Ghost Writer picks up a homework assignment from Marti while she whoops it up living the good life. Yep, I'm stuck at the helm while Marti goes and celebrates her 20th anniversary. Indeed, she is taking time off of her obsessive compulsive relationship with her job to enjoy her marriage. Here's hoping her hubby can stand all that attention.
Before Marti took off, she and I were discussing how the proposed health care plan is like a chocolate Easter Bunny. You know the kind -- shiny, foil-wrapped yumminess. The big decision after seeing it is whether to eat the ears first or the tail first. This is ostensibly how we should feel about the government's proposed changes to health care. Yay! We have a shiny new health care plan. Yay! Everyone will have health care. Yay! No more lifetime limits. Yay! No more denied coverage of pre-existing conditions. Where do we sign up? We rip open the foil, chomp down on the ears and call ourselves happy.
Alas, though, like every child learned after the first time he or she got tricked, don't get too excited. The shiny, foil-wrapped bunny needs to be picked up and felt, because appearances may not be the full story. Is the bunny solid or hollow? It's still chocolate, but is it really good to the core? As the health care proposal is picked up and weighed, we find it's missing a few things at the center. Like the ongoing use of Emergency Rooms as primary care providers for the booming illegal immigrant population in the U.S. Like the cost distribution. Money is a zero sum game last I checked and you don't get more of something without paying for it. Michael Cannon wrote, "Government programs do not contain health care costs; they shift, increase, and hide them. Government shifts the cost of my consumption to you. Costs rise overall, as they always do in a commons: nobody spends other people's money as wisely as they spend their own." Amen, Michael! Name one program the government has created or problem it has "solved" that it hasn't made worse or eventually corrupted through application of politics. And just because the government says we're already paying for all of these issues doesn't mean I believe them. The government has been price fixing the health care system for years in the form of "reasonable and customary" reimbursements for services provided to those covered by Medicare and Medicaid. That's clearly helped contained cost.
Sure enough. We've figured out we've got a hollow bunny. It's still shiny. It's still chocolate. Which is probably better than nothing in the Easter basket except unrefrigerated hard-boiled eggs (eew!). So we unwrap it and we take a bite. Oh NO! ICK! SPIT! GROSS! We find out it's last year's hollow bunny, and it's stale and the cocoa butter is separated, and we're pretty sure something is alive in that hollow core. What's creeping around in it? The first piece of scum we find is the Middle Man. Middle Man creeps around in the heart of things, does nothing, and spoils everything. Does anyone else remember the days when mom wrote a check to the doctor at the time of service for your ear infection? How much of this situation is the hedge-fund, junk bond system called health insurance? These are the people who for the last several decades have said they are negotiating health care costs lower for us, but yet, they keep getting higher. How does that work? [Insurance is a racket designed by lawyers, executed by lawyers, and foisted on a paranoid population, but that's a rant for another day.] Ask the Amish. They negotiate cash payment rates far lower than what any of us, including the government pay. Why? Cash now beats fighting insurance companies and the government later for money. Cash flow is king, even in the world of health care.
The second piece of creeping crud we find under the foil and gnarly chocolate we thought was something good is Middle Man's best friend No Personal Accountability. The company that generously helps me acquire health insurance (at a nice premium out of my paycheck and their profits, too) put into action a "play or pay" system this year. If I don't take so many steps to maintain a healthy life, I pay more for my health insurance. Period. My participation is evaluated quarterly. Play that quarter or pay next quarter in higher premiums out of my paycheck. The government is never going to get this radical. No Personal Accountability is at the heart of most government programs. Heck! Our government is still arguing about whether welfare recipients should be tested for illegal drugs. Really!? Wow.
For those shouting at your computer, "We've got to do something! We cannot continue this way." I agree. But let's start they way any fixer-of-broken-things would -- using root cause analysis. This plan doesn't address what's broke. It just addresses the symptoms far greater issues.
So, welcome to your Health Care Easter Bunny. Foil-wrapped? Yes. Shiny? Yes. New? Maybe. Better? No. Yes, really.
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