Healthcare a Basic Right?

We live in a complicated world. Anyone that has recently filled out a form, added an email account or dealt with any government agency or large company can tell you that. Things are not so simple as the days when our focus was on mere subsistence, of course they are not quite as easy as we have it these days either, but it seems we keep slowly moving down the path of complication. At my son's recent birthday party I was informed by another 6 year old that he "had a lot going on this summer." I wonder if that was the actual truth, or if he had heard that from a Mom or Dad that wore that phrase as a badge of honor. Seems to me that unless we have a lot going on we are not worthy of each other's respect, or perhaps not included in the natural sympathy we are expected to show for the busyness we have created.

Now I for one don't want to give up my hot showers, microwave and washing machine for a shot at simplicity, but I would sure like to have the time back that those conveniences were supposed to provide. No matter what we create to bank up time for ourselves, the decision still falls to us to organize and use our resources. It is our own fault for letting our society and culture of busyness eat away at the conveniences our modern society has provided. We are trading our simplicity away for more "stuff," and this trend will continue until we bury ourselves with extra burdens. As a Christian, I believe that anything which takes our focus away from God has a potential negative affect, whether or not the activity is generally positive or not. We can create a negative situation even by "over-volunteering" for good causes!

I have been trying to decide whether the whole issue of universal healthcare is a good decision or a bad one, whether or not this is a good thing that provides for the needs of many Americans, not just those facing issues of aging but all Americans that deserve a shot at the advances that our modern society has provided in medicine, or a bad one that forces us to sacrifice something important in order to have this important care. I am still on the fence about some of the issues, but universal healthcare is growing in importance for everyone and deserves a closer look. Are we adding healthcare to the role of busyness in our lives, to our badge of honor looking for sympathy at the amount of specialized care that we need, or are we actually taking care of patients that need this care in a way that makes our society a better place? When I get sick and need a doctor I want to be able to go and get it fixed, but I am not so sure that it is in my interest to have the government paying for it out of my taxes.

I recognize that perhaps my personal views are different from other folks, but at the same time my views are likely very similar to others. It seems that reconciling personal viewpoints in a way that improves the general condition of society is why we have government in the first place, whether or not we agree on the nature of government and what it is "supposed" to provide for citizens. The current healthcare "crisis" is basically a fiscal one, the costs continue to rise at an exponential rate for even basic care, forcing decisions to be made regarding the level of care that is appropriate for each individual. If the costs were not increasing so quickly, this would not be such a big issue, but since they are and expected to do nothing but continue to increase, in my opinion we should tackle the cost side of things at the same time as deciding who pays for it. I see 3 basic elements to rising healthcare, elements that may have legitimate importance to some and disdain for others, but nonetheless contribute to the fiscal crisis surrounding healthcare.

3 elements contributing to healthcare costs include:
1-Our legal system. It is no secret that malpractice insurance for doctors is a huge element of rising healthcare costs, not to mention the costs on the industry from mega-million dollar judgements against insurers, doctors and hospitals alike. There are some bad apples out there, but I think that merely making a doctor's record available to the public will take care of that in the marketplace, absolving the need to let the legal system take care of it. No one is perfect, people will make mistakes and people will die, but I am not so sure that every time someone dies it should result in a huge settlement. I see law firms advertising for certain people to call them if they fit within certain guidelines for a lawsuit, so that the firm can represent them in a situation they have already identified and now only have to convince the person that they have been "wronged" so that a suit can ensue. This is only to improve the bottom line of the firm, and a gross twisting of our legal system, leading to huge costs in healthcare that have to stop.
2-Government intervention. No one can argue that involving our national government in something so personalized as the doctor-patient relationship will add to complexity and cost. That is a given. What people rationalize is that the benefits of having the government pay for some or all of the care is worth the added cost, not considering that it will be our taxes that pay for any government program. For me, I think that the only way to sort out a patient's specialized needs is to let the doctor/pharmacist figure that out, then let private insurers deal with how much the premiums will cost to manage that care. Having our government involved will only add to the costs, and while I am for everyone getting the best care available, private insurers need to deal with the issue in order to improve the quality of care and keep the costs as low as possible. We don't need to add to that layers of government inefficiency that will make things take longer and cost more than they already do.
3-Drug Company Advertising. When the FDA allowed drug companies to advertise on national tv, our "need" for drugs went from the doctor's advice to that of the marketing agency. You could argue that the doctors were already under some pressure from the drug companies who make regular office visits with samples and profit sharing, but at least you could trust your doctor to make a decision in your best interest. Marketing has a powerful impact on our ability to make good decisions, how much "need" has been created by marketing from these companies is open to verification, but it exists and contributes to the overall costs of healthcare. We have over 100 million prescriptions annually for anti-depressants, the largest category of drugs sold in the US, you can't convince me that the need is that great without some assistance from advertising. They advertise and convince consumers that we have an issue worthy of taking a new pill, then we go to the doctor and convince him that we need that pill, then we take the pill and go back to the doctor for another pill to counteract the side affects of the first pill. I wish I could get a doctor to comment on this subject, because they are the ones that hold the keys to this answer and I am not qualified, but the costs due to advertising are a direct redistribution of wealth from our pockets to the media (so they can show more disturbing stuff to our kids so they need anti-depressants at an earlier age), ad agencies and drug companies. Advertising of drugs is the same as advertising hard liquor on tv and needs to stop.

Philosophically, I am for health care and consider it one of the best benefits any company can offer an employee. I own a business of my own and have provided healthcare for many years to my employees, and they always comment how important it is to them as well. The costs for the plan that existed in 1999 have basically gone from $1000 annually to about $5000 annually for the same number of employees, what has changed even more is the content of the plan. My hope has always been that insurance would be available to cover that catastrophic need, if an employee or a family member gets cancer or needs a major operation they will not have to declare bankruptcy in order to pay for it. The original plan was very reasonable and even included normal doctor's visits with a reasonable $20 copay. The copay had to be increased over the years from $20 to $30 and $50, and just this past year we were forced to go to a high deductible plan ($6000), but placed a significant amount ($500 to $1000) in an HSA account with a debit card for each employee and instructions to use that and let me know if they went over that amount so we could work something out. This satisfies the need that exists and mitigates the costs to a bearable amount, but I am already thinking about what happens next. If my company with less than 10 employees cannot bear the rising costs, how much worse must it be for larger ones? Once the costs rise again I will be forced to do one of several things-reduce the work force and continue to offer insurance, continue to reduce the coverage and push more and more of the burden toward the employee (same thing as raising taxes, takes money out of our pocket), or stop offering insurance altogether and put that money toward a pool to help in case of an emergency, buy health club memberships for the employees, or some other such compromise. If I were forced to provide the original level of coverage to all my employees today, then the company would exist only to provide that coverage instead of growing and I would either sell out or close the doors. If we do not contain the costs noted above, the every company in America will be faced with the same choice sooner or later.

What concerns me the most is that if our government takes over the issue, then we will have another albatross other than Social Security to pay for, the cost of such a program will strip the life out of the economy and force the government to pay for healthcare with huge tax increases. In many socialized nations with universal healthcare the tax rates are over 50% of income, is that worth the changes that would inevitably be forced on us? We would quickly move from a "free" society to one that is enslaved by our fiscal responsibility. Do not let the Socialists among us force us into this scenario, they want all wealth redistributed so there are no income gaps in our nation and the government takes care of everything. What needs to happen is private insurers work with companies to provide the best care at the lowest costs, churches are able to receive monetary and volunteer gifts that are appropriate to help people in need, and friends and neighbors step up to do the same. If we do this, then the care will improve, our social network be strengthened, our fiscal responsibility be maintained and our nation allowed to remain free and strong. If we adopt universal healthcare, then our nation will take another step toward socialism and we will continue to put more of our focus on government instead of God for our providence. The slide in this direction is slow and purposeful, we cannot continue to vote ourselves more benefits from the public till until our nation experiences a new form of slavery, the answer must be in our individual resourcefulness, private investment and personalized response to this crisis. Healthcare is important, especially for those Americans and their families who are working for a better tomorrow and not trying to "beat" the system, but it is not a "right." We have to decide the importance of universal healthcare as a nation and decide the best course to take, hopefully the simplest and least costly approach will be preferred even if it does not cover every need.

Whose Fault Was It?

It has been a long summer. I counted at one point a stretch of 19 straight days that I was out "on the road" working in June. Not a lot of time for family, relaxation or tending to the basic things of life for certain, but life goes on nonetheless. Bills still have to get paid, kids to their summer "stuff," groceries bought, gas in the car...just a lot to do even as many think of summer as "vacation." Maybe this little story will help put things back in perspective, and give you a little relief from the summer heat.

We had a small water leak from our refrigerator this past week, when I was home for a few minutes between trips my wife noticed that the wood floors near the fridge had separated slightly and were bowed at the edges. I thought it was curious but did not give it much thought other than a cursory inspection, and went off to bed. The next day the situation was a bit more evident, the slight warping had moved outward to a few more boards, so we decided to investigate. Eager to avoid a trip under the house for a leak or some other source, I wanted to take a look at the only appliance with water involved that was in the vicinity-the fridge. Sure enough, as we pulled it out, we found a valve that transferred water to the ice maker was leaking, the leak was dripping down and running along the very slight cracks in the wood floor so it was not very conspicuous. I turned the water off to the fridge, but the damage had been done. The seeping water had warped several boards that would have to be sanded and repaired.

Over the next few days, the slightly warped floor issue was pretty much stabilized to about a 10 foot area, not really a huge deal but enough that you could feel it when you walked over it. I thought about calling the floor guy to have it sanded and repaired, but after looking at the floor and trying to decide where we would have to re-apply the coating to the entire floor to make it look correct again, I decided to take a shot at calling our insurance company to see if the homeowner's policy covered such things. Lo and behold it turns out that such damage is covered, and they would be sending a check for the damage after the estimator took a look at it. He made sure to tell us to keep the faulty part, because they would try and recover damages from the refrigerator manufacturer.

After he left, I started thinking about that. Whose fault was it? I guess the manufacturer made the thing, so they must be responsible, right? But I suppose that the story will not end there, because if you look inside the part you can see evidence of some calcium deposits. I feel sure the manufacturer has a case against the water softener people since the damage to the valve could have been caused by those deposits. The attorneys will no doubt have a meeting to discuss culpability and loss due to damage, you know, lawyer type stuff. The billing will probably reflect the legal opinion of several key attorneys whose experience will also be reflected in the cost of the consultation, after all, they have several years of school to pay for. After the meeting they will advise the manufacturer to hire an expert to examine the part and decide what went wrong. The expert will spend several hours at $100/hr or so, he may have to consult with a design engineer who will undoubtedly notice that the part has a "Made in China" sticker on it, concluding that the part was outsourced by the manufacturer to a Chinese company that was undoubtedly at fault, because they should know that we Americans like our ice convenient and properly softened. That's it, it was their fault, case closed. Estimated cost is approximately 5 refrigerators and 2 new wood floors, to be recovered by increasing my homeowner's policy slowly over the next 10 years, and including a percentage to be amortized by everyone in my nearest zip code.

What really needs to happen is that we develop a government committee to examine the costs of the production, sales and shipping of that part to the American manufacturer, then establish the costs of a flight and $1/hr labor for an underage Chinese worker to come over here and sand my floors smooth and re-clear them. That has to be cheaper than the whole process as it exists now, and could lead to better relations with the Chinese on a cultural level. The only person that would be out anything is my floor guy, but he got paid once to put the floor in the first time so he should be OK. The guest worker could then apply for citizenship while they were here, or just defect and request asylum due to the intense political pressure of the job. The cost of getting them here is already absorbed but the government committee's budget paid for by our taxes, so they can be a productive member of society almost immediately.

So there you have it, a reasonable solution to the water leak issue and the blame properly placed on the manufacturer of the fridge, the water softener company and eventually the real culprit, the Chinese company that made the thing without considering American tastes in the first place. I'll just keep making my homeowner's policy payment in the meantime until they sort that all out, in the end figuring I don't deserve to cash the insurance check because if I was still using those old plastic ice trays instead of expecting my ice to appear out of the front of my refrigerator door, this would never have happened in the first place...