The Honorable Ron Paul M.D.
203 Cannon House Office Building
United States House of Representatives
Washington, DC 20515
Re: Web Post of July 20, 2009
“Health Care is a Good Not a Right”
Dear Representative Paul:
I beg to differ with your assessment. You appear to have mixed your analogy. Right is to Privilege as Goods is to Services. That is a basic SAT analogy.
Health care would be a SERVICE. One provided by trained individuals, each with their own reasons for entering the field. Health care is NOT a commodity. Beef and potatoes are commodities. Beef and potatoes are commodities produced and brought to market by individuals wuth some degree of college education; although a higher education is not specifically required.
For arguments sake, I will address Health Care as a commodity and as a commodity; the way to reduce consumer costs would be to increase supply. If beef costs are too high then flood the market with cattle. Consumer prices drop. It is simple supply-side Economics. You do remember Supply Side Reaganomics from the 1980’s.
If Health Care costs are too high, then increasing the number of Practitioners will reduce the costs. However, the AMA limits enrolment into medical schools. Why? They do it to keep the supply of Practitioners to a premium. This is where I see you as a hypocrite. You call for free-market solutions yet your professional organization institutes monopolistic controls that artificially inflate fees.
In Paragraph 3, you state:
"…if healthcare providers were suddenly considered outright slaves to healthcare consumers, our medical schools would quickly empty. As the government continues to convince us that healthcare is a right instead of a good, it also very generously agrees to step in as middleman. "
Under the current system we are all indentured servants. Employees are to their employers for fear that they might lose their health care and Providers to the Insurance companies in order to receive a continuing stream of clients. I cannot quote the exact statistic, but it is my understanding that the top 10 Insurers have secured the sole right to represent over 80% of all employees receiving health care. In order to have the right to provide services to these clients, doctors need to sign contracts with the Insurers and the insurers dictate what pay the provider. In effect, the Insurance Companies have become the middleman all the while taking between 20% and 50% for CEO Salaries and stockholder dividends.
At this point, let me tell you about myself.
I am a self-employed Civil Engineer. In 2002, I left a management position with a medium firm to become an entrepreneur; to start my own consulting firm. At that time, I was paying $900/month for Health Coverage ($30 Rx Co-pay and $250 deductible), for my wife and myself. That was a rate I could afford and net more than I did as an employee. However, even at those rates, I struggled to afford additional staff to expand my business. Therefore, after a short attempt to grow the business, I went back to a one-man operation. I had one Large Developer and two small developers as Clients in addition to “overflow” work from larger Engineering Firms. I had sufficient work to earn a comfortable living.
In the fall of 2007, as the recession started to slow development in San Antonio, the over flow work trickled to a halt. By February 2008, my largest client declared bankruptcy and the small developers found it difficult to obtain financing.
At the same time my Insurance premiums, which had been increasing, jumped from $1,200/month to $2,000/month ($5,000 deductible, no Rx). I was subject to the increase even though my total claims were three general Practitioner visits in the five years and one visit per year to an Ophthalmologist.
In 2008, after expenses, my net income was less than the cost of the Health Insurance. I am among the uninsured; one of then NON-Privileged. I work hard every day but, at this time, I do not earn enough to afford health care. You assert that Health care is “something you work for and earn”. How much harder do I have to work?
Continuing on, in Paragraph 4 you state:
"Universal Healthcare never quite works out the way the people are led to believe before implementing it. Citizens in countries with nationalized healthcare never would have accepted this system had they known upfront about the rationing of care and the long lines."
If this statement is true, then answer me why have the citizens of Canada, France, Italy et al NOT had a revolution at the ballot box? Why does the Conservative Government in the Canadian Parliament not toss out their system and replace it with an American System. They have the majority.
I ask you in what country currently is there rationing? It is the United States. Health Care is limited to those who can afford to pay high premiums, work for large companies or the Federal Government, that can qualify for lower group rates. Since you do not think Health Care is a right then, by analogy, you must consider it a privilege; available only to the privileged few. How do you compute the wait time for someone who does not ever get to see a Doctor? Those people are in the longest line in the world; longer than any found in Canada or Europe.
Next you continue:
"As bureaucrats take over medicine, costs go up and quality goes down because doctors spend more and more of their time on paperwork and less time helping patients..."
The real bureaucracy that is burdening Medical Practitioners is the Business School Graduates employed by the Insurance Companies.
When I last visited my Ophthalmologist (paying out of pocket), we had a discussion regarding Insurance. He has a small practice and yet has to have a full time employee devoted to “dealing with the Insurance Companies”.
"As costs skyrocket, as they always do when inefficient bureaucrats take the reins, government will need to confiscate more and more money from an already foundering economy to somehow pay the bills."
As opposed to Insurance companies taking up to 50% for dividends and pay their CEO Millions, if not in excess of $1 Billion as with United Health Care and Bill McGuire.
"The frightening aspect of all this is that cutting costs, which they will inevitably do, could very well mean denying vital services. And since participation will be mandatory, no legal alternatives will be available."
What legal recourse do I have today with insurance companies? Change carriers and be subject to a pre-existing condition exclusions? Recent history shows that this activist Supreme Court rules for big business on every case. If I show up at United Health Care, they can have me thrown in jail. I have no say about the CEO of United Health Care; I can vote for or against candidates for Congress and President.
"The government will be paying the bills, forcing doctors and hospitals to dance more and more to the government’s tune. Having to subject our health to this bureaucratic insanity and mismanagement is possibly the biggest danger we face. "
Can you really say this with a straight face? Replace the word Government with “Health Insurance Companies” and describe have the current system. Can you deny that the insurance companies do not deny services and control what which procedures Doctors can and cannot perform?
"The great irony is that in turning the good of healthcare into a right, your life and liberty are put in jeopardy."
Currently my right to life is in jeopardy. If I cannot get any health care because I cannot afford the Insurance Premiums then the quality of my life and my liberty are at stake. Of course, the only thing I have to fear is a serious illness that would cause me to lose my home.
"Instead of further removing healthcare from the market, we should return to a true free market in healthcare one that empowers individuals, not bureaucrats, with control of healthcare dollars."
Yes, I would like to see a truly free market for health care; one where practitioners could charge what the market will bear. I would like a free market where Practitioners must compete legitimately for my business and the supply of Practitioners is not artificially limited.
"My bill HR 1495 the Comprehensive Healthcare Reform Act provides tax credits and medical savings accounts designed to do just that."
Can you tell me how tax credits and medical savings accounts work if one is not earning enough to pay the premiums in the first place, much less have excess capital to invest in the savings account? Your Bill HR 1495 is only adventitious to the upper middle class and the current Insurance Companies. In fact, it directs even more money and control to the Insurance Companies; Monopolistic Insurance companies that are exempted from anti-trust laws. It benefits those who are not having any trouble getting health care today. Your bill does nothing to help the under-employed or the small business trying to expand.
Single payer is not something Corporatists should fear. We have single payer fire protection and that works quite well; as does our Single Payer Police Protection. A Single Payer program takes the basic premises of Insurance and risk management to the perfect state: The larger the pool of insured, the lower the risk. What bigger pool can there be than Everyone. Everyone in; everyone pays.
I have given serious thought to Health Care reform. In my vision for Single Payer, private insurance companies are included. There is a profitable niche for them. The can continue to sell Supplemental Policies. In addition, I would propose that they process claims on a percentage of claims paid. That will be a good incentive to pay the claims quickly and accurately. There can be good profit in that. Health Care Providers have the choice of which company the want to process their claims.
Providers can charge what the want for their services. Clients would pay the difference between the charges and the approved the government reimbursement. In addition, since you believe the Private Insurers have a better handle on reimbursement, initially reimbursement rates will be the average of current Federal Employee Insurance schedule and top five providers as indicated on their January 1, 2008 schedules.
Paying for the program and implementing cost reductions would require a comprehensive rework of our tax structure and modifying the current Medical School model. The system can realized savings over the total of all current expenditures. There is more detail than appropriate for this letter and I have attached an outline as a summary.
No comments:
Post a Comment