It started with 4 stitches in a toe …
My 9-year-old boy ripped open his toe doing what he does …being a 9-year-old boy. I took him to the emergency room to get stitches (this wasn’t our first time at the ER – did I mention he’s a 9-year-old boy?) About ten days later it was time for the stitches to come out. He was scheduled to attend a birthday party at one of those jumpy house places and we had to have them out before he would be allowed in. So, instead of hauling all the way down to the ER again, I popped in at one of those little mini clinics.
Mini clinics are an unsung medical innovation that don’t get enough credit. Getting a strep test or a flu shot used to require scheduling and appointments and a full-fledged doctor visit. Now, you can do those things with the ease of picking up some soda and ice at the convenience store. The free market creates things like that and I think it’s a good thing. I also thought they might remove four stitches quickly and without a problem. As it turned out, they didn’t accept our insurance but said they would do it for a cash payment of $280.00 dollars.
To his credit, when my son heard the price, he was was appalled. He called for a conference. So, we jumped in the car to talk it over. He said, “dad, that is too much money to take out 4 little stitches. How much is that per stitch?” I did the remedial math in my head (the kind we used to do before common core forced us to use it in a sentence and invert it four times …but I digress). “Buddy,” I replied, “that’s $70 bucks a stitch. And it’ll only take 3 minutes. If you’re in pain, we’ll do it. i’m totally cool to pay the money. But if you’re not, I say we shop around.” He LOVED the idea of shopping around …so we headed out on an adventure tour of mini clinics in our area.
Along the way we thought about what a fair price might be for this procedure. We discussed expertise and time needed to perform the procedure. We unpacked the removal of four stitches as best we could. I told him I thought it was worth $20 bucks a stitch. He balked. “No way, dad. This is only worth $10 bucks a stitch.” So we decided it was worth between $40 and $80 bucks to get those stitches out. That’s what we, the consumers, were willing to pay. But what was the market saying? We wanted to find out.
In the end, we couldn’t find another open clinic. So we just went back the ER, where they did it for free, as the completion of treatment from the first visit. It took less than 3 minutes …and he got a free popsicle to boot …by FAR the best deal. But it did give us an opportunity to have a pretty in depth discussion about the price of a service, how those prices are set …and the importance of those services.
The stitch removal was not something we could live without. It was not a luxury item. It was not a consumer item. It HAD to be done. But even a human imperative bears a price and that price can be negotiated.
My son had stitches in his toe. My daughter, on the other hand, is a completely different story …
She requires state-of-the-art, world class medical care. And, at one time, was considered “uninsurable.” So, I have lived every aspect of what can be the healthcare nightmare in America. I wrote a whole book about it. After the book was published there was a whole NEW healthcare saga that unfolded in my home. But suffice it to say, there is NOTHING you can tell me about healthcare in America I don’t already know or haven’t already experienced …probably more than once.
My daughter was dropped and picked back up by Blue Cross Blue Shield seven times in ten years. I’ve cleaned out bank accounts and investment portfolios to pay for ambulance rides. I’ve sat in congressmen’s’ offices and insurance agency board rooms. My family was offered “poster family” status during the Obamacare debate, (by some people in government) if we would throw in with the effort to get it passed. But when my manager and I raised a question about a self-employment issue and something that was unspecified on paragraph 16-A (of the 2700 page monstrosity), our contact stormed out of the room, declaring that we were listening to too much Rush Limbaugh. I didn’t then …and do not now …have the slightest idea what he was talking about.
In our healthcare odyssey, we went through everything from state insurance officials telling us we were “screwed” (their word) to state and federal agencies having to confer with lawyers in Washington DC as to an interpretation of the wording of a law. It required someone getting on the state S-CHIP program, to be uninsured for either 3 months …or 90 days. The law said three months …but they couldn’t determine if that meant 90 days …or three months. It threw our entire ability to receive that service off by ONE day. It got resolved by someone in the government office taking on our case personally …the law is still ambiguous. Thanks, government bureaucracy!
I got a college education, on one phone call, with the insurance commissioner of Tennessee, when I asked a question that actually made him snicker. I, in my naiveté, asked, “why can’t I buy insurance in Iowa or Delaware, like I can car insurance?”
His answer was, “the law doesn’t work that way.”
My reply? “This sounds like state run monopolies to me.”
His reply? “You’re very perceptive, sir.”
America DID have some cracks in the pre-Obamacare healthcare system. That is a fact. Families DID go bankrupt because of medical expenses …we were one of them.
I credit the Obama administration with at least addressing the issue. I get pretty fed up with conservatives who rail against the Affordable Care Act, but who didn’t fight for free market alternatives when they had the chance. Pretending there wasn’t a problem was not leadership and we got what we got as a result. That’s what always happens when someone doesn’t lead. Someone ELSE will.
Having said that, the Affordable Care Act is a horrible piece of legislation that became one of the most unwieldy laws in our nation’s history. Still, there are certain things about it that have helped my family. There are other things about it that have made it worse than before it was passed. And it has placed the country at an interesting cross roads.
As I write this right now, my wife and I don’t have health insurance …we simply can’t afford it. But our children DO have it. Before Obama care …it was the other way around. Go figure.
The main problem with the ACA is that it regulates against human nature (most progressive, collectivism does this). It forces mitigation on businesses that expand …assuming they will simply comply because they have good hearts. But all living things race toward freedom and self interest. So, businesses don’t want to expand beyond 50 employees, because the health care mandates in that zone can literally put them out of business. Those businesses may or may not be evil. It doesn’t mater …they want to remain alive. And until you understand that basic premise of the nature of life, you cannot govern.
This nation is on the precipice of two directions: we can return to free market solutions. OR we can nationalize the entire healthcare system. The scales are tipping toward the later. If you’re not thinking it all the way through, universal healthcare sounds wonderful and logical. After all …it’s UNIVERSAL! That means EVERYONE gets healthcare. Right? What could possibly be wrong with that? Anyone who wouldn’t support that can only be in the pocket of lobbyists or they are a horrible person or someone who just wants rich, white people to get healthcare …right? Why wouldn’t you want everyone to have healthcare???
Well, there are some myths about “universal healthcare”:
Just because you don’t believe in the government being the single source of healthcare doesn’t mean you don’t want everyone to have it. I want everyone to have access to GREAT healthcare. That means I want doctors and nurses and orderlies and interns and front desk people to all be well paid. Or at least paid what the market will bear. I want the hospital to be clean and efficient. I want access to state-of-the-art everything. And I want it quickly.
How is this achieved?
On paper, it seems like we could just give everyone a card they can use anytime they need to go to the doctor. We could then simply pay for all of it by taxing people more. You basically put all the money in a big bucket and you pay for doctors and surgeons and procedures out of that big, nationalized bucket. That seems super easy! Why hasn’t someone thought of that already? I mean all those tiny Scandinavian countries do it. Surely, anything that works in a country the size of Dallas would work here …nation wide … right?
Only two other countries the size of the U.S have ever tried nationalizing healthcare: The Soviet Union and The People’s Republic of China. Both of those examples are epic failures. EPIC. I’ve personally witnessed the “free” healthcare system in China and trust me …you don’t want it.
Sure, EVERYONE gets free healthcare. They sure do. But the quality of healthcare and the standard of healthcare should be job one. And I can say, without a doubt, that my daughter would be dead had she stayed in China. Her 10-plus-minute grand maul seizure (at nine months old) was only survived because of the state-of-the-art talent and techniques cultivated at Vanderbilt Children’s Hospital. It cost me thousands of dollars …but she’s alive.
These things are cultivated in systems that compete. Single payer healthcare also means “single BUYER.” That means there’s only one buyer …the government. If I have to explain why ONE buyer of anything is a bad idea, well …we’re worse off than I thought.
I have a health care proposal on my computer from my representative, Marsha Blackburn. It was written in 2009 and would’ve addressed the cracks in the system that we were victims of, pretty well. It is 27 pages long and could’ve been implemented in two weeks …as opposed to 4 years.
Ironically, the best proposal I read during that time, came from a senator from Indiana …Mike Pence.
I, myself, had some suggestions for senator Bob Corker. I met him at a function and he was very receptive and listened to me. Then, he said, “that sounds like that could work …but I can’t get it passed.” This was when Republicans were in the minority.
My fixes were:
1. Allow health insurance to be sold nation wide …just like car insurance. Open the income pool, thus freeing up risk.
2. Mandate that INSURANCE companies (NOT individuals) keep 5% to 10% of their actuary tables as a high risk pool – people like my daughter.
3. For every high risk person on their rolls, they get a dollar-for-dollar tax write-off for high pay-outs.
4. Make medical expenses COMPLETELY tax deductible. 100%. Dollar-for-dollar. If middle class earners could write off medical expenses completely, they would be WAY more apt to pay for more things out of pocket. If I hadn’t had crushing medical bills ALONG WITH crushing IRS debt, my situation would’ve been manageable. I could’ve mitigated one with the other, and it might’ve been a wash.
5. Make pro-bono medical service for the poor and needy a complete tax write-off for doctors and medical professionals.
People think health care has to be complicated. But it doesn’t. My doctor doesn’t take any insurance at all, anymore. It has made things much simpler. I walk in. I pay his price. We’re done.
For things I can’t afford, however, I will need coverage. If I were diagnosed with cancer next week, I’d be in trouble. And I understand when this argument gets complicated. But I believe we can figure it out without swallowing the whole system in government bureaucracy.
There was a time when simple hydrogen peroxide and bandaids would’ve been state-of-the-art healthcare and would’ve saved lives. If you lived a hundred and twenty years ago, those things would’ve been miracle cures. Today, they are sold over the counter at Wal Greens for mere dollars. The market worked that out for us …not the government.
I envision a day when we take our own X-rays with our iPhones and text them to doctors. I can see a world where we swab our own mouth and rub it on a screen (in our home …on some $30 home appliance like a toaster …made by Maytag) and it tells us if we have the flu or a virus or whatever. Our computer automatically orders a Z pack (or whatever the miracle drug of the day is), a drone delivers it within minutes, and we are literally back in service by the end of the day.
But those things won’t happen with the government controlling health and health care. They will happen because people want to make money and see an opportunity. I’m sure the makers of Percocet don’t do it for the love of humanity. They do it for the money …and the benefits …and the bonuses. And you know what? When I’m laying in a hospital room, writhing in pain from a kidney stone, I don’t give a shit WHY they do it. I’m just glad they do.
I also realize that I can’t negotiate the price of that product when I’m in pain. And that gets us back to the stitches in a toe …
We chip away at healthcare costs on the non life-threatening things. Laser eye surgery is unprecedented in human history and it is very affordable. I don’t think people realize what miracles are happening with eye care. And the prices keep coming down. That’s the market at work. Dentistry has pretty much opted out of insurance altogether and it is doing amazing things with the human smile …one cash payment at a time.
If you want government healthcare for all, go visit a VA or talk to someone on Medicare or Medicaid. Because THAT’S what all medicine will become once the government runs it.
In the mean time, I would just like to explore the other options we have first …before we surrender it all to suits in an office who know nothing about but calculate it in a way to minimize the state’s liability and maximize it’s resources …in order to please the higher ups and make sure everyone makes their numbers this year.
I realize this same scenario happens with insurers. But with enough competition out there, we can make those guys operate in a dynamic state as opposed to a static one …where there is no shopping and no market driving down prices.
Even my 9-year-old son’s FIRST inclination was to shop around. I didn’t tell him to do that. It was his nature. He was acting in self interest.
Maybe we should all be so smart.