Why You Can’t Afford Health Care

I’ll give you the answer right up-front, and then tell you why. Here it is: The reason you can’t afford Health care is because of Health Insurance!

A Bed Time Story

Once upon a time, in a kingdom far away and long, long ago there lived an Insurance CEO. And just like all other CEO’s he wanted to sell more of his companies products, increase net sales and get a big $bonus. He pondered long and hard wringing his hands day and night. Finally, being at his wits end he called his minions to court – read as Executive Management Office, the room with the golden chairs. 

“Gentlemen, we have saturated our markets. Profits, although substantial, are flat. My $bonus will be flat and I assure you that yours will be flatter if you don’t come up with a way to sell more insurance!” Hearing this the minions wailed and cried out as one, “but majesty, we are already working on mandatory auto insurance. We have our best people in Washington pledging contributions to legislators on both sides of the isle. We just launched two new annuity products that will charge even more exuberant hidden fees to the uninformed. What else can we do? Please don’t screw us out of our $bonuses!” More weeping and gnashing of teeth ensued.

Just when it looked like $all would be lost a small voice was heard at the back of the room. “Sir, sir, I have an idea.” The room was hushed and frozen as all searched for the small quiet voice. It was the General Counsel, the sniveling lawyer sculling in the corner. As one they turned beady red eyes upon him.  He hesitantly stood from his chair pushing he glasses up the bridge of his nose. “Sir, we could sell Health Insurance.” Immediately the room filled with laughter and they all pointed at him and jeered. Voices rang out, “Nobody needs health Insurance you dote.” And another, “They already have major medical for hospital stays.”  And the coup de grace, “Doctor’s fees are reasonable. Why would anyone buy Health Insurance?” The little man sank back in his chair in disgrace.    

But then, the CEO said, “I like it! Nobody knows they don’t need Health Insurance. We could tell them they do. Hey, we could even do the same thing with Dental Insurance too!” The minions rejoiced and began to dance and sing their praises to the little man to the tune of  “Take the Money and Run.” The little lawyer was redeemed and began to dream of the day he might be CEO.

Was that a Fairy tail? Well maybe, but I almost feel like I was close by (wink).

The Way Things Were

The Doctor’s Office usually only had one person in it, the doctor. There were no Administrative Assistants, no Receptionist, no Nurse Practitioners or Medical Technicians. The doctor worked his fee out of his pocket i.e., he took your cash and gave you change if it was needed. And the price of a visit was three to five dollars! He never charged more than he thought you could afford.

Medications? He always gave you samples on the spot and called in a prescription to your Pharmacist. In fact, if you were a patient you could just call the doctor; tell him your symptoms and nine times out of ten he would prescribe over the phone. No visit necessary! Oh, and those prescription medications – a few bucks at the pharmacy because no one could afford to pay twenty dollars a pill and the Pharmaceutical Companies new it.

The other great thing was the doctor knew you and new your family very well. You were not just a file with a name. In fact you never saw a file. I think he just logged his treatment. Then to top it all off the doctor even made House Calls! Talk about great coverage. And, we all had it, Universal Health Care.

A Prescription For Disaster 

Out of Pandora’s Box comes Medical and Dental Insurance. The insurance Companies require Claims Data and Payment Authorizations. They need statistics for actuaries. They want to know what they are paying for so they can figure out how not to pay it (it’s the nature of the business). The doctor has no time for all this paper work so he hires office help. Then the entire medical profession along with the Pharmaceutical Companies and Medical Manufacturers has a little epiphany of their own. Hey, if the Insurance Company will pay five dollars and I know the patients can afford five dollars; well then, my price is now ten dollars!

Another wire trips when the doctor’s and hospitals find out that the Insurance Companies will not pay for their time, but they will pay for tests and procedures. The doctor thinks “I know what’s wrong with you just by looking at you, but the Insurance Company won’t pay me for my diagnostic ability.  But for every test and procedure I send you for I get a part of the action.” A scam is born!

The Insurance Companies fight back and institute Managed Care. You have to go to their doctors and they will only pay the price they set for the procedure. All doctors eventually agree to become “Preferred Providers” and accept the lower fee just to keep their patients. But doctors are not deterred. They just order more test and will not talk to you unless you make an office visit. No visit, no money – You must come to the Doctors office – Can you blame them.

Cyclone In A Pill Bottle

So round and round the cycle goes. The Medical Industry gets a little more here, the Insurance Industry a bigger premium. As you know, it has spiraled out of control. God help you if you don’t have Health Insurance but even if you do you are taking a bath for a service that had always been available at a reasonable charge. I’ll grant that the rich did receive the best care and they still do. Hell they paid a lot more for it. But the average guy and his kids were still able to see the doctor.

Where does it go from here? I don’t know. $Up I guess. As long as the “Cash Cow” is in the barn, someone is going to milk it. I can’t wait for the government to take over Health Care. Government taxes – now there’s a real Cash Cow. Wait until you see how hard they squeeze that teat!