Thursday, May 21, 2009

Health Versus Healthcare

Nearly thirty years ago, as a Fortune 500 employee, I attended a seminar on health care finance. Newly hired and full of enthusiasm I volunteered for every "extra curricular" I could fit into my schedule. This one was very revealing and ominously prescient.

To my great good fortune I arrived in my new position just as the Nixon-Ford-Carter wage and price controls were lapsing so my income increased by about 40% on my starting day.

Other effects of the 1970's economic policies were more pernicious and far reaching. Prohibited from raising salaries beyond the government limit, employers sought alternative ways to attract new employees and retain current ones. As a result, non-salary benefit packages were expanded.

Health care benefits, which were referred to as "Hospitalization" in prior generations now became more comprehensive, adding layer upon additional layer of services that benefit plans would cover.

One member of the panel predicted that the current system of medical insurance was in danger of becoming a bureaucratic third-party payment plan for routine doctor visits.

As with all third-party payment plans, he warned, health-care costs were sure to skyrocket as administrative costs spiked up and consumer choices spiraled down. That was in 1981.

Now, three decades later, we are mired in another self-inflicted catastrophe which the ruling class has termed:The Health Care Crisis!

We can debate the merits of one health policy proposal versus another, but thoughtful discussion of any complex issue requires precise definitions, common lexicon and the agreement among all parties to refrain from personalizing policy disagreements.

In the current climate, thoughtful discussion is impossible.

Those on the left claim that those who oppose national single-payer health care want to see people die in the streets. Those on the right, myself included, brand national health care advocates as communists. Whether they are true believers or merely useful idiots is yet to be determined.

At the heart of the crisis, though, is the mind-set (predicted long ago at that seminar) that reaching into your wallet for routine medical treatment was an ordeal that no American should have to endure.

This is where precise definitions are critical.

Insurance versus third-party payment.

Health care versus medicine.

Most important, the definition of good health and how to achieve it.

This last element has been uniquely damaging. Over the years the term "preventive medicine" has become the Holy Grail of the health industry. While the prevention philosophy is well established, a collective mythology has emerged which equates good health with more trips to the doctor.

Nothing could be further from the truth.

Today, advocates for coercive universal, single-payer health care claim, rightly, that insurance is about spreading the risk. What they fail to accept is that insurance is also about pricing risk. This is the paradox:

How can our national government devise an equitable medical insurance paradigm when the leading causes of disease and premature death are self-inflicted?

The short answer is that they can't.

While very few would advocate for a universal single-payer automobile insurance system that allows a motorist with five drunk driving violations to pay the same premium as another with a clean driving record, this is exactly what the single-payer health care advocates demand.

Moreover, while we all pay auto insurance premiums to protect against large property and liability risks, we don't dip our government-issued insurance cards into the gas pump every time we fill up.

If we did, we should not be surprised when regular unleaded jumps to $8 a gallon.

Once again, as with nearly all social and personal crises, the fault lies not in the stars but in ourselves.


Anonymous said...

Guess who pays to subsidize self-destructive behavior?

Anonymous said...

Obama should take over McDonald’s, Burger King, etc. to make sure we get government approved fast food.

Anonymous said...

Here’s my deal...halt to all cigarette and cigar sales....bring the speed-limit down to 45 mph...terminate all beer and alcohol sales...then we can sit down and discuss universal health care for everyone. The Republicans should sit down and lay out how it’s not just care but “forcing” people to be healthy in the first place...then lay the whole mess into the lap of the Democrats.

Anonymous said...

Nixon's fault!

Joseph Martini said...

Well... Nixon did impose a 90 day wage and price freeze which actually lasted three years. By the time Jimmy Carter was inaugurated wage and price controls were thoroughly discredited so Pres. Jimmah decided to impose his own wage/price plan, thinking he could get the formula right.

We all know how well that turned out.