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Article
Is
There a Right to Health Care?
by Annemarie Colbin, Ph.D.
With all this talk about healthcare, I feel the need for
clarification. For example, we are not talking about health care,
we’re talking about who pays for it. Most people think that
insurance pays for it – but the truth is, insurance pools all the
money paid in premiums, and out of that pool they pay for those who
get sick. Of course, the trick is that the pool of premiums should
pay for the insurance company’s overhead, including salaries,
bonuses, and perks – therefore, they will not willingly pay for
everybody’s health care – only for some people’s health care.
Much as I sympathize with President Obama’s efforts, there were some
things that he promised in his big speech that cannot be done. He
said, and this is verbatim:
As soon as I sign this bill, it will be against the law for
insurance companies to drop your coverage when you get sick or
water it down when you need it the most. (Applause.) They will no
longer be able to place some arbitrary cap on the amount of
coverage you can receive in a given year or in a lifetime.
(Applause.) We will place a limit on how much you can be charged
for out-of-pocket expenses, because in the United States of
America, no one should go broke because they get sick. (Applause.)
And insurance companies will be required to cover, with no extra
charge, routine checkups and preventive care, like mammograms and
colonoscopies -- (applause) -- because there's no reason we
shouldn't be catching diseases like breast cancer and colon cancer
before they get worse.
(http://www.huffingtonpost.com/2009/09/09/obama-health-care-speech_n_281265.html)
While it sounds great, I would be astonished if this came to pass
– it’s not possible! That means that everyone can get as sick as
they want and get every treatment in the book forever and ever, no
limit, no caps. There will not be enough money to pay for all that.
Insurance companies are basically betting pools – everybody buys
into the pool with their premiums – but it is not possible for
everyone to win. Make no mistake: when you get sick, you win, and
the insurance companies pay doctors and hospitals that treat you as
part of your winnings. However, there is no way that the insurance
companies can cover procedures that all healthy people want, such as
routine checkups, mammograms, and colonoscopies – there would not be
enough money in the pool, as these would cost more per person than
the premiums we pay in.
Example: Lulu, Joe and Oscar each put 100 in the pool per month,
that is, they pay this premium. In six months there is $1800 in the
pool (income). Then Lulu wants a mammogram – cost, maybe $250, and a
checkup - $550, so that would be $800. Joe wants a checkup and a
colonoscopy ($550 + 200). Oscar wants the same, for another $750.
Total medical costs: $2300 (expenses). So you can see, this is $500
more than the $1800 in premiums paid into the pool. The insurance
company goes bankrupt.
This is the way it’s supposed to work: with the same premiums and
pool, in 6 months Lulu does not get sick, Joe gets the swine flu and
costs $350 in doctors’ visits and $100 in meds; Oscar, who was
diagnosed with cancer years before and got over it, gets cancer
again but this time they say, sorry, it’s a pre-existing condition,
and he gets no money towards treatment. Financial Result. Income
$1800; expenses $450. A clear win for the insurance company! That’s
what happens with for-profit insurance companies. They have no
incentive to pay out all the money in the pool for the health care
of their subscribers. The more money they keep, the better their
stock, the more their higher-ups get paid. Can’t blame them. It’s
the American way.
Meanwhile, the health care industry, including the pharmaceutical
companies, hospitals, and doctors, they also are in business – they
are all for profit. So while we complain of the high cost of health
care, those who provide it laugh all the way to the bank. Can’t
blame them either – they’re trying to make a living.
So what happens with single payer systems? The government sets fees
as to what they will pay for different aspects of medicine. It is a
not for profit system – there are no stockholders, only tax payers.
Everyone pays their tax, so the pool is big. Doctors are on salary.
There is little incentive for running up health care bills.
Regarding insurance companies, there are people who can’t, or won’t,
buy insurance, so they put no money in the pool. If the current
administration has its way, everyone will be forced to buy
insurance, even if they don’t want it:
for those individuals and small businesses who still can't
afford the lower-priced insurance available in the exchange, we'll
provide tax credits,
Therefore, and here is what I object to, if you
don’t want to put money in the pool, shame on you! You are
irresponsible! You’re not playing!
Now, even if we provide these
affordable options, there may be those -- especially the young and
the healthy -- who still want to take the risk and go without
coverage. There may still be companies that refuse to do right by
their workers by giving them coverage. The problem is, such
irresponsible behavior costs all the rest of us money. If there
are affordable options and people still don't sign up for health
insurance, it means we pay for these people's expensive emergency
room visits.
…….But we can't have large
businesses and individuals who can afford coverage game the system
by avoiding responsibility to themselves or their employees.
Improving our health care system only works if everybody does
their part.
Of course, these irresponsible people may not need
to use the emergency room. Or they may be willing to pay for using
it. When I was a self-employed cooking teacher with a very modest
income, some 25+ years ago, I did not buy insurance because I didn’t
want to. I thought it was way too expensive, and I preferred to use
the money for health in ways that made sense to me. I used
alternative therapies for myself and my kids, and paid for them. The
few times I had to resort to Western medicine, for any one of us, I
paid for it. Of course I was very careful with our diet and so on.
Humans are not perfect, so when there was a problem, I dealt with
it. I have no problem paying for health care, alternative or
conventional, if I agree it’s what I or my family need. But we are
told these days, even by our president, that we shouldn’t have to
pay for health care. Insurance should pay.
With insurance, you pay before you get sick; that
way, when you get sick you feel you got your money’s worth. In other
words, the incentive is to get sick. I preferred to pay after I got
sick, even if I paid it over time, as I did in several instances,
because then when I was done that was it. I prefer to incentivize
myself to not get sick, so I still use alternative therapies as
prevention (acupuncture, chiropractor) and pay for them. With the
option of a flexible spending account, I can pay for such therapies
with pre-tax dollars.
So do we have the right to health? In our culture,
health is a commodity. It costs money. Someone has to pay for it
because the people who provide it need to make a living. If the
insurance company pays, then they have the right to own all your
health information – no privacy, your information belongs to other
people. I prefer to be responsible for my own health, so I’ll use
medicine paid by insurance as little as possible. What if something
terrible happens? Well, I’ll deal with it if it does. But what if
nothing terrible happens, and I’ve paid thousands and thousands of
dollars into health insurance I don’t use? That, of course, if what
insurance companies want. They want everybody in the pool,
especially the young and healthy. That is how they pay for others
who run up the bills.
Here is what I would like to see: a non-profit
single payer system, paid for by taxes on everyone – in other words,
an expansion of Medicare/Medicaid – with doctors on salary in
non-profit hospitals. I would favor a large deductible, and to pay
for that, we could have pre-tax flexible spending accounts in which
you can accumulate the money you don’t use one year into the next.
If our elected officials had any backbone, that’s what we would get.
But they are all beholden to the pharmaceuticals and the insurance
companies, and the tax payers would rather pay for insurance than
taxes for a single payer system. Go figure.
How to take care of yourself:
1. Eat fresh, real food, home cooked, or cooked in
an establishment you trust.
2. Use natural remedies to take care of minor
health issues such as headaches, fevers, colds, stomach aches, and
such.
3. Use alternative therapies like massage,
acupuncture, and chiropractic regularly, to keep your energy flowing
smoothly.
4. Use pharmaceutical drugs only to take care of
real problems that you cannot fix with diet, such as asthma or
congestive heart failure. Avoid just-in-case drugs like preventive
aspirin (which can cause bleeding) or vaccinations. Their
side-effects can be worse than expected.
5. Keep yourself grounded and deal with stresses
regularly – do not let them accumulate.
6. Make sure your relationships with friends and
family are pleasant and smooth. Don’t carry grudges, they’ll make
you sick.
7. Attend to your spiritual well-being.
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