Sunday, July 30, 2017

Health care better for EVERYONE?!

      In the exchange below I respond to the statements and positions of a person who thinks that mandatory government coerced insurance is the answer to the need for better health care.  My conclusion is that more freedom and less government will lead to more choices.  The more choices we have the better the chances of finding a policy right for each individual.  I propose that explicitly providing charity will actually serve our society and individual better.   Government coerced health care is certain to reduce health care quality, increase price and result in less charity because that is always the result of coercive government policies.

Pro-Mandatory Health Insurance Person: 
       "I hate the word "entitlement." It assumes a lot of judgmental things about the people who use assistance in this country. The problem is that the "healthy" 25 year olds that have to take a gamble are more likely to be poor. As a 25 year old I opted out because I was in grad school and couldn't afford it. In the meantime I knew healthy 20 somethings who suddenly got very sick. At that time if I had gotten sick with cancer or such it would have been a preexisting condition and I would have been stuck. Making you pay extra for the big things is a way that the insurance company avoided having to pay for the big things while making more money off the fear/caution of those that had the means. Insurance is unaffordable for many in this country, but not because it has to be. It could be cheaper if insurance companies didn't need to make record profits each year. There are plenty of hard working people in this country who are one diagnosis away from financial disaster and neither the ACA or the ACHA will fix it.  Also, as a married 20 something I would have had to pay extra in case of pregnancy if I hadn't had the unusually good UMass insurance. Is that pro-life? I have since had all natural, insured births and still had a healthy balance afterwards.

Freedom Response:
    Entitlement is an attitude that some institution or individual should provide a service to another not by choice but out of a requirement dictated by social norms or government edict.  It merely names something that exists.  Right, wrong, judgmental the meaning of entitlement is what it is.  Why is it an emotional trigger for so many?  People do, in fact, feel entitled and that is merely a fact. 
    There are many things that contribute to the "unaffordable" insurance you speak of.  There are evil corporations seeking profit (got to have that one!)  There are politicians who are corrupted and supported by insurance companies and professional organizations who supply regulations and laws that favor thier biggest donors.  There are doctors seeking to maximize income through fraud, deceit, anxiety and fear.  There are hospital and medical equipment owners seeking to fetch the maximum price for use of equipment and facilities sometimes with excessive multiple charges in a single day or visit.  There are patients seeking to use insurance for elective surgeries such as sex changes, abortion, tubal ligation, vasectomies and plastic surgeries.  No matter how the government dictates people find some way to exact wealth and advantage at the expense of the person who needs the insurance.  No amount of Government coercion will change this fact.  The result is that government coercion only increases the pay off and makes insurance cost MUCH worse.
    Freedom is the answer.  When a policy becomes to expensive or corrupt people move to policies that are more reasonable and provide the services desired for the price they are willing to pay.  If the insured  are not personally paying then you can be assured that corruption in inefficiency will become the norm.  People are capable of making good choices when there are as many choices available as possible.  People are unable to make choices if the insurance policy is one they must select because it is mandated by rule of law.
    I just want my high deductible back that we had and then the government terminated arbitrarily.  That awesome plan was taken away from my family (HSA's are no longer allowed). We can no longer contribute and that contribution instead now goes to insurance executives. Why not give people freedom? Why force a particular "health care" view on everyone? Why tell others that they MUST pay in to a health care plan that they find objectionable? Why not let UMass offer the insurance nationwide and let others stay on the policy they WANT to have? 
     Our policy was terminated by rule of law. We had no choice. Despite the "promise" I did not get to "keep my policy". Meanwhile donor insurance companies laugh all the way to the bank (based on stock prices and splits since the boondoggle was delivered in 2008). A purchase is now REQUIRED by law, forced on everyone by fine and legal threat. Helps sell the product when the law requires the purchase! Insurance companies are so delighted! Take away the coercive force of law and and 20 million people flee the government yoke called "health care" by the press. Why? Maybe they know that "government care" is truly an oxymoron?
     We had 4 children via natural child birth and for 3 of them we paid cash to state approved midwives (in SC, TX) and did not use "insurance" at all (all in our 20's). It was far CHEAPER to do it that way than pay insurance premiums for that benefit (we were home the entire time-the midwife came and left our home). In that time we thought our insurance was for sickness, illness and disease and did not consider pregnancy a sickness, illness or disease. We liked it that way and is seemed pro life to us. So maybe the idea that policies WITHOUT pregnancy coverage are seen by some (like us) as pro-life because they are more affordable and free up more resources for our family. Just want you to know that there is another perspective.

Pro-Mandatory Insurance Person:
        "I was curious, and I looked up the cost of a home birth. It is about the same as what we had to pay out of pocket for a natural hospital birth (not counting premiums of course). We were able to do an interest free payment plan with the hospital, it would have been difficult for us to pay cash. And we have always been able to pay our bills, if not much more. And we have supportive families who we can rely on. Many people in this country cannot say as much, even working full time. Paying cash for a home birth (even without preemies, or NICU, or preeclampsia, or c-sections) is not affordable for every family. But then neither is the alternative. That's why I will restate my belief that our system should be much better for families than it is."

     The midwife was MUCH MUCH less for us at home than in the hospital combined with the very high premiums for the full policy.  I do count the premiums because the exact so much money over time (for us the high deductible was $500 less a month for the family per month!)  We looked into it and realized that in addition to the cost of the premiums, the room, the nursing care and the typical "hidden expenses and charges" at the hospital all meant multiple times more than just the midwife in our home. In Texas we had to have an ambulance on call but that was a standby deal (notification provided but not a call). Hospitals love complications and profit from c-sections as well. Guess what? They have much much more in the way of complications and c-sections than home births. Disability from hurried deliveries, brain damage from excess oxygen and complications from numerous other intrusive procedures appear to make hospital births very risky using available data. Yet no one discusses how dangerous hospital births can be. Why not look at the data? Is it possible that there is a lot of money to be made in "health care" using fear and anxiety as motivators? Is it possible that the insurance companies, hospitals and associated services have a vested financial interest in maintaining fear and anxiety about something that happens naturally and is not an illness? 
     Our sixth child was in the hospital due to projected possible complications (that did not happen) and it was 5 times the price as our latest home delivery (but ONLY double the out of pocket costs).
      It appears that your research (home vs. hospital) did not match our experience. I am not surprised. The data out there often does not match reality. I wonder why? Is there a vested interest in making sure the supplied data supports the present system income model (fear/anxiety provided to increase demand and price)? Why must the government force ALL to accept some "wonderful pro-life system" with laws, mandates, taxes, fines, penalties and jail. Does a "mandate" make anyone wonder besides me?
     Why FORCE us to accept federally mandated "health care" that we do not want? Why not let us choose a path we can emotionally and financially manage? What is wrong with freedom?  My point is that freedom allows people to choose their poison as well. By restricting my freedom I am definitely hurt.  It is so sad for me to see a country that once had people yearning for freedom now scramble to find ways and reasons to exchange it for medical care.
    Freedom will make ALL health care better than it is.  Less freedom will ALWAYS make it worse (as it has done).

Pro-Mandatory Insurance Person: 
       "It doesn't seem right that riches can buy you better cures, unless you buy into the idea that rich people are all rich because of their many virtues (and therefore are more deserving), and poor people are all poor because of their many personal failings and therefore do not deserve it (never mind if they are children or the elderly, those entitled types, you know). I can never buy that."

     The incredibly wealthy Steve Jobs (multi-billionaire founder of Apple) found out that it doesn't matter how rich you are (he died of liver cancer in his 50's).  We all meet the same end no matter our wealth.  All the king horses and all the kings men could not put  Mr. Jobs back together again (there are lessons in those stories of old). Things happen to rich people and poor people alike.
     It is true that those who eat healthy foods, exercise, avoid unhealthy activities and have both parents as good examples tend to live better and longer. Those things (according to the raw data) combine to be the MOST unfair advantage of all (even more so than wealth). It is totally unfair that some understand that they are personally responsible for their health have better health than those who do not take responsibility. 
      How about the data? How about the fact that for the first time in a century mortality in the US increased as universally mandated insurance was implemented? Then Life expectancy declined! That is the exact opposite of what we were told "health care" would do.  The fact that this unexpected result happened is not discussed except in vary narrow terms.    
     Could the reason for opiate and medication deaths may be ease of access to narcotics and "health care"?  Do we have a system that benefits and profits from addiction.  Then our generous and corrupt government, with good public intentions, funds those enticing addiction and then those seeking to end addiction.  So many are then making a profit using the vulnerable to obtain government mandated funding. 
     Some people want out. Why not let them out? Why punish them with mandates, fines and threat of prison? We just love this discussion. Thank you for helping me understand better.

Pro-Mandatory Insurance Person: 
      "The idea that everyone has control of their own health is problematic and puts an unfair value judgement on sick people. We can try to be healthy but we don't always have control. Preemies are born to healthy mothers. Environmental issues affect people's water without their knowledge. Others are born with genetic predisposition to cancer. We need to be careful not to blame people for getting sick."

It may be "problematic" and seem "judgmental" but reality requires that insurance and society recognize what reality tells us in the data and statistics. Generalizations ALWAYS have exceptions but that does not stop what generally happens. Yes there are obese, sedentary, heavy smokers that who drink heavily and abuse narcotics living long lives. That is not fair. Insurance will never make life fair any more than finding the pot at the end of a rainbow will make one rich.
I happen to think it is impossible for insurance to "make things fair". Insurance can only mitigate the suffering that befalls you. Insurance deals with generalizations. It happens that as a general rule people who live with less risk, who take PERSONAL responsibility for health, who eat wisely, live active lives, are engaged in service will in fact live longer AND better quality lives whether they are rich or poor, black, white, gay or straight. It has nothing to do with value judgement of those people.
Those unfairly burdened with genetic dispositions that take compensatory behavior will almost always do better than those who do nothing and then expect a government program to foot the bill after a disease becomes chronic. Then the same "victims" have the audacity to claim the treatment is not better because the taxpayer is not generous enough to cure the disease! To think that we can stop the rain from falling (on the just and unjust alike) and attempt to "make all life fair" is certain to end in BOTH a bankrupt and declining culture. Coming soon to a culture near us?
I happen to think freedom is the only way out. Genuine charity (not government coercion) is a real solution (example: St Jude's which treats thousands of victims without charge). Government edict and coercion will ALWAYS end with politicians enriching cronies and donors. That is the sad fact (more government means more corruption). Freedom and charity, in contrast to more government and coercion, are (in my view) the only way out of the mess. I am also confident that genuine charity will flower whenever there is freedom. A system that relies on coercion in the form of fines, mandates and seizure of assets from those unable to protect them will never work to make things fair. Those like me who are too poor to hire lawyers and accountants to hide assets are stuck and bullied and accused of being "judgmental".


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