Wednesday, July 22, 2009

"Obamacare"

My two cents about it all:

I was listening to Sean Hannity today, and he was discussing this whole "Obamacare" (as he put it) issue. Some salient points he made (some of you may have already heard these stories):
  • Great Britain has state-run health care, and recently some women with terminal breast cancer were denied the drugs to lessen their pain because their cases were terminal. So they died in agony. And the government says that they do this because they care about people?
  • A lady in Canada, where they also have state-run health care, almost went blind from a tumor behind her eyes, waiting for her doctors to do something about it. She went to her doctor up there complaining about bad headaches and blurred vision. They told her that she would have to wait 4-6 months to see a specialist. She argued, appealed, and played the whole bureaucracy game -- to no avail. Canada does have private health care as well, but there are so many rules, laws, and stipulations to be able to have private health care instead of government health care that it is almost impossible for anyone to obtain. So she came to the U.S., where a doctor saw her right away and diagnosed the tumor that needed to be removed immediately before she lost her vision. She took the orders back to Canada to have the surgery done, but the doctors up there would not even look at the orders from the American doctor. Again she begged and pleaded; and again she was told that she would have to wait several more months for anything to be done. So she went back to the states where they performed the surgery in no time, and luckily her vision was fully restored. Now she gives speeches about her story, although she does not claim to be an activist; she just wants to share her experience from both sides of the border.
When I first heard this story I was surprised. Then I thought about it more and wondered why I was surprised. Do government programs ever run better than this? They simply can't! Government agencies are, by nature, bureaucratic monopolies, which means they are cumbersome and inefficient. There is no way to get around this.

Lesson learned: other countries have tried state-run health insurance and, while it may solve a few problems, it also inevitably creates a whole host of much bigger problems!

Mr. Hannity interviewed Jim DeMint, a GOP Senator for South Carolina, who said that even some democrats are upset about this bill because they feel that Obama is not being clear about it, and that he just wants it passed by the August recess; consequently he is just trying to push it through as fast as possible. Obama himself hasn't even read it. And he seems to be especially cryptic about how it will be paid for; which means that it will be hidden in all kinds of new taxes. It is estimated to cost ~$1 trillion right now, and ~$3 trillion over the next ten years or so. Even the NYTimes admits that if this health care bill passes, taxes will go up an estimated 3-4% for everyone, and the very richest people in California and New York, for example, will be taxed up to 55% of their total income.

Mr. Hannity made the point that our congressmen need to start fearing their voters more than special interest groups in order for this bill to be stopped.

A few weeks ago on CNN a reporter was interviewing Bill Clinton about this health care plan, and he asked Mr. Clinton if he thought that long waits would be an issue with government owned health care, to which Mr. Clinton acknowledged that "there would be long waits for the patients, but we are working on that and trying to fix that." It can't be fixed. That is the nature of a government agency, the very opposite of capitalism.

Kathleen Sebelius, the Secretary of Health and Human Services, was also being interviewed about this bill on PBS a few weeks ago, and she referred to the current health care system as "the private health care monopoly". That has got to be the most interesting definition of a monopoly that I have ever heard. Either she is incredibly dumb or incredibly deceitful, and I am inclined to believe the latter.


All of this really hit home to me when I had to take my daughter to get her immunizations. We have private health insurance, but it doesn't cover immunizations, so our insurance sends us to the County Health Department for her shots. I expected it to be busy so I took my six month old daughter early in the morning, right when it opened.

A sum-up of what transpired (this is the general situation every time I've gone):

1. Filled out 2 (long) forms in a crowded room without enough seating.

2. Walked into another room that was even more crowded, took a number and waited to be called by one of the two ladies sitting at the only two desks in the room.

3. After about 15 minutes I got called up, I gave the lady my form, she did the paperwork and sent me to another crowded waiting area.

4. After waiting for several more minutes, I got called up, more paperwork, then sent to another waiting area. This time I was actually waiting for the nurse that would give the shots. I asked the lady if this was a particularly busy day for them, and she looked at me a little surprised and said,

"Ohhhhhh no. We get much busier than this."

5. After waiting about 15 more minutes the nurse called my name. She gave the shots to my daughter.

6. I was then sent to yet another waiting area to wait to pay. Yes, I had to wait another 15 minutes or so to pay. All the while my baby is hurting and screaming from her shots. $13.00/shot. Total time: just under 2 hours.


Contrast this experience with...

We recently changed insurance since I stopped working when the baby was born. Our last insurance used to do immunizations in their own office, instead of sending us to the County Health Department. Here are some differences I couldn't help but notice:

1. With our old insurance, immunizations were covered with the regular insurance cost, no extra charge. BUT, they do administer immunizations for people without insurance, for $11.50/shot -- less than the government price. And you don't have to wait forever at their office, either.

This is an example of the private sector providing for people without insurance, and for a lower cost than the government provides. (Note that the private sector does this even with all the government interference as it is. Can you imagine what it would be like if the market were actually free?)

2. Sometimes babies have reactions, like a fever, to immunizations. I wanted to ask what shots she would be getting each time, and what reactions they typically cause, etc. so I could give her Tylenol before she got the shots, if necessary. When I called our old insurance to ask these questions, my call was answered on the first ring every time. Why? Because there is competition. My questions were invariably answered in a detailed and satisfactory manner. And when I take her in to get her shots, total time: just under 5 minutes. Maybe 10-15 on an exceptionally busy day.

When I called the County Health Department, my phone calls were never answered. Never. So I left a message. And another. And another. A week goes by, I am waiting to hear back from them so I can ask questions about the shots and what I should do to prepare my baby, etc. I leave more messages. Another week goes by.

Why don't they answer the phones or return my messages? Because nothing can make a government agency go out of business, so they (usually) don't care about the consumer/patient at all. Finally I give up and just go in and get the shots done. I ask the nurse about reactions to the shots, and she said,

"Oh, all babies get fevers from these. So always give them Tylenol before they come in."

Which I know is not true. Because the doctor I visited under my old coverage told me otherwise: some immunizations cause reactions to some babies, and some don't. It depends on the baby, and it is not good to give them medicine when it is not needed. And I tend to trust a private doctor more than a government nurse.

This is just a small and relatively insignificant example of private vs. government service.


....................So, why do we want state-run health care again?


***I realize that there is no easy answer to this, but Obama's plan certainly isn't the answer either! Hyrum gave a good summary of what should be done about it in his letter to his Senator. But even if nothing is done about it at present, our current situation would still be worlds better than this proposed "Obamacare".

3 comments:

Hyrum Andrews said...

I meant to comment on this a while ago, when I read it. I really liked your post. You did a good job of pointing out fundamental flaws involved in the inefficiency of government, and integrating it with your own personal experience.

I have been thinking recently if some kind of health care savings account would be the best option. If people had an incentive to spend as little as possible on health care, some competition might drive the prices down.

It seems like the problem now, is that no one is willing to spend less on health care. The general model is that any amount of money is spent on any sort of problem regarding health care. It is a tough question because it is obvious that our system needs to change. Our health care costs right now are higher per capita then countries that have socialized medicine, and Medicare is bankrupting our country.

But just how can that change realistically happen? I am in favor initially of of less governmental involvement, but I'm not sure if that is realistic. If anyone touches Medicare, the elderly go up in arms. No one is talking about less government involvement in health care, and the broken system can't wait until people wake up and realize they want their freedoms back.

Sparrow said...

Ruth, great comments. I agree with you that from a service perspective government run HC would be inferior to private. Just like if you shop at Ross the service would be inferior to Nordstroms. And of course if it comes to HC you want the best right. Actually, as it turns out when you crunch the numbers socialized medicine returns about the same results that private HC does at a fraction of the price:

Unitied States UK Canada France Germany
2007 Total expendit. on health /capita, US$ 7290 2992 3895 3601 3588
2007 Total expendit. on health % gross domestic product 16.0 8.4 10.1 11.0 10.4
2007 Public expend. on health % total expenditure on health 45.4 81.7 70.0 79.0 76.9
2007 Public expend. On health/capita, US$ 3309.66 2444.464 2726.5 2844.79 2759.172
2007 Total hospital beds Per 1000 population 3.1 3.4 3.4 7.1 8.2
2006 Infant mortality Deaths per 1 000 live births 6.7 5.0 5.0 3.8 3.8

From: http://www.oecd.org/document/16/0,3343,en_2649_33929_2085200_1_1_1_1,00.html
So you’re paying a hefty price for the personalized attention. Especially because if you look at the numbers government run HC doesn’t harm adversely appear to effect peoples health. I go into detail on why US health care is so much more expensive in a previous blog post. In any case because our health care system is so expensive Medicare and Medicaid will go bankrupt and 15% of our population has no HC, which is then paid for by our government through a very expensive system. We simply cannot afford our HC system and it’s saddling future generations with huge debt. Although I don’t think that a public option is a good idea I like Senator Bakus’ proposal. The basic idea is to force everyone to purchase HC who can afford it, and make it mandatory for HI companies to cover everyone. This eliminates the factor of adverse selection that I discuss in detail in my previous post. My previous post can be found here: http://hjandrews.blogspot.com/2008/03/some-market-problems-that-government.html

Hyrum Andrews said...

Paul, do you know what these two stats are?

2007 Public expend. on health % total expenditure on health 45.4 81.7 70.0 79.0 76.9
2007 Public expend. On health/capita, US$ 3309.66 2444.464 2726.5 2844.79 2759.172