The Health Blog by Ryan Healy

The Health Care Racket...

A brief rant about health care...

My wife, Stephanie, called me up at work the other afternoon, an hour before I was going to go home. I could hear my daughter crying in the background.

Stephanie told me she thought Annabelle had an ear infection. She'd been cranky all afternoon. Stephanie said she was going to go to the doctor's office for a 5:30 appointment.

So she went to the doctor. The doctor peeked in Annabelle's ear and confirmed what Stephanie was already 99% sure of: Annabelle had an ear infection. Cost: I'm not sure yet, but probably $50 or more for less than 10 minutes work.

Then the doctor writes a prescription. Stephanie goes to the pharmacy at King Soopers and pays $50 for it.

The part that angers me is how the doctor is the gatekeeper to the pharmacy. Why can't we self-diagnose for minor illness? It's easy enough to identify an ear infection... don't have to be a doctor for that.

Health Savings Accounts

The company I work for is moving to a new insurance plan on January 1. It's a high-deductible plan with a Health Savings Account (HSA).

Although it will initially make things harder for me, I think the new plan is closer to the way health insurance should be structured.

To learn more about HSA health insurance plans, I suggest reading Patrick Stevens' article posted in yesterday's Early to Rise: "Pay Thousands Less with a Health Savings Account." (Scroll down to "Today's Message.")

Ken Salazar on Health Care

Since it's Election Day and I live in Colorado, I thought I'd throw in a small excerpt about health care I found on Ken Salazar's web site. (Ken is a Colorado candidate running for the U.S. Senate.) I've bolded a small section that really caught my attention.

[W]e're never going to really solve our health care problems until we find ways to lower the costs, including: lower prescription drug costs; working harder to prevent medical errors and eliminate administrative costs; reduce groundless medical malpractice lawsuits; and place greater emphasis on prevention and education to prevent expensive hospitalizations and other crisis care. "An ounce of prevention is worth a pound of cure," especially for chronic illnesses. (Excerpted from Salazar for Colorado.)

Ken's statement really encourages me. All too often I feel like politicians "just don't get it." I think a lot of people feel that way. But here's some good, old-fashioned common sense—straight from a politician's mouth!

Dentist Throws Down Gauntlet

I received a letter in the mail yesterday from Robert L. Martinich, a dentist whose practice is close to my house. I almost never throw a letter away—even if it's junk mail—without giving it a quick scan.

I started reading Dr. Martinich's letter and was thrilled with what he'd written. I quote it here for your benefit.

I am honest and fair to all of my patients and to all people I meet. This means I do not participate in any insurance schemes that deny you a choice in oral medicine. I do not participate in any HMOs, DMOs, or PPOs, nor am I part of any group dental management corporation. I am an independent general dentist who manages his own practice and provides the best quality of care possible to all patients at the same fee, regardless of what insurance program the patient has.

Most, if not all, dental practices that participate in an HMO, DMO, or PPO have different fees for different patients. In these practices the quality of care you receive can vary depending on your insurance; and if you have regular "endemnity" type of insurance, or no insurance, you are probably charged a higher fee to support or subsidize these other patients in the practice. I morally can not and will not do this.

Bravo Dr. Martinich! If we had more doctors and dentists like him, our health care system would be in far better shape. Read about Dr. Martinich.

Top Down or Bottom Up Solution?

I realized today that my ideas about what we should do about health care are driven by a fundamental belief that the changes need to come from the bottom up, which means I believe the changes in our health care system need to come from America's citizens—not its government officials or its pharmaceutical companies or its hospitals or its health insurance companies, etc.

Apparently, others believe the changes need to come from the top down, as evidenced by the approach the Center for Practical Health Reform takes. They never explicitly say the changes need to come from the top down, but to accomplish all they suggest (things like "universal health coverage" and "compatible information technologies") would certainly require government intervention and some kind of centralized control.

Although I disagree with CPHR's approach to health reform, the organization does do a great job of summing up the crisis in health care and its probable impacts.

On a side note, notice how CPHR equates those who don't have health care coverage—health insurance—with those who can't pay for health care... as if insurance is a requirement for obtaining health care. And notice how they fret about the increasingly uninsured population.

Do I fret? Maybe a little. But, as I wrote on May 19, I believe individuals paying cash for health care is what will ultimately bring health care costs back under control. And that can't happen when all of America is depending on health insurance....

What to Do about Health Care

While going through paperwork yesterday morning, I was reminded of how nightmarish it is to deal with health insurance companies. Health insurance and health care are in a sector of business that is so complex it rivals the complexity of the IRS tax code.

Which raises the question: How do we simplify the system?

Here's my take. The purpose of health insurance should not be to pay for routine doctor visits and prescriptions. Rather, it should be used only for extraordinary circumstances that you could not pay for on your own.

I believe the primary reason health insurance companies have become the ubiquitous arbiters of health care costs is because of Americans' poor money management. The fact is, if the money wasn't deducted out of most Americans' paychecks automatically, they wouldn't be able to pay for any health care.

But imagine a system where we could walk into any doctor's office and afford whatever service we needed. Imagine a system where we could compare prices online and find out how different doctors had been rated. Wouldn't that be cool?

Prices would inevitably drop because we'd be paying the bills, not the health insurance companies. Furthermore, doctors wouldn't have to charge as much because they wouldn't have to pay one or two or three receptionists to try to get money out of health insurance companies all day.

Waiting in the doctor's room would be thing of the past. Why? Because without health insurance companies limiting your choices, you could simply find a better doctor if your own doctor made you wait too long.

While I'm at it, let me emphasize one point that most Americans seem to forget: You can't get more out of a health insurance company than you pay in. Otherwise, the health insurance company couldn't survive.

Sure, there will be years where you take out more than you put in. And there will be years where you put in more than you take out. But, ultimately, the health insurance company has got to make money. They do that by taking a cut from every dollar you give them. You put in a dollar, you get, say, $0.75 back.

How can we simplify the system and curb rising health care costs? Get rid of the middle man—AKA the health insurance companies.

That doesn't mean that we should get rid of them entirely; only that we should take back the responsibility of paying for ordinary health care costs, leaving them with the much-diminished role of paying only for extraordinary circumstances.