Ronin of the Spirit

Because reality is beautiful.

Health Care Debate III

I thought this was going to be an easy post.  I thought, hey, the insurance companies are a bunch a bastards, but it turns out insurance companies, while not blameless, are not quite the devils I’d thought.

Basically, health insurance is expensive because (1.) Continual, long term expenses are a really stupid thing to pay with insurance. (2.) Hospital bills are really high and require high premiums.  Could insurance be improved? Certainly, but it is not the real cause of high medical bills.

So, then I went into why hospital bills are so high.  Basically hospital bills are high for a few reasons. (1.) Fear of litigation, rather than litigation itself, causes a lot of unnecessary stuff to be done.  (2.) Hospitals are a skilled labor intensive industry, and skilled labor is very costly. (3.) The existing socialized care costs the hospital about 15% loss off of net, or about a 40% loss off of gross.  Could hospitals improve administration and information management?  Certainly, but those are marginal gains compared to over-treatment and labor costs.

So, can hospitals be run cheaper?  Yes.  Should they be?  Should is a surprising long word. Every war in history has been fought between the S and the D of should. Should implies is an ideological question, not an economic one.

So lets talk about ideology.  First off, do you have a right to health care?  Absolutely!  You have a right to life, liberty and the pursuit of happiness.  Rights are tricky things though. The First Amendment says you have right to freedom of press.  Does this mean the government has to assist you in setting up your own news network? Or merely that the government is forbidden from preventing you from doing such?

You do have a right to life. You have right to not have the government forbid you from seeking health care. You categorically, do not have the right to have them provide it for you.  If you believe that health care is a right and the government must provide it, you must logically believe that government must provide printing presses to those to poor to afford them,  protests marches to those to poor to organize them, and guns to those to poor to buy them. (Your first and second amendment rights, respectively.)

Clearly, your right to life means the government cannot prevent you from seeking health care, not that it must provide it. So, accepting that fairly obvious fact, what is the health care problem? The fact the health care consumer is complaining health care costs too much really doesn’t amount to a hill of beans.  Consumer think everything cost too much.  Producers think everything goes too cheap. Demand drives prices up, supply drives them down. So, what’s the problem?

Two possible ones: false expectations and market failure.

First false expectation?  You are entitled to long life.  Actually you’re not. No one is. Long life is combination of four things, genetics, choices, luck, and health care.  You know what the leading cause of death is in the United States? Heart disease. You know why that is pathetic? BECAUSE 80% OF IT IS PREVENTABLE THROUGH LIFE STYLE CHANGE!  That’s right, 80% (Harvard School of Public Health, Department of Nutrition)  Over 600K people died in 2006 from heart disease,  480,000 at the end of a series of stupid ideas.  Even if the US had the best health care in the world, even if by some economic miracle it was free, 20.8% of all fatalities would have happened anyway because people found health care more attractive than responsible living.

Second false expectation? The Law of Diminishing returns  doesn’t apply to health.  Actually it does.  Moving the age of mortality from 45 to 55 takes pennies.  From 55 to 65, took much more.  Surgery is a risk. We choose the risk of surgery when it is lower then the risk of not having it.  Unnecessary surgery means risk for no reason, and that means expense and injury.  Which leads me nicely into the…

Third false expectation: Doctors will make decisions dispassionately, and never expose patients to extra risk just to cover their legal rear.  Actually, doctors are people too.  And the fear of litigation hangs over them like anvil on string.  They order to many tests, and treat too agressively for fear of malpractice suits.  Which leads finally, to the…

Forth false expectation: people are entitled to a risk free life, and are entitled to compensation when risk has consequences.   No.  Just plain no.  Life is risk.  Hospitals, treatments, etc, all have risk, and if a person is made aware of the risks and choose the course anyway, they aren’t entitled to any form of compensation.

That just leaves market failure.  I try to keep my blogs under 1000 words, so I will have to write that one later.

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August 27, 2009 - Posted by | atheism, Pharmacology, Politics, Science, Self discovery, skepticism, Slice of life, Uncategorized | , , , , , ,

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