Tuesday, November 25, 2008

Health Care post for Obama

Here's how single-payer health care helps people, in terms that "economic conservatives" can understand.

For any given insurance pool, the larger the pool is, the cheaper the cost for coverage is overall. You want to buy insurance from "Bob's health care" that covers 3 other people so far? Didn't think so. If one of those 3 gets big bills, you get hit hard. Ultimately, one single pool of all people in the country would be the cheapest-per-person insurance possible. Therefore, single-payer insurance is the cheapest insurance possible.

Now let's talk about unions. All of the union contract disputes in the last decade have hinged on the increased cost of the health care coverage of those contracts. I dare anybody to find a counter-example ot the previous sentence. Taking the cost of health care out of union negotiations removes most of the cost of those contracts, thus helping the industries involved.

Let's go a little bit larger. Here's an economic-conservative talking point for ya: business should not be burdened with the cost or trouble of managing their employees' health care plans. Ask a small businessman about the HR overhead in just managing such plans, much less paying for them. In fact, there's already an outsource industry regarding merely processing the paperwork for health care for businesses. It's stuff that they shouldn't have to deal with since it's not their core competency. Seriously, forget everything you know, and ask yourself - why do employers have to pay for health care? Why should they have to? Ask any small businessman about health care for their employees and they'll talk your ear off for the next 24 hours at least. Then ask the big 3 automakers. This hits business across the board already. There's no real reason it should have to.

Also, single-payer health care in America wouldn't even be "socialized" to the levels as provided in Canada or England; in our case, private doctors and hospitals would be reimbursed for providing care, rather than being state employees themselves, as they are under European models. In other words, it would still be privatized, thereby still allowing for efficiency incentives.

All we need is a basic/preventive (and emergency) level of health care covered for every citizen. Insurers could still sell "gold-plated" insurance to more affluent citizens.

As it is, the insured already pay for health care for the uninsured. If an uninsured person gets sick, they get sick or get over it until they go to the emergency room. If they go to the emergency room, then the cost runs to hundreds or thousands of times of the cost of having prevented it in the first place. Where does the cost come from for treating these uninsured? Here it gets interesting. Hospitals typically have nondisclosure agreements with drug companies, and cover their revenue to costs in some rather creative ways that are unique to the health care industry. Gave you a $200 Vicadin? How about that $120 blood test? Those are hidden transfer payments, baby. They're covering their emergency room costs by overcharging your insurance.

Normally, the first step would be to create transparency in the relationship between what hospitals charge the insured and the costs of treating the uninsured in their emergency room. But much of that is covered by nondisclosure agreements anyways, and besides is unnecessary. We can skip all of this problem by... single payer health insurance. If the presently uninsured had health care coverage up front, a $80 doctor's visit could prevent a $8,000 emergency room bill.

Unless some Republican is willing to step up and say "let them all die in the streets," and unless every doctor in America is willing to renounce the Hippocratic Oath entirely, then we're not only paying for the "uninsured" already, we're doing it in a way that produces the worst possible outcome: less care for more cost.

Single payer. It's not only the right thing to do, it's the profitable thing to do.

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