All day I’ve been involved discussing healthcare on Facebook. The heat of the moment is the revision of how we administer the cost of healthcare in this country and the plans we have in store; either the government will expand Medicare to cover us all or there will be cooperatives formed across all states to pool risks together, à la Iowa as a model. Well, let me tell you what I know and what I think.
I know that 44 years ago, before Medicare came into existence, we did not have a healthcare problem of spiraling costs in this country. I know that doctors did not have to worry about their profiles to get paid by the government for their services. I know that the elderly were covered by private insurance that did not cost an arm and a leg.
I know hospitals spent on medical equipment according to their capital capabilities, not mandates from the federal government as to proximity to similar equipment. Hospitals were run for profit. Everyone knew that going into business had as a goal the earning of revenues to ensure another day of operations with the profits.
Doctors performed lab tests in their offices routinely. People carried insurance for their health, their life, their retirement and sums of money were earmarked to cover those premiums first. Families spent what was left after being responsible, paying the bills, saving for difficult times. It was not customary to borrow without the expectation of paying back sooner rather than later the sums borrowed. There was a high degree of diligence, respectability, and honesty.
I also know that when Medicare erupted into the scene all kinds of spiraling costs sprang up. Doctors needed to charge more to create a profile with Medicare lest they continue to receive in payment from Medicare less and less for their professional services. Insurance companies did not withhold payment sixty or ninety days because the free market did not allow them the luxury of bad service to their policyholders. They paid promptly. Really, everyone paid promptly.
I know that pooling risks was the norm at the time, not the exception. But pooling risks of all insured persons is what I’m talking about, not pools of the healthy versus the sick. It follows that pooling risks of healthy versus sick will not be profitable for the sick and will increase the cost of their benefits while the pool of healthy insureds continues to decrease in size and payment of benefits. Clearly, it is more profitable to keep premiums and not pay benefits. Withholding payment for benefits to retain premiums without paying claims incurred is clearly not what insurance companies are contracted to do. It follows with only an ounce or two of grey matter.
Before Medicare, everyone knew they had to pay for healthcare coverage. No one expected the government to pay for anything. The indigent could resort to public hospitals, but those were the few, the exceptions to the rule.
Now, I read of vast numbers of individuals who prefer to travel and not get health coverage because it is more enjoyable to spend money doing what we want than facing the obligations we all want to avoid. This creates in our society a group of freeloaders that comes to burden the rest of us. They boast about it on the pages of Facebook and Twitter. And it irks me.
As I have written on this blog before, insurance is the substitution of an unknown loss (the risk) for a loss of known magnitude (the premium). If we take the money that should conscientiously go to face unexpected difficult moments that may arise in the future and spend it traveling for pleasure, going on vacation, buying expensive automobiles or homes we cannot afford, and charging credit cards with loans we cannot repay, all while expecting the government to pick up where we cannot afford emergency expenditures, we are nothing more than a burden to our society. We do not belong to the capitalist society that formed this country, where everyone works hard to find a better footing.
Truthfully, there ought to be provisions for genetic illnesses, serious medical conditions, unemployed individuals who lose their ability to fend for themselves, the old, the mentally ill. But not for those who refuse to take care of themselves because they would rather spend their money doing stuff that immediately rewards their hedonistic behavior. For those people, we should pay their bills and then make them work to pay it back, forcefully, even behind bars if necessary.
If we all insure ourselves during youthful and healthy times, we should not face illness and old age with fear. Our insurance coverage would be there to respond. If we choose not to insure ourselves, we should have in escrow with trustees hundreds of thousands of dollars to ensure that our bad planning does not affect the rest of society. So if we do not have those funds to escrow, we should then resort to buying insurance.
I believe the government should have a pool of money for those who cannot help themselves temporarily, but not blanket support for all the loafers that would rather take from the rich to give to the poor. The taking from the rich to give to the poor is a dead end game. Soon all the rich are poor and all the poor are equally as poor. And no one has anything any more.
We need to reform the laws that regulate insurance companies. We need to ensure by fear or by force that insurance companies pay the benefits that their customers buy from them. We need to levy stiff penalties and heavy fines, including criminal prosecution for executives of companies who fail to live up to the promises of their insurance policies. This is the true role of the government; not run healthcare for everyone.
As free individuals, we need to account for our own needs. We are free to pursue happiness, but not free to burden others and condemn the nation to pay for our financial failures. My freedom to do whatever I want ends at the step of my neighbor’s right to do the same. If the exercise of my freedom tramples someone else’s rights, then I am breaking the law.
We must shape this discussion into arguments that forge ahead with our country’s culture. We are not a socialist country. We are a country of laws. We should honor and respect our heritage. It is what made this country a great nation, a beacon to the world.
We should contemplate eventual occurrences where a handful of individuals lose their ability to support themselves. We should be there as a country to lend them a temporary hand. We should not encourage sloth and lack of responsibility by blanket support that hinges upon the ability of the rich to foot the bill. This course of action is dictatorial and socialist. It points to the end of the country that we know and love today.
Let’s create a fund that the government will use to defray the cost of medical care for the exceptions, not the rules; the temporarily unemployed, the genetically disadvantaged unable to secure regular coverage, the mentally ill unable to cope with reality, those that lose their employment but actively seek another. We should use the funding to pay the premiums these unfortunate individuals cannot cover. But it would be the same premium pooled with 350 million insureds from all walks of life within our country.
The insured’s geographical location in the country, sex, occupation, avocation, age, and history of illness becomes irrelevant. The premium would be the same, actuarially determined ahead of time. What we would seek then is a better service provider, not a lower premium. Service would be the new area of competition: service unequaled by competitors and the free market would flock to that carrier.
But we would all be responsible and, outside of supernatural occurrences that we all encounter from time to time, we would pay our own healthcare premium from cradle to grave. We would find our own doctors. We would go to the hospital of our choice.
Let’s legislate that. Let’s legislate integrity and self-determination. Let’s stop discussing how the rich earned or not what they have.
Envy is the worst of human conditions. It blinds us to the point of ignoring how detrimental it is to our psyche and the country as a whole. We should rise above these petty exchanges that currently shape our discussions on healthcare and find workable solutions to our present situation without ignorantly expecting the government to take care of us with other people’s money.
As we come to the end of this blog today, please let me know your opinion and how these topics may better reflect your personal interests. All points of view are respected. Thanks for reading my blog.