Thoughts on Health care legislation

A couple of experiences mold my view of debate over any government actions. The first was seeing some material printed in the 1960’s when going through an old piece of furniture. This article, published by the U.S. Chamber of Commerce, discussed the great problems that would arise if lenders were required to tell consumers what the annual percentage rate of borrowing would be on a loan. The legislation passed and none of the terrible things foreseen came about.
The second incident occurred as I read a book What Kind of Nation

http://www.amazon.com/What-Kind-Nation-Jefferson-Marshall/dp/0684848716/ref=sr_1_1?ie=UTF8&s=books&qid=1270578141&sr=8-1

About the political differences of John Marshall and Thomas Jefferson. They each claimed dire consequences if the other was elected (This was before John Marshal became a Supreme) The political rhetoric of today has nothing on how it used to be. They each in turn were elected and none of the dire consequences occurred.

I am not persuaded that health care is the worst thing that has ever happened in our nation, nor that it is the great panacea that others claim it to be. It contains some good, some neutral, and some bad.

I have worked with people who have had good job offers to go elsewhere, very much wanted to take the offer, but because they were diabetic and would not be covered under the proposed employer’s plan because of the pre-existing condition, remained in a job they disliked. That borders on involuntary servitude, aka slavery. The cost of medical care (even with health insurance) is one of the three major causes of personal bankruptcy, (the other two are loss of employment and family break up) I believe it is a good thing that lifetime limits has been eliminated. I believe it is a good thing that those who are unable to afford health insurance can now be covered.

I believe the health care bill also does some neutral things. I believe that health care costs need to come down. I recognize that shifting the cost elsewhere is not the same thing as reducing the cost. That is at best neutral and at worst negative as the true costs remain hidden. I was intriqued by a study by a Professor at Arizona State University who specializes in health policy. After researching the health care systems in all of the industrialized nations, she discovered that the percentage of people in each nation who liked the system they were under was the same for all systems and the same was true of the percentage that did not like the system they were under. Each system has to deal with the issues of cost of care, quality of care, and availability of care. A change in one of these affects the others. The balance between them may tilt one way or another. An action which will benefit one of the factors will reduce one of the others. Each action will delight one group and disappoint another but it all stays in balance for the entire country.
This is similar to when I was a boy with a paper route. Each day the papers came at the same time and it would take me an hour to deliver the newspapers. I experimented with different methods to cover all of the streets on my route. When I would make such a change I discovered that I got big tips and thanks from those who got their paper earlier. When I went on a different street first I would get a tip and thanks from the ones on that street. Either way the time I took to do it all did not vary. On the whole, I believe the same will happen with health care.
I see a significant negative with the passage of the health bill and this is what it is. The momentum to correct problems in the health care delivery process has stopped without addressing the most significant issue. That issue is that there has been confusion in health care over who the customer is. The customer is the one that pays the bill. In health care that is the insurance companies, not the patient. If the patient was the customer I believe health care would improve and costs would decrease. See this article from The Harvard Business Review:

http://hbr.org/web/extras/insight-center/health-care/will-disruptive-innovations-cure-health-care

Another problem is that prepaid health care is masquerading as health insurance. Insurance is used when there is a high cost risk which will occur in a population. It cannot be determined which member of the population will incur the cost. Insurance spreads the cost of the risk among a large group. That way the large potential unknown cost becomes a known cost, the cost of insuring against the loss. Such a program does not cover the routine and the expected anymore than my auto insurance covers the costs of brakes, oil change, and replacing windshield wipers. Yet health “insurance” asks me just to pay $10 or $25 when I visit the Dr. (True he only sees me for three minutes and 15 seconds so those add up over the course of the day.) but that really isn’t insurance.

I have also found these additional articles on health care to be of interest,
http://hbr.org/web/extras/insight-center/health-care/why-innovation-in-health-care-is-so-hard
http://hbr.org/web/extras/insight-center/health-care/redefining-competition-in-health-care
http://blogs.hbr.org/cs/2010/03/health_care_of_the_future.html
And just for perspective.
http://www.theatlantic.com/magazine/archive/1969/12/how-good-is-government-medical-care/6085/