Obamacare, Health Insurance, Ear Hair, and Looking at Breast Implants

“No, Steve, the guard, accidentally looked at Medusa’s head.  Turned to stone.  Who covers that? Is that health insurance or Workman’s Comp?” – The Librarian: Return to King Solomon’s Mines

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A picture of Fairbanks Memorial the day Pugsley was hatched born.  I had good insurance then.  Too bad it’s gotta go . . .

Almost everything in the world (almost!) has gotten better since I was a kid.  Well, the music isn’t as good.  And the movies are gloomier.  And my hair has migrated from my scalp to . . . everywhere else.  For heaven’s sake, why did it have to go INTO the ears???

As I look to things that have gotten much worse in my lifetime, the number one is . . . health care costs, which is even worse than ear hair.  Obamacare (or the Affordable Care Act for those of my readers that regularly appear on CNN®) was supposed to fix that.  In my case, my premiums nearly doubled while my deductible went up by a factor of eight.  If my math is right, that means my health insurance is worth, on a dollar basis, one sixteenth what it was before Obamacare.

When Pugsley attempted to self-amputate a finger on a camping trip, The Mrs. took him to the emergency room.  He came back with two stitches.  My bill?  Over $1000.  And I had to pay it, in cash.  Did he really need all of his fingers?  Nine is a good number, right?

I’d love to blame Obamacare – but it’s really just part of the system that’s vaulted health care costs upwards.  We’ve all experienced it – we’re paying unconscionable rates for care that’s not (in some cases) as good as it was in the past.  I know we have fancy equipment and machines that go “ping,” but the idea of a family doctor that knew you family from your birth until his death is over.

Now doctors have to see as many patients as possible to pay for their rent, BMW® and the loans they took out for college, their divorces, their small airplanes, and their portion of the partnership.  And they practice defensive medicine.  They run tests that you have to pay for to protect their medical license.  And if your insurance doesn’t pay for the test because it’s unnecessary?  You pay for the test.

I love capitalism.  It’s awesome.  But our health care system doesn’t even remotely resemble capitalism.

Let’s start with theft.

Our current health care system was changed in the 1980’s.  If you showed up to an emergency room in 1979 and had no ability to pay for care . . . they had no obligation to provide care.  None.  As a matter of principle they’d stabilize you, but a life changing surgery involving 20 heroic doctors?  Not so much.

I heard a story about a woman who lost her health insurance.  And then got cancer.  She couldn’t afford the $80,000 or so in costs for chemotherapy and treatment.

She died rather than bankrupt her family.

And, sadly, that’s the right outcome.

The economist Thomas Sowell said (more or less), “If an economist was designing a car, instead of an airbag in the steering wheel, there would be a knife pointed at the driver.  Good economists believe in in consequences for actions.”

There needs to be an incentive for people to pony up and get insurance.  And in the 1980’s they removed that.  Now, regardless of my ability to pay, if I show up at the hospital, they have to treat me.  Can’t turn me away.

Now I’m all for compassion.  But in this system, the person who is compassionate (the politician) forces the provider (doctor/hospital) to treat someone for “free” – but in reality passes on the costs to the responsible idiot with insurance and money (me and you).

Why does a Tylenol® cost $11 each in a hospital?

Yeah.  You’re paying for the freeloaders.  For the lawsuits.  For the administration costs.

One hospital (Duke) had 900 beds.  It had 1500 billing administrators.  Why?  They have to navigate through Medicare rules, as well as rules and correspondence from hundreds of different insurance companies.  You spend a night in the hospital?  You have 1.7 people there with you just counting the costs.

Yikes!

Of the things that determine a capitalist system, it’s all missing.

  • You don’t see those until weeks or months after the event.  How can you make a decision?
  • They don’t have the choice to refuse to serve you.
  • You don’t have one if you’re bleeding out.  You go where the ambulance is taking you.  You don’t haggle when you’re unconscious.
  • The system is so regulated that the American Medical Association determines the number of doctors in the country.  Think that they’ll increase competition?  Hospital regulations (mainly Federal) are extensive.
  • Lipitor®, which treats something or other, was making Pfizer $5billion a year.  After it went generic?  Less than a $1million a year.  Protections for drugs are routinely extended and live longer than the original patent period.  Apparently Viagra™ also keeps the patent system going for a long time, too.
  • LOL, whut?

What does a free market look like for medicine?

We actually have great examples.  Laser eye surgery costs have plummeted over time.  And, it’s never been cheaper for ladies to become . . . ahem . . . enhanced.

Why?

People have choices.  They don’t need the surgery.  They want it.  So they shop around, and will only get it if the price meets expectations.  $10,000 to not need $200 glasses?  Not on this planet.  And even the girl who wants bigger boobs is budget conscious, even though her boyfriend now has had laser eye surgery and can see them.

Recently several doctors have cut the cord.  No insurance.  None.  Come see the doc?  Cash.  But the prices . . . are much lower.  Much.  Many are less than the copay for your insurance.  Here’s a link (LINK).

The Mrs. and I were discussing this problem last year.  I outlined the issues.  The Mrs. leaned back and contemplated.  She swirled the Johnny Walker Blue Label™ in her glass and said . . .

“Make it illegal.”

John Wilder:  “Make what illegal.”

The Mrs.:  “Insurance.”

When she said that, I immediately pushed back in my mind.  The costs were so high . . . how could anyone ever consider that?

But then I realized that she was right.

Health insurance as a concept really took off during World War II.  The government had frozen the wages of the workers so we didn’t have runaway inflation as the tank factory tried to steal workers from the bomber factory.  But . . . you could add benefits.  Life insurance.  Pensions.  And?  Health insurance.

This began an 80 year distortion of the health market.  The person taking the action (you) was not paying the bills (insurance company) or writing the prescriptions (doctor).  How could costs NOT explode under such a twisted system?

So, The Mrs. is right.  We have to burn this village to save it.  And we will – because otherwise it will torch the whole country as I’ve previously predicted (LINK).

Until then?  We can stare with perfect vision at augmented . . . attributes.

If only there was a cure for ear hair.

Author: John

Nobel-Prize Winning, MacArthur Genius Grant Near Recipient writing to you regularly about Fitness, Wealth, and Wisdom – How to be happy and how to be healthy. Oh, and rich.

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