Friday, August 29, 2008

Spiraling Costs: The Biggest Risk in a Nationalized Health Insurance Program

As far as anyone really knows, there are about 47 million "people" in America, not just Americans, that are uninsured. The reason I say "people" and not just Americans is because more than 15 million of those 47 million are estimated to be illegal aliens. Half the remainder of that number are young people who have the available option for health insurance at their jobs but elect not to buy it because they feel they are young and in good health. So, that leaves about 15 million people who truly can't afford health and health care insurance. That's the number that any nationalized health insurance program should aim to fund. But, the Democrats want to fund the full 47 million. (Some actually want a single, socialized medical system in America and that's a topic for another blog entry).

A major problem with any nationalized health insurance system is having a system that truly provides government compensation for those, and only those, who can't afford it. Unless there are controls on edibility for government-funded health insurance, my guess is that the 47 million, who are uninsured today, will easily become 100 million or more in short order. That's because Americans will work the system. Why pay for their own insurance if they know the government will pickup the tab? That's only common sense. Without controls, I would expect millions of Americans to drop their out-of-pocket insurance and apply for government-funded and payed-for insurance. This is when things go completely get out of control and the burden to the taxpayer literally explodes. It will become another nightmare program like welfare, food stamps, and social security that will place unfair tax burdens on the future workers and tax payers of this country.

Along with some form of "means testing" in order to sort out those who can't afford insurance from those that can, we need tort reform. Lawsuits are directly driving costs up with higher and ever higher jury settlements in the millions upon millions of dollars. Every lawsuit that is awarded results in higher insurance costs to the doctors and other healthcare providers. These higher insurance costs result in higher bills to the patient. Additionally, there tons of indirect costs, too, as doctors try to "cover their asses" against being a target of a lawsuit. Even a simple sore throat, that is presented to a doctor, can result in hundreds of dollars in testing to make sure that the doctor didn't missing something like cancer. Of course, if he did miss a diagnoses, you can bet he will get sued. This is the effect that all these lawsuits have had on the medical industry. Costs can be further exaggerated by the use of medical specialist. Again, a general practitioner is less likely to make a diagnosis on their own. They would prefer to send a patient to a specialist rather than solely make a diagnoses. In the past he may have rarely used a specialist. But, lawsuits have changed that practice. So, again, costs are skyrocketed because of the higher costs associated with the increased use of expensive specialists.

Lastly, the preventative drug regimens of today have forced doctors to increase testing procedures to insure that specific drugs like statins (cholesterol lowering drugs) aren't having a damaging effect on the kidneys, liver, or other organs. While the incidence of drug-related organ failure is probably quite rare, no doctor will never risk being sued by passing on blood testing; even though the annual costs of those tests can be quite expensive.

To me, the biggest risk of any nationalized health insurance program is the ever spiraling costs. Unless a national health insurance program has protections against dumping-for-government-coverage and the explosion of lawsuits in this country, it is doomed to fail. That's just my opinion.

Image by interplast's on Flickr with Creative Commons Licensing. All rights retained. (Click to View Other Works).

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