t) work, as they haven’t, in real life, for the last few decades, why would you think that they will work now? And, in extreme, are you willing to allow everyone to deduct every last medical expense? Surely, even if we cap such deductions (all and everything being, well, a tad extreme), you will end up bankrupting our economy further, seeing as how some drugs and procedures can cost tens, if not hundreds of thousands, FOR EACH PERSON? How is this any better than paying into insurance? (Or changing the oil which is cheaper than replacing the engine, by the way.) And HSAs sound so good on paper, but how many people are actually using them? How can people on Medicare, and by extension, Medicaid, afford to pay into something like an HSA when they can’t even afford enough to eat, a place to stay, or their prescription drugs to sustain their health? (Yeah, boo hoo, but where’s the compassionate conservatism?) What people want isn’t an HSA, or more of the same; they want good healthcare coverage, and they don’t want to pay an arm and a leg for it (pun slightly intended). I think they could give a bleep less where it comes from, or who administers it (a bureaucracy is a bureaucracy no matter who runs it, unless you’ve never worked for the government or a multinational corporation before, and foolishly believe otherwise). About the only thing we can agree on is that the government doesn’t pay enough for the services that it insures, but that’s an explosive political issue, because who wants to bankrupt our economy ahead of schedule? And ultimately, if you don’t want to pay for it, then stop buying into it. Surely you understand that all insurance involves a pool of people, and that ultimately you are paying for someone else when they get sick, right? And when you get sick, they pay for you, right? And that when someone who isn’t insured, gets sick, they go to the emergency room, right? And that you pay for that as well (it’s why a band-aid cost $100–slight exaggeration). For the insurers, it’s just another cost/benefit ratio. For conservatives, it’s about denying the Democrats any political traction. For everyone, it’s lose-lose. Surely you could take a minute or two and google other healthcare systems in other countries, and find something you like, somewhere (universal healthcare isn’t all that unusual)–even something you would be willing to pay for? Just don’t repeat the same, bored, tiring old arguments that you see on Sunday morning talk shows. You’re indulging in some heavy-duty make-believe if you think that somehow Obama is going to ruin this country by instituting some much-needed reforms to our healthcare system. You’re also engaging in histrionics by pretending that whatever comes out of Congress won’t be some watered-down POS that pleases no one in it’s attempt to please everyone (and won’t even be close to the nightmare scenario you envisage).

    This is why the right has run out of steam. They don’t have any good arguments left. If healthcare reform won’t happen now, it will in ten years. Do the math. The present system is unsustainable, and if we end up adopting even half of the so-called Republican “reforms” that you proposed then they will end up creating a de-facto single payer healthcare system run by the government, by default. Good grief.

    Stick to what you know.

  5. Tracy Coenen

    Yes, how bizarre to suggest that individuals should be responsible for themselves and their children. God forbid that anyone actually have to work and pay for their own needs and wants. Instead, it’s more popular to let “someone else” pay for the things you need and want. The problem with such a mentality, however, is that eventually the naughty rich people who should be made to support everyone who can’t be bothered to support themselves will stop investing and creating jobs. Then what happens to our economy? At that point even those who want to work won’t find jobs. But that’s okay, because they will feel good at night knowing that there is some great equalizer out there called universal healthcare.

  6. john lichtenstein

    Tracy the other problem with people not paying for their own healthcare is that it removes incentives to choose less expensive treatments or leave marginal conditions untreated. The system can stand a lot of wealth transfer but if prices are completely hidden from the consumers, it will lose individual restraint. Rationing and queues then take the place of prices.

  7. Tracy Coenen

    This is very true. I see friends with health plans that cost them virtually nothing, no matter what they do… and they are extremely wasteful in their health choices (i.e. emergency room for sniffles on a saturday, x-rays when totally unnecessary, etc.

    I, on the other hand, am responsible for my own health costs. And that means (hang on… ready for this???) … I am responsible with my choices. I could go get the $250 blood test. But instead, I get the one that tests exactly the same things, but for only $89. I do preventative care to avoid more costly treatments later. When I do need some sort of medical care, I look for a cost-effective option.

    I really do wish that we were back to the days when health insurance covered mostly only the big emergencies and surgeries. It was more affordable then, and was doing what insurance should do… be a fall-back in time of serious needs.

    Yes (*gasp*) I’m suggesting that all people should budget and pay for their ordinary health care needs. That might mean that some lower income people might have to cut off the cable television, give up the cell phone, stop smoking cigarettes, and quit buying junk food for their families. The priorities of many are out of whack.

  8. john lichtenstein

    MSA rollovers would help a lot. Now you have to empty your account or the IRS grabs it. Rollovers would provide a sane way to save for predictable expenses (orthodontia, wheelchairs …) and even self-insure.

  9. Craig Hansen

    I follow the US health care debate from a distance (of about 100 km), and it’s at times like this that I’m really glad I live in Canada. Other times, I’m just less enthusiastically glad I live in Canada.

  10. John DeAguiar

    The idea that lowering costs requires limiting access to healthcare is logical, but wrong. Case in point: The Japanese visit their doctors more than three times as often as their US counterparts, but the national average per-capita healthcare spending in Japan is only 37% of the corresponding US spending, and both produce comparable health outcomes. (Reference OEDC Health Data for 2006.) The core US problems are mainly excessive/unnecessary (and sometimes counterproductive) tests and services, high administrative costs in private insurance, and highly inefficient healthcare for the poor and uninsured.

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