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General News    H3'ed 2/10/09

The Healthcare finance drill down

By       (Page 1 of 3 pages)   19 comments
Message Matthew UTae

I'm writing this as a response to Donna Smith's very well written article:

Some things that Donna has a problem with is:

1. - Obama is using healthcare industry folks as his consultants on the matter.  These folks are not impartial consultants.  Specifically, she claims health INSURANCE folks, which isn't all true.  I would say there are healthcare industry folks, not all of them are health insurance industry folks.

2. -  The acceptable level of care that should be provided is "care is given as care is needed.  Period."  If Donna were allowed to act as the grand poopah, If people do not understand "care is given as care is needed" and why that should be, the dissenters should be left to fend for themselves and die unless the do "get it".  These are Donna's words.

3. -  A commentor (Not Donna) said the people who should create a supposed single payer system should be the people who have chronic conditions and those who are terminally ill.

While this is a plan of action, I don't think it is necessarily a good one.  It may be a good one, but I have some doubts which I'd like these folks to comment on.

Donna says that healthcare reform conversation in Washington reeks of terms like "cost containment", "reinsurance", "tiered benefits", and "payment incentives and physician bonus opportunities".  She further assert:

"I've heard all this sort of pitching many times before as insurance agents and intermediaries peddled their wares in conference rooms and break rooms for employers I've worked for over the years."

First, I'd like to say that the insurance folks you meet in your break room are probably not the people that Washington is consulting with. Your supposed situation where the "bad guy" at the root of the problem is a for profit insurance industry lacks distinction.  One thing is that the insurance company is probably not the one who is setting the rates for your company benefit plan since your company benefit plan is probabaly self funded.  

Do you know who the consultant is that gives advice to your CFO, HR director, and CEO about your benefits plan?  I believe you should rephrase your general wording of "health insurance industry" to "healthcare industry".  Otherwise, we are looking at the bean counters (i.e. insurance) as the problem.  I would say the "beans" they are counting are a large part of the problem. Also, why those "beans" are so expensive needs elaboration beyond collusion, corruption, and profit motive.  I've written about this here before, to the chagrin of some.  Also, how do you blame the bean counters (i.e. insurance) when they are not-for-profit companies?  Are these non-profit insurance companies also involved in collusion and corruption?  If so, is it just the practice of insurance you don't like?  

The "acceptable level of healthcare" you mention needs clarification.  In Canada, there's a story about someone who wanted a surgery done, but the doctor in Canadian system denied the request since the he looked at the MRI, and in his opinion, the surgery was unnecessary.

Who determines "care as needed"?

Also ancillary to this, Donna's "healthcare as a human right" is a concept I'd like to understand more.  If you get hit by lightening or are born with cleff palate etc...this is through no fault of your own (unless you were golfing while getting hit by lightening).    You have a right to healthcare in those cases.  But what about the 3 packs a day smoker who develops lung cancer at the age of 44?  If you cover them, I can accept that. One thing though, supporters of universal healthcare are often against the financial industry bailout.  Why?  Its wholly inconsistent.  You favor bailing out moral hazard with universal healthcare (i.e. irresponsible risk taking in the form of smoking), but not bailing out moral hazard in the financial sector (i.e. irresponsible risk taking in the form of mortgage backed securities). However, I can see the point that one involves a human life.

This is the crux of the argument.  The valuation of human life.  Healthcare (not just health insurance) takes this into account.  A value IS attached.  What folks here on this website often write about, in a in-direct way, is that this practice of displaying the value of a human life in the form a cost, premium payment, etc... is wrong.  My contention is that your being naive and unrealistic.  For you to get your way, I don't know how you would without sacrificing your principles.  Ghandi's Swadeshi concept may be what you are looking for.  There are ashrams out there available for you. 

Moving forward to explain why healthcare must involve a conversation about costs and therefore a valuation of human life and risk.  Right now, some employers who self fund consider health factors (such as smoker vs. non smoker) in hiring; as they should.  Some employers do not and provide healthcare as a fundemental right of employment regardless of your personal behavior. To consider why your employer does all these "silly benefits meetings" and "wellness initiatives", lets look at the auto industry bailout.

Car manufacturers pay their employees about $30 per hour.  Car manufacturers pay UAW workers an additional $39 per hour in benefits in the form of health benefits, pensions, and retiree benefits.  The UAW's VEBA fund information should be available to the public via their 5500 form filings.

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