Health Care Part 2

The second step is to try to understand the financials. Insurance and health care are big business. When we are thinking about this subject we need to remember that insurance companies are for-profit. That means that they are trying to make money. They have CEOs, Presidents, Vice-Presidents, all kinds of managers and supervisors, and many other employees that work to make sure that the company is profitable. In this sense they are no different from Walmart, The Home Depot, Shell Oil Company or Citigroup. The primary goal is to ensure the survival of the company. That means that they want to take more money from the insured than they will ever consider giving back in payments for health care services rendered. To that end, insurance companies like to break us up into groups based on health risk or based on our employers and set the rates they charge based on the potential use of their services. Some people have it relatively easy and some people get screwed.

Medical providers follow the same structure. There are very few non-profit medical facilities left. As time passes we see increasingly larger medical groups that buy up smaller hospitals and expand their influence to the point where we often have little choice in who will provide our medical care. In the city in which I live we have two choices of health care systems, and insurance pretty much dictates which medical chain we have to use. Then there are the medical equipment and pharmaceutical companies. Again, these are for-profit companies. The main goal is to make money. They will charge as much as the market will pay and then some for new drugs and technologies.

Now, I'm not trying to dispute capitalism here. We all have the right to work in a job or create a business that makes a profit. The problem here is that the profit comes at the expense of people's welfare and lives. I'm sure that I could search the internet and find hundreds or thousands of cases where people were denied coverage for medical procedures by their insurance companies, or who maxed out their medical benefits and ended up physically well, but financially and emotionally bankrupt over their medical concerns. The comparison here is that there is a choice involved in other transactions. When you buy a new house you can choose to spend $120k or less and get a modest house that will provide shelter for you and your family. Or you can spend $300k or better and get a house that provides more than you probably need. As long as you can afford it, it is your choice to make. But when it comes to health care we are dealing in people's lives. No one should have to make the decision of whether they can afford to go to the doctor and receive treatment. No one should have to go bankrupt and lose their home and possessions just so they can live. No one should have to ration their medications because they can't afford to take their full prescription as prescribed. These are basic quality of life issues. Capitalistic value can be placed on a car or an outfit or a house, but it should not be placed on a life.

Then there are the concerns about who pays for the medical care. Those of us who are insured feel pretty confident that if we become ill our insurance will help to defray the costs. But what about the uninsured? Who pays for their medical care? If you guessed that we do then you get an A+. If someone doesn't have insurance they tend to go to a walk-in clinic if they can afford to. If they can't, they often end up in the emergency room. Who pays for the visit? Either the Government pays or the medical facility writes the charges off. As you may well have been able to deduce, as medical facilities write off charges they have to raise their rates for all of us who have insurance. Remember, the medical facilities are in the business of making money. Somebody has to pay for the services they provide. They have to make a profit. And in the end, we pay.

So, how much do we pay? Well, I can say that I contribute a little over $1,000 dollars a year to my medical insurance. That's around 3% of my gross income. I can also say that the company I work for contributes around $2500 a year for my insurances. So that's $3500 a year. I can assure you that I do not use that much in medical services in a year, so the insurance companies are making money off of me. But I have to keep medical insurance because if I have a catastrophic illness there is no way that I would be able to pay for it on my own. Many of us are in the same situation, we and our employers overpay the insurance companies so that they can make a profit, we do not use up all of the money that is paid in.

Many people would say that insurance is a necessary evil. We have to have it in case we become seriously ill, but we don't like paying in when we reap little reward for it. One thing I didn't mention above that we have to remember is all of our copays. Even though insurance pays out to our medical providers and pays some of the cost of our medications, we still shell out additional money, maybe $20 or $30 when we go to the doctor, maybe $30 or $60 when we fill a prescription. All of that money adds up. That is money we are paying for health care outside of the current system.

So you would think that with all of that money going out to the health care industry, we here in America would have the best healthcare in the world. Well, that's a subject for the next post.

And here's your music break for the day: