In a recent (Sunday, February 26) editorial column, the Editor of the Omaha World-Herald opined that a main engine of ever-rising health care costs is "Americans' preferences[.] We as a society avoid shopping for care (because we want constancy in our providers) and have distorted insurance from a backstop against disaster into a 'prepaid medical' plan."
WRONG.
What acutally has happened is that technology totally outstripped planning. Illnesses, accidents, and assaults that used to kill people--and quickly--now can be managed medically, as chronic medical conditions [consider Lee Harvey Oswald: if he'd been shot nowadays, he'd not have died from a single gunshot to the abdomen.--ed.] . . . which means continual care, which means high long-term costs. None of the health insurance plans I know of were created in this context. Medicare, for just one example, will pay for a lot of procedures when done to someone who is an inpatient, but will not cover the very same things when the patient is at home. The costs of being an inpatient are much higher, as they include the hospital room, meals, and a lot of other things that the patient is already covering as ordinary costs of living while living at home.
This obviously makes no sense. To some degree, Medicare and other insurance plans are beginning to recognize this, as they are modifying and adapting their coverages to include certain preventative care tests and procedures because a problem caught early is, as a rule, a problem less expensively resolved than a problem caught late. But getting the insurance industry as a whole to totally revamp itself is a haphazard hope at best.
Besides, the people most often in immediate need of health care are not in a position to shop around for it. If one has spiked a fever of 103°, one isn't going to go calling everyone in the phone book to find the cheapest treatment: one is going to the first place one finds. One doesn't have the luxury of taking the time to shop around.
Furthermore, who has a crystal ball to determine in advance what kind of health care/insurance one needs? My own example is telling: I, a lifelong NON-smoker, have a chronic and ultimately terminal pulmonary disease. Before I was diagnosed, if I were shopping for health insurance coverage, I would not have chosen a plan with a lot of pulmonary coverages had it been cheaper not to include that in the plans from which I was able to choose. And I'd have been sunk once my disease manifested. Which I nearly am as it is, so I know whereof I speak.
Thus is revealed the fallacy of running health care as a for-profit business. The free market is not a panacea for every economic problem plaguing mankind. When one is talking about health care, one is talking about life itself, the most fundamental of our inalienable rights. Second, the people who need health care the most (especially under the current system, where preventative care and early detection are not necessarily covered) are the least able to afford it--for they are already ill.
The entire point of insurance is to spread the risk so broadly that everyone's costs come down. This won't happen under present "health-care reform" suggestions like health savings accounts (HSAs). Those who don't need health care will amass savings, while those in the most dire need are unable to, because whatever money they have is already paying for prior health-care services rendered. The net result? A segregated society: those who have good health and money on one side; those who have poor health and no money and declining care due to same on the other. In the long run, this will be slow genocide, or Social Darwinism run entirely amok.
If the goal truly is to solve the problem, a national health insurance plan that covers everybody is inevitable. That is the only way to spread the risk widely enough to ensure that no one is bankrupted by one debilitating, chronic illness . . . which is all too often exactly what the chronically ill are forced to suffer now. Which means no more "for-profit" health care, which means government must run the program. (1) National problems require national solutions; (2) "government" is not a dirty word; (3) therefore, if we truly are united in society to further our collective rights to "life, liberty, and the pursuit of happiness," we need to start thinking and working together to solve the problem instead of limiting ourselves to letting "the market" literally kill off the unlucky.
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