Saturday, March 13, 2010

Healthcare and the Free Market

First, I must admit that I am no expert on the current "workings" of the healthcare industry in the United States. Although I have always lived in the US, am a natural born citizen, and am a frequent user of the healthcare system, I do not know how doctors, hospitals, and insurance companies do their business. I only know what I see and experience as an end user. And I am not happy with what I experience.

Most doctors make a lot of money. Most hospitals are big, modern, expensive buildings with a lot of fluff (unnecessary decorations, artwork, etc. You know. Like government buildings.) Most health insurance companies make enough money to pay their executives huge salaries while claiming that rates must be raised 20% to 70% per year (personal experience as a former business owner.) In a normal free market environment, companies would have to provide superior customer service and be managed very efficiently in order to have the type of financial success that most doctors, hospitals and insurance companies experience. But I personally do not receive good customer service from any of these providers. Do you?

Do not get me wrong. I like my current doctor. But I have to wait days or weeks for an appointment, many times to only have it rescheduled for me because the doctor is going to be "out." Then when I arrive for the appointment, I am so conditioned to the bad customer service that I know I will receive, I promise myself that I will not get upset and leave unless I have to wait for more than one-hour past my appointment time before getting called back (luckily I have not had to experience the 3-hour to 5-hour waits that I hear are common at the OB-GYN.) But that is not the end of the wait, for then I have to agree with myself that a wait of up to 45-minutes in the examining room is also acceptable. But that is really only the beginning of the wait. If I actually have a problem, I will be scheduled for more tests. But not at this doctor's office. Somewhere else. Some other day. The note on the examining room wall says, "If you have other tests done, do not call for your results for a week or two." First, why does it take a week or two to get my results? Second, why can't they call me?

Then I go to pay. I have insurance. It is a Health Savings Account policy with high deductible. That means that I pay the first $3,000 every year ($1,500 for me. $1,500 for my bride.) That is not good, but it is better than paying even higher monthly premiums. Even though I know I must pay, I still have them file the charges with my insurance. By doing this, I can pay the insurance company's rate, rather than the "no insurance" rate, which is much, much more. But I have no idea what my charges will be, because we are all just expected to accept whatever charge the doctor, lab and hospital want to charge us.

Here is what is wrong with our healthcare system (and this is before Obamacare): It is not a free market system! Doctors, labs, hospitals and insurance companies do not have to compete for our business by offering competitive pricing and good customer service. Do you know of any store that stays in business when customers have to wait hours to get inside (other than when the new X-Box goes on sale)? Did you know that when a business shops for insurance (with one of the limited number of health insurance providers in a particular state) they are REQUIRED to tell the companies bidding on their insurance what they are currently paying? In most situations, that is considered unethical, or at least unfair. Did you know that patients without health insurance are required to pay many, many times more for their healthcare services than the amount paid by patients who have insurance? In most businesses it is either unethical or illegal to "price gouge" a class of people (those without insurance), but not in healthcare.

Take a minute to think about the businesses who give the worst customer service: 1. Telephone companies - heavily regulated by the Federal government to control competition. 2. Cable TV companies - heavily regulated by local and state governments to control competition. 3. Insurance Companies - heavily regulated by State and Federal government. 4. Healthcare providers - heavily regulated by government to control costs and insure access. And on. And on. And on.

Obamacare is not the solution. Here is the solution: Shrink government and deregulate. In other words, Get Off My Back! Follow the Constitution of the United States. Understand that I want to be responsible for myself. I do not want or need a government to take care of me. Without 80% of the government oversight and regulation we have today, I might not live quite so long. I might fall prey to an unscrupulous crook. I might have to decide between a new car and new teeth. That is all OK. Just let me be responsible for me. Let me decide how I want to spend my money, and who I want to share it with.

Three things that will save our country: 1. Term Limits. Two terms. No more career politicians. 2. Fair Tax. Tax what I spend, not what I earn. 3. Balanced Budget Amendment. Lets not give them the chance to continue bankrupting our country (except in instances of war or national emergency declared by Congress.) The real shame is that none of these three things would be required if our elected leaders could just follow the Constitution that they all swore to uphold.

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