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Monday, October 29, 2007

Hillary versus Rudy versus Mr. Unloadingzone on Healthcare

Illegal Immigration is only one of the key hot-button issues in the 2008 Presidential Elections. Health care is another big one in which Hillary and Rudy could not be further apart.

Rudy comes out swinging in his new ad "Chance". He talks about his own bout with prostrate cancer. He credits his survival in large part to the American System of Medicine which has an 82% success rate against prostrate cancer as opposed to a 44% survival rate in socialized medicine Great Britain.

The gist of his message is that the free market will always do a better job than governments, both in delivery of service and in cost. He uses plasma TVs and Lasik eye surgery as examples.

His solution is a $15,000 tax deduction for families and a $7500 tax deduction for individuals to go out and buy their own insurance. The positive is that Rudy is coming out strong against government and corporate-sponsored health care. The negative is that a tax deduction is not money in your pocket; it's money deducted from your taxable earnings. With the price of individual health care coverage being what it is today, those deductions are just not going to cover the bill except for the most basic of health care.

Hillary, on the other hand, is absolutely convinced that all the problems and costs associated with health care today are the Fault of the free market. Her mantra that a government-run, limited selection, and few health care choices; are a worthy trade-off for providing health coverage to all Americans.

I personally think Rudy's opinion is the correct one, but his solution will come up short. Hillary doesn't see people as individuals but as groups, so it's difficult for her to grasp why socialized medicine is failing in the countries that practice it but is correct in thinking non-standardization is part of the problem. She is also correct in having a low opinion of the way most insurance companies operate. The medical arena is no different to them than their home, car, or life insurance business. And when have your premiums on those ever gone down?

Another issue which no one addresses directly but is the big white elephant in the room is that every American expects the absolute best in medical care when they need it for a low, low price, but don't really understand the costs involved in delivering that care. Long gone are the days the family doctor would show up for a house call with his little medical bag, containing everything he needed.

Does the average person have any idea what an MRI machine costs? Much less than they used to when they first came out, of course, but new state-of-the-art diagnostic and treatment equipment is coming out all the time. It significantly increases the quality of our health-care which Rudy demonstrates in his "Chance" ad, but it does come at a price. Today you can get an MRI same day if needed. In Canada, it can be up to a nine month wait.

So what can we do to ensure high quality care at a lower cost? Today's doctors, hospitals and insurance companies spend an enormous amount of money on administrative staffs trying to keep up with the different rules, forms and paperwork, and reimbursements of the different insurance plans and companies. The bureaucracy in medicine is here already even without Hillary-Care, and it's sucking up billions of dollars.

Law-makers, Doctors, Insurance Companies, and Lawyers need to sit down and agree to fair, yet sane, medical malpractice laws. Many doctors are giving up high-risk fields such as OBY/GN because their malpractice insurance premiums are bankrupting them. And the American people are going to have to get over this "victim" mentality and stop looking at a malpractice lawsuit as a winning lottery ticket. Doctors are human. Mistakes can happen. Unless there is provable gross negligence or incompetence, a doctor's humanity should not be a ticket to the bank....and he shouldn't have to pay outrageous malpractice premiums to protect against being human. Can anyone reading this honestly say they've never made a mistake at work? The only difference between you and your doctor is that he is working in a much more demanding and risky field.

Doctors and all the Insurance Companies need to sit down and first standardize, then simplify, their administrative protocols. Something as simple as standardizing diagnostic codes would save millions. The insurance companies pay a huge amount of money to administer their programs so they have a vested interest in this as well.

Imagine a handful of mega-clearance centers, supported by all the insurance companies, which would process all claims. The savings through the economy of scale alone would be huge. Insurance companies would still be able to offer the plethora of plans and coverage that Americans demand, but at a much lower cost.

And the "group plan" concept must be expanded to include the American Citizen Population as one group. No more charging for pre-existing conditions or so-called risky behavior. No more policy cancellations because a person has had one condition too many. Spreading the risk over 300MM+ Americans is going to result in much less expensive coverage than spreading the risk over a few thousand employee group plan.

Government would have a role too. The primary is oversight: we are a capitalistic society but, like car and home-owners insurance, there needs to be a watchdog to balance profit against gouging....and at the same time make sure there IS a profit because this is America; because businesses reinvest their profits in new products and services (which means even better health care); because Doctors start out hundreds of thousands of dollars in medical school debt, not to mention the cost of outfitting and staffing an office. Either everyone wins or everyone loses.

The Government would also have the responsibility of moving citizens off of Medicare and Medicaid and onto private policies. With the prices of health care policies now so much lower, only a fraction of the money spent today on Medicare and Medicaid would be needed to subsidize poor Americans. I stress the word "Americans" here. Illegal aliens, while theoretically could buy health insurance I suppose, should not receive one dime in tax-payer money towards health care. They should not be here in the first place and the only money spent on them should be to deport them. If their home countries have socialized medicine, they can take advantage of it. If they don't, then let their home countries subsidize their care. It is not our responsibility; not our obligation; not our duty.

The only purpose this Government-Insurance Company-Medical Community collaboration has is to provide as many Americans as possible the best possible health care at the lowest possible price; and do it in a market environment. It is obtainable if all parties stick to this mission. Absolutely obtainable BUT only if all parties have the same goal with no extraneous add-ons like subsidies for illegal aliens. No subsidies for Americans who chose not to invest in their own health-care and suddenly have an emergency.

Americans can have the best medical care at an affordable price. It's just a matter of will.

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