Health Insurance Is the Problem, Not the Solution

So disgusted with both Republicans and Democrats in their so-called quest for better, cheaper healthcare. Disgusted too, with the pundits and media. They ALL are concentrating on health INSURANCE as being the solution, when in fact it is the problem.

Start with this simple fact: Health insurance is NOT health CARE!

It is important to understand exactly how health insurance contributes heavily to the problem. First, understand that administering health insurance plans, payments etc. requires thousands of employees, many of whom are paid hundreds of thousands, even millions of dollars. Those costs must come from insurance premiums, adding substantially to health care costs. But that is nothing compared to the excessive costs by health care providers - costs they raise to unconscionable amounts because insurance makes it possible to do so - as long as the individual is not paying directly, and as long as insurers can raise their rates, who is to complain when the hospital charges $8.00 for one aspirin?

Case in point - a full-body cat scan. Here are the facts on the cost:

National Average: $3,275

National Range: $300 – $6,750+

Outpatient Facility Average: $525

Inpatient Facility Average: $4,750

Now ask yourself - if an outpatient facility can do the scan for $525, why are hospitals charging as much as $6,750? BECAUSE THEY CAN! Insurers allow that. And they allow it so they can charge high premiums so the insurer can pocket those huge salaries.

Yet another reason health "care" (i.e. insurance) costs so much - as long as a person has insurance, they no longer need to live a healthy lifestyle. They can smoke, drink soda, be a couch potato - they do not have to concern themselves so much with making poor health choices. This results in the need for more health care. And when the demand for anything goes up, so does the cost.

If we want to decrease the expense of health care, we must first address the actual needs and the costs of those needs, and THEN we can address insurance to cover them.

First and foremost we need to address the poor lifestyle choices that contribute to over 70% of all health issues. One hundred years ago the average person was in good health, barring an injury or contagious disease. In nature, the normal state of health is good health, and poor health is abnormal. We have managed to turn that on its head with our proclivity towards making poor choices like smoking, too many sweets, fake foods (if it wasn't food a hundred years ago it is not food now), an over-abundance of chemicals and perservatives and an aversion to actual exercise and physical labor. You don't have to be a doctor to understand that our choices are largely responsible for our health. It is estimated that over 70%, and perhaps as much as 80% of all health care needs are attributed to poor lifestyle choices. If we were to all live by the Biblical statement, "All things, in moderation", and get sufficient exercise, we could cut health care costs in half.


And we could cut them even more by using our tax system to discourage poor and harmful lifestyle choices and apply those taxes to directly reduce the cost of healthier options. For example, we could increase tax on sodas and cigarettes and use those taxes EXPRESSLY to reduce, by subsidy, the cost of healthy, whole food and/or fitness equipment or gym memberships.


Costs can be reduced further by capping malpractice awards. Medicine is an imperfect science; honest mistakes can be made. The ONLY lawsuits that should be permitted are for instances of gross neglect or incompetence, and then the awards should be capped at reasonable levels. This would reduce costs in two ways: first, by reducing the exorbitant costs that doctors and medical establishments must pay for malpractice insurance, and second, because doctors will not feel obligated to "over-test" in an effort to cover their butts. Currently, doctors must test a patient for many things unrelated to the healh issue, just to play it safe. After all, $250,000,000 dollar awards are outrageous, even criminal - especially since the vast majority of those awards go to the ambulance-chasing attorneys.


To reduce health care costs further, it is as simple as stopping the "revolving door of referrals." If you know you need a gastroenterologist, why should you be required to first see a personal care physician for a "referral"? The cost of seeing the PCP adds significantly to the cost. We should be able to schedule our own appointments with the medical personnel we need.


Case in point - I suspected my medication for ulcerative colitis may have caused PML, a serious viral infection, so I wanted to see a professional to get an MRI to see if I was infected. I had to first see my PCP ($225) to get a referral to see the neurologist ($640) who referred me to an unnecessary HEART specialist (my heart is perfect) at a cost of $1200, who then, finally, got me an appointment for an MRI ($1550). A total of $3615.00, when all I needed was the MRI at less than half that cost. And as it turned out, I did not have PML. But $2,000.00 was wasted in getting that eventual determination.


Now that we have lowered the actual costs of health care into the realm of sanity, we can NOW address the cost of insurance. Having reduced health care costs by at least 50-75%, it is safe to assume one of two things - either the cost of insurance can be reduced by 50-75% OR most people can afford their health care costs without the need of insurance, as they would only be paying as much for their health care as they would have had to pay in insurance deductibles, anyway.


As a  final thought, assuming we bring costs down significantly, the ONLY insurance a person should need is catastrophic insurance, to cover things most people cannot afford, such as cancer treatment. If insurance covers only  catastrophic issues, the cost is significantly reduced even more.


Together, these things are not difficult to achieve. Certainly, many  people will still make lifestyle choices detrimental to their health, but the high taxes on those things would help offset the costs incurred. In other words, people choosing to harm themselves would be the same people carrying the brunt of the costs of their treatment. No longer will you and I be paying too much for insurance because someone else chooses to drink, smoke or junk food themselves into oblivion.


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