The Health Blog by Ryan Healy

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.

First Things First

I had all these great ideas for what I would write about when I got my blog up and running. Well, I did that yesterday (got my blog up and running), but then I started to doubt my plans. Why would anyone would want to read about the details of my life?

I really couldn't think of a good reason why.

You should know I've decided not to bore you with the details of my life, but rather plan to share my musings and insights about life with you.

In general, those musings will probably fall into one of these categories:

1. Finance & Money - I like to read a lot about money and how to build wealth. I imagine this will surface pretty frequently.

2. Government & Politics - I really don't have a burning interest in what's happening in DC (frankly, how could one possibly keep up with it all?), but I do think about it a lot.

3. Books - I love to read. About half fiction and half non-fiction. I'll probably post more about the non-fiction though.