Reform, For The Health Of It

It’s been health care overkill here at TMT lately. I’ve been purposely side-stepping only the most controversial political debate/stalemate of the Obama administration — health care reform — because it’s a vast, layered issue, and frankly, I don’t know enough to pose an informed stance.

Uncle Mark does.

Parts of yesterday’s post were stuck in his craw, namely the part where I insinuated my physical exam was “free” under my health insurance. I’ve since changed that statement. My physical exam was covered under my plan, and by “free,” I meant there was no copayment. My provider, Aetna, still receives over $300 per month from my employer for the group insurance I’ve bought into. That’s not free at all. Good looking out, Mark.

OK, here goes nothing: I refuse to look at health care as a political view, but something that should be available to all of us, just like policemen, firefighters, postal workers and libraries. However, I realize health care is much more expensive than all of these services, and this idea that every American could ever receive free health care is downright preposterous. There are real costs involved with hiring doctors, supplying and operating hospitals, researching cures and treatments and so on. Just scratch that idea from your mind — never going to happen.

I  have literally no idea what the U.S. Congress has come up with or what’s going to change if and when a bill passes. I know these are a few items I would like to see:

  1. More incentives. Lower costs for individuals who are independently pursuing a healthier lifestyle through diet and exercise. These people are making an effort to lower their health care costs. Reward them.
  2. Make gym class mandatory. I believe K-12 students should be required to take at least 2-3 hours of gym class per week. Many schools are cutting back on gym classes under tight budgets, but we’ll never win the war on child obesity if we can’t teach the importance of exercise at a young age.
  3. Allow parental coverage until 27. College students are paying more than ever to enter a bleak job market. I can tell you personally the first thing young adults pass up is health coverage, simply because it’s not in budget. Allow young adults to remain on their parents’ plan to avoid that dangerous 4-5 year window after college where all-too-many don’t have coverage.

Now, Uncle Mark doesn’t write an e-mail just to tell me I’m wrong or I should correct something. Clearly, he knows much more about this issue and he’s given it more thought. He had some questions:

“Health insurance companies rely on healthy people paying their premiums so that the insurance companies can pay for unhealthy people.  If everyone is required to buy health insurance and the insurance companies are required to insure everyone, will the healthy people be able to support all of the unhealthy people?”

Anyone got a calculator? Uncle Mark’s question raises another question: If American were to radically become more healthy and would lower medical expenses as a result, would insurance companies actually lower costs to meet the lowered demand, or would they continue on and profit from their ridiculously good fortune?

“Given #1 above, if healthy people, like 20+ year olds, are required to buy insurance, won’t those people want to “use” what they are paying for and go to the doctor more than they are now?  And won’t this decrease the amount of money insurance companies have to pay for unhealthy people that the insurance companies are now required to cover?”

If that’s the case, the system is broken. I guess some of the higher-ups would have to settle for six-digit bonuses next Christmas. Interesting point, nonetheless. Any math majors out there?

“Does preventative care really cost less?  Preventative care always sounds good until someone is having to pay for examinations and procedures that produce negative results.  It is the same way with your car.  No one wants to buy new tires, or change the timing belt because they “might be going bad.”  Particularly if someone besides the owner is paying for those things.”

This one really speaks to me. The difference is we’re not talking about tires or timing belts, but our lives. If there’s one area in your life to be cautious, it’s here. I’ll go with the metaphor, though. I look at a preventative care more like getting an oil change — it’s about being proactive rather than waiting for something more costly to go wrong.

“Would universal health care be better?  The country is broke.  Why would a doctor want to be a doctor if he gets paid like a plumber and has all of his school loans to pay for to boot?”

This is where the rubber meets the road. I don’t know if universal health care would be better. The country is broke. But, I hope money isn’t the single largest motivator for future doctors. I would hope the service, the honorable work, was the motivating factor, as with policemen, who are proud to protect. That’s not operating in reality, though.

This is the issue of the year and maybe next year, too, at this rate. Uncle Mark and I see things a little different, but I think we both agree the current system as well as every proposed model of a future system seems fatally flawed one way or another. There may be no perfect system, I hate to say.

What are your thoughts? What’s been your experience with health care? What would you like to see change or stay the same?

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