Tuesday, May 02, 2017

HealthCare Solved - You're welcome

Talk show host, Jimmy Kimmel, just took the healthcare debate to another level with his tearful on-air plea; and the story of the recent birth and heart issues of his son. There’s going to be a lot of people talking about it. Lots more arguments. But nothing will change. The reason nothing will change is because the argument isn’t about health care at all. The argument is about money.  And the left and the right will never agree about how money should be spent. I don’t agree with either of them.

While “Obamacare” seemed to be a step in the right direction – toward making healthcare accessible to those who didn’t have it before – it also wasn’t really about providing healthcare, it was about providing insurance. “Health Insurance” is a misnomer.  Nothing about it insures that people are healthy, any more than homeowners insurance guarantees that your house won’t burn down; or auto insurance guarantees you won’t run into a telephone pole. It’s not meant to. What it’s intended to do is guarantee payment to medical providers when the “insured” seeks the services to keep him/her healthy. Obamacare was an effort to reduce the cost of health insurance by volume. Once everybody was insured, medical providers wouldn’t have to break it off in those who could pay to compensate for all those who couldn’t. They could drop their prices to keep that high-volume business coming in. Once everybody had to be insured, the insurers would also have much greater volume and they could drop their prices as well. See? It’s all about business, not health. It would work in much the same way as WalMart keeps down the cost of, say, a television. Volume.  Problem was, it was going to make both the providers and the insurers – as well as the “insureds,” take it on the chin until the program came to fruition, and nobody wanted to, or thought they could afford to make that sacrifice.

Insurance companies make a lot of money. Doctors make a lot of money. They both like that, and they don’t want to make less money. We all understand that. Right? So, even though they might be able, in the long run, to make, say 2x the money they’re making now, under the plan they’d be doing, say, 4x the amount of work. So they’d still be making less (much less) per unit of work than they’re making now.  Assume you’re an artist. You sell your original paintings for $2 per square inch, meaning you get $1728 for a 2’x3’ painting. That’s real good money.  Now, you work out a deal to have your paintings mass-produced and sell the same size prints for $39.95 through Hobby Lobby, and you lose the rights to sell the original image. You’ll only net, say $10 per unit, but you’re getting orders for a thousand at a time. Ten grand for a painting that you would have sold yourself for less than 1/5 of that. Foolish pride aside, would you do that?  Sure you would. But, the difference is, you wouldn’t have to hand paint that image 1000 times. You’re not doing any more work than you did before.  There’s the difference. Nobody, including insurers and healthcare providers wants to make less money per unit of work. Thus, the resistance to ObamaCare.

Here’s where I get all communistic on the subject. Don’t hate.

In 2015, the U.S. military budget was 598.5 billion dollars ($598,500,000,000). That was 54% of the total $1.11 trillion budget. Of the money spent on the military, roughly 22.5% was to pay the salaries of military personnel. For the sake of my argument, let’s call that $135 billion.  That’s all fine and good. We like our military. We want them to get paid, and most of us would probably agree that they deserve more money for what they do for us. But, not everybody enlists in the military because they just want to kill people and break things.  Many enlist because it’s a job, and it teaches them skills for use after they are out of the military – so they can make a living and afford things like health care for their families.

For perspective, keep in mind that medicine was once a calling to help people, and it had nothing at all to do with money.

WHAT IF?  What if we, as a civilization, were able to make it so again? What if the government took a chunk of that $135 billion military payroll budget and started another branch – the Medical Corps – and trained doctors like they do soldiers? Qualified applicants would enlist for ten years; receive their education in 6; and, if they were able to complete their training, would come out of that training as doctors (nurses, technicians, etc.) Instead of paying (with money) for their education, and therefore having to pass that enormous cost on to their future patients, they’d be getting paid to do their training. The remaining four years of their enlistment would require them to work in government-run hospitals and clinics, treating anybody who needed their services for free.  After that, they could re-enlist and remain on the government payroll, working as doctors (nurses, technicians) for what active-duty soldiers get paid, or go off and be medical providers on their own, making whatever that market dictates.

No insurance necessary. If you are a human, there are plenty of places you can receive needed medical attention, at no charge. None. Zero. Zilch.

If you’re a rich person and you think you won’t be able to get the quality of care you deserve at the free clinics and hospitals, you can always go somewhere else for treatment and pay for it just like you do now.  But, given the competition, those rates should come down.

I think it’s a win/win.  Arguments expected.
(c) Rick Baber, 2017

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