National Healthcare: Why Another Trillion Dollars? Something Doesn't Add Up!

• Fact: No one in this nation can be refused healthcare at any one of our hospitals. It is the law and it the reason why most of our hospital emergency rooms are clogged with colds, flu, and broken arms that need medical care but would have been better treated --- at an extremely lower cost --- by a family practitioner or at some clinic.
  
• Fact: In a country of 300 million people, about 16 percent of our population -- 46 million people -- don't have medical/healthcare insurance.
• Fact: The cost to cover the medical cost of the uninsured is already in the healthcare system. That is why the majority of hospitals, clinics, and doctors remain profitable. The majority of the uninsured's expenses are being picked up the medically "insured" of this country in their own family insurance programs (See Full Story). The remainder of the costs are covered by our Federal government and by the individual states in various assistance programs; by out of pocket expenses; and, by charitable organizations.

Just focusing on the fact that uninsured healthcare costs are already being absorbed by the "system" in various fashions and assuming that Obama is claiming that he will reduce healthcare costs in America; then, why is Obama asking for $634 billion over the next decade (See Full Story) as a down payment on his Nationalized Health Care system. Some experts actually expect that cost to be double that number because of government waste and fraud that will result in higher costs for nationalized heath care.

However, any of this additional expense makes absolutely no sense. If the costs already are in the system and Obama is promising to reduce healthcare expenses across the board, the cost of a nationalized healthcare system should be, in theory and at the very worst, a zero-sum game. This is especially true if you assume that a lot of uninsured medical care is being doled out at emergency room rates; and those rates can be as much as 10 times the cost of a normal doctor's office or clinic visit.

As I have vehemently stressed before in this blog, the elephant in the room that everyone is ignoring when it comes to health care is litigation (See my May 17 blog entry). Beyond this, we need to get people out of the hospital emergency rooms and into less expensive care. Maybe state or federally supported clinics might do the trick? But, the bottom line is that health care is already 16% of our Gross Domestic Product and Obama wants to up that ante with billions of dollars more in federal expense. Does that sound like a cost savings to you? All the money we need for national health care is already out there. We just need to find a way to better utilize it. This means that some thought must go into the formulation of a national health care system for America... It must be outside the political arena and not involve the Federal government and all the waste that usually goes along with that type of program. As a country, we should not be rushing, as with the stimulus program that still has yet to be spent, to just spend money and to get "any" nationalized healthcare system, good or bad, because it was this President's campaign promise! Let's get all the healthcare service suppliers and the government together to put a real plan together that doesn't have all the pitfalls of those in Canada and Europe. For once, can we use the best and brightest and not the dumbest and dimmest of Washington, D.C. to decide the fate of America!

Heathcare and the High Cost of Perfection

Many say that we Americans have the best healthcare in the world. Certainly, hundreds of wealthy non-Americans travel here to get the care they couldn't get in their own countries like Canada and Britain that have socialized medical care systems. At the same time, our healthcare is admittedly the most expensive in the world.

Years ago, I attended a company-sponsored seminar on the concept of quality. The primary thing that I took away from that seminar was that, with every increased level of perfection, costs will go up dramatically. In other words, to build the absolutely perfect anything, the cost would be so high that only the richest in our society could afford to buy it. The other thing that I took from that seminar was that true quality is matching people's expectations of a product's performance and not trying to exceed that expectation.

In large part, our healthcare system is being forced by constant litigation to meet perfection; and, with that perfection, comes a very high cost. For this, I blame the medical malpractice lawyers. A doctor, hospital, medical or drug company may have saved thousands of lives without a hitch. But if they injure or kill a single person, the cost of that one mistake can be extremely significant. Lawyers don't care about how many times you get it right. When they are in the process of suing a doctor or a hospital, they only look for the missteps or the imperfections that occurred in the treatment of a patient. Then, they magnify any imperfection to make a jury believe that the doctor or hospital was totally negligent. The result could be damages that are awarded in the millions of dollars.

As a result, all doctors, hospitals and all medical related corporations have been "conditioned" by our legal system towards perfection. Costs are rising faster than inflation because nobody in the industry wants to be wrong or make a mistake that could injure or kill someone and suffer the high costs of being sued. Also, the rates for malpractice insurance, especially in some specialties like OB/GYN, are rising twice as fast as the overall healthcare costs in America; which might give you a hint as to where the true high cost of healthcare lies . No longer is a simple sore throat a simple sore throat. The doctor, as a result of widespread litigation, must now look at every patient as possibly having the widest ranges of illnesses when he/she walks into their office; even including the rarest of diseases. To insure that the doctor doesn't screw up by missing something, they will, at the very least, order up a wide range of expensive diagnostic tests. Those tests may even include extremely expensive MRI's or CAT scans. Further, he or she will probably refer their patient to a specialist to make sure they aren't missing something else and, in effect, give that patient a second opinion that they never asked for. In essence, the doctor has developed a "CYA" mentality; and, with this, costs are skyrocketing.

The same applies to drug companies. When a lawyer sues a drug company or medical equipment manufacturer, they come after the company as if they expected that company to have tested for every conceivable human variance and/or combinations of human conditions before a drug or piece of medical equipment was put on the market. But, those companies can't do that because it would be just too costly for them to develop a supposedly perfect and totally safe drug or piece of equipment. In reality, the lawyers know this and take full advantage of this limitation. So, whenever a drug company decides to manufacture and sell a product, they do cost/benefit analysis and, as a result, they price in any anticipated law suits. That's why new, lifesaving drugs are so extremely expensive. Sometimes the drugs that could save many lives never come to market because the market is too small and the risk of lawsuits are too high and the product can't be priced low enough to make it marketable. When that happens, the sick and dying with rare diseases are the ultimate losers.

Obama's healthcare program completely ignores the primary driver for high healthcare costs in this country - those lawsuits that are forcing medical perfection. Instead, he appears to be going the route of withholding expensive forms of medical care in order to avoid high costs. All indications are that the Federal Government will ultimately play God and decide what care Americans are able to get; especially for the elderly. Remember, it is the elderly who cost the government the most amount of money because they are the ones receiving social security, prescription drug coverage, and Medicare assistance. That means that some people will unnecessarily die when they didn't have to because the government might view them as a financial liability.

Obama, as a lawyer himself, doesn't want to upset all those lawyers who helped get him into office. Don't forget, we have half of the world's attorneys with only 5 percent of the world's population. Most of those lawyers probably voted for Obama and contributed to his Presidential campaign. Their intention in doing so was to absolutely insure that they could happily litigate over medical malpractice and continue to reap very high settlements and, subsequently, their high and getting higher incomes; settlements that are now doubling in the amount of damages at a rate of every 5 to 7 years.

For years, the Republicans have been trying to effect tort reforms to try and stall the rising costs of healthcare. But, at every turn, the Democrats and their cozy relationship with the lawyers in this country have blocked every attempt. Now, again, with Obama in charge and with complete control over Congress, we will be instituting a government healthcare system in America that protects the lawyers and limits that amount of care that we can get; especially in our later years.

What Obama's Call For Sacrifice Really Means

Barack Obama touts electronic storage and the electronic data transmission of medical records as the means by which he will reduce health care costs in this country. He makes it sound like, that by reducing administrative costs and clerical errors, there are massive savings to be achieved. But, in reality, he is establishing an electronic eavesdropping system that will give the Federal Government the ability to deny any medical care that is deemed unnecessary by some unknown bureaucrat in Washington, D.C. (See Full Story). This is another one of those not-so-transparent things that Barack Obama has managed to sneak into our lives since taking office. This time, it was slipped in under the cover of the Stimulus Package. If you are an elderly person and there isn't an absolute odds-on bet that some procedure or medicine will actually benefit you, funding will be denied by the bureaucracy of Washington, D.C.

I find this to be unbelievable. For years, the Democrats have been screaming about HMO's and other health care insurers who have not provided or denied medical care to someone based on their cost/benefit analysis. Now, they want to do the same thing; and, on a much broader basis. Further, the left-wing of this country was incensed over warrantless eavesdropping by the Bush Administration. This program, by Barack Obama, is out-of-control warrantless eavesdropping that will affect the healthcare of millions of people in this country. The Bush Administration's eavesdropping was only aimed at a minute percentage of those who might be suspected of terrorism and who would want to hurt this country. In a way, this Obama plan is a twisted parallel to the underlying concepts of Soylent Green and Orwell's 1984.

This is the kind of socialism that Barack Obama and most of his like-minded progressives want for this country. Under this current and nearly complete Democratic control, every American will lose their individual rights and the Federal Government will become their ultimate care giver and caretaker. During his campaigning Obama kept talking about the sacrifices that every American must make. I guess the lack of medical care is one of those sacrifices we are expected to make. Is this the change we want in this country?

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).

Fact-Checking Hillary: A Full-Time Job

Well, the inevitable happened again! Hillary got caught in another whopper.

This time it had to do with a pregnant Black woman who was uninsured and she and her baby died because a hospital refused her care. To make it worse, as Hillary told it, if only she had $100, the hospital would have cared for her; and, her life and the life or her baby would have been saved. (See Full Story).

Certainly, Hillary jumped on this story because it was so perfect for her as a Democrat. It had all the elements that a Democrat looks for to paint a bad picture of America. It had a poor, Black, pregnant woman. She had no health insurance. And that mean ogre of a hospital, like all hospitals and health care providers in America, refused her care and she and her baby died. Of course, it was so "perfectly disgusting" as a story that Hillary couldn't wait to tell it before making sure it was accurate. And, so happy with this lie, she continued to tell it for 5 weeks on the campaign trail. After all, it sounded just like the America that Hillary was so familiar with.

Of course, Hillary Clinton, as a United States Senator who has made health care such a prominent issue of her campaign, should have "known" that something didn't smell right with this story. In fact, if it had actually happened as Hillary said it did, it would have been a violation of Federal Law. That's because the 1986 Federal Law, the Emergency Medical Treatment and Active Labor Act (EMTALA), requires all hospitals and ambulance services to provide care to anyone needing emergency treatment or who is in labor; regardless of their citizenship, their legal status or their ability to pay. That's why so many illegal aliens come here to have their babies. Further, as specified by the law, all hospitals post a placard in their emergency rooms that clearly states the provisions of that law. This law and the guarantee of emergency care is one of the many reasons why we have 47 million Americans without health insurance in this country.

Instead of telling this phony story of "woe" in order to bolster her political agenda, she actually should have been calling for a criminal investigation against that hospital for violating a Federal law. Of course, that too, would have blown up in her face because that action would have been based on a false story. Oh well! Maybe, it would be better if Hillary tried something "original" like telling the truth for a change!

The Real Story Of Health Care Costs in the U.S.

Truly affordable, and possibly mandated government-sponsored or government-controlled health care insurance in this country is at the forefront of all the political campaigns this year. Both sides of the aisle believe they have the answers. However, none (and, I mean "none") of them addresses the real reason that health care is so unaffordable for so many in this country.

The answer is fairly simple. It is malpractice lawsuits.

In their defense, the attorneys who are involved in malpractice litigation will point to the fact the dollars being awarded as a result of their lawsuits pales in comparison to the aggregate annual cost increases being charged by the health insurance companies and the medical profession. And, that is true.

However, to see the "true" impact of lawsuits on the medical system in this country, you need only look at "9/11" and the loss of the World Trade Center buildings as a parallel. The replacement cost of those buildings, two planes, and the remaining lifetime salary potential of those killed in that tragedy, are a mere fraction of the trillions of dollars that Federal, State, and local governments and corporations are now (and probably will be forever) spending for increased "security measures" to prevent that event from ever happening again.

The same is true in health care. Today, doctors have a fear of lawsuits. They don't want to be sued because their individual rates will increase. As a result, patients are subjected to more tests than ever to make sure that their reason for seeing a doctor isn't something "more" than just a cold, a sore throat, body ache, etc. In the same way that we, as a country, are trying to prevent another "9/11" with extensive and very costly security measures, doctors are taking extraordinary steps to insure they don't misdiagnose and, ultimately, get sued. That's why many doctors are increasingly using "specialists" as a form of second opinion to insure that they, alone, don't make an erroneous decision on what ails you. This is "CYA" to "nth" degree! All these tests and referrals to specialists are driving costs through the roof. And, while insurance companies and Medicare can control the costs of the "individual tests" and office visits; they are unable to step in to control the frequency and breadth of either. That's why costs are going up so fast.

In addition, we know more than we did years ago. For example, we know that high cholesterol can lead to a stroke or heart disease. Millions of Americans who can't control their cholesterol are put on "statins" to control it through medication. Once you are put on one of these "statin" drugs, you have now committed yourself to an expensive blood test every 90 days to insure that your liver function is not impaired. And, it's the insurance companies (and, ultimately us) who pay for all those tests. Even though the incidence of liver failure as a result of taking a "statin" drug is relatively low, the doctors are "not" going to take the risk that you have an impaired liver function and wind up suing them. So, as a result, 2 or 3 thousand dollars a year will be expended in medical costs and the cost of the medications, themselves, to insure you, primarily, don't have a stroke or heart attack (which could also result in a lawsuit against a doctor), and, secondarily, don't have liver disease which could result in future litigation.

And, here's another example. One of the reasons that we have so few influenza vaccine manufactures in this country is because 90% of them were driven out of that business by lawsuits. Every drug manufacturer builds a certain amount of cost into every drug they develop and market to cover the risk potential of lawsuits. And, that's why so many drugs can cost more than the cost of dinner each day. Those manufacturers know that "no" drug is 100% safe. There are always side effects and potential long term consequences. However, the legal profession sues on the basis that there be no risk at all!

If we, as country, want to get serious about making health insurance broadly available to everyone, we have to start with tort reform in the medical care arena. In many countries, that have socialized medicine, the ability to sue is severely limited because, to do so, would be to sue the government. Doctors are just employees of the State. There's no juries awarding millions and, subsequently, a third of that award being given to an attorney as a big fat paycheck. Nor are there any awards for pain and suffering or any premium imposed as "punishment". Generally, a governmental panel will decide if you are entitled to any compensation; and, if so, it is usually in the simple terms of wages being lost. In some countries, the panel can refer a case to the courts. But, it's their call and "not" some attorney's. The punishment of failing doctors is left up to a governmental review system and "not" done in the court system.