From: hrubin@pop.stat.purdue.edu (Herman Rubin)
Newsgroups: alt.politics.clinton,alt.politics.bush,talk.politics.misc
Subject: Re: National Health Care
Date: 23 Aug 92 14:47:45 GMT
Organization: Purdue University Statistics Department

In article <VBg-P=+@engin.umich.edu> jwh@citi.umich.edu writes:
>In article <92234.071414DGS4@psuvm.psu.edu>, <DGS4@psuvm.psu.edu> writes:
||> In article <1992Aug15.223532.19090@oakhill.sps.mot.com>, pjm@anegada.sps.mot.com
||> (Patrick J. McGuinness) says:
||> >
||> >In article <1992Aug14.213401.27774@berlioz.nsc.com> worden@bouncer.nsc.com
||> >(Dennis Worden) writes:
||> >>tag@hermes.ecn.purdue.edu (Tony A. Gibbens)
||> >>>      In the US, currently only the rich and the lucky people with
||> >>>good employers get health care.  The fact that the infant mortality rates
||> >>>are among the highest in the western world, and that some 30% of the
||> >>>country isn't covered for all medical costs is quite pathetic.

But what health care?  I am one of those "lucky people with good employers"
and I believe that I am getting worse health care than I would have if my
employer did not run what is a prepaid health care system, rather than an
insurance system.

||> >This number is way off base. See below.

||> No, it's not.  Read what was written, "30% of the country isn't covered for
||> all medical costs."  The past ten years have seen large increases in required
||> co-payments, deductibles, reductions in benefit coverage.  Studies show that
||> a large number of Americans (even more than 30%) would have their savings
||> completely wiped out by a single serious episode of medical need.

Raise this figure to 90%.  There are few coverages which would handle a 
multi-million dollar medical bill.  Few coverages will handle "experimental"
treatments, even if the bulk of physicians would consider those the appropriate
treatment.  The proposed Oregon plan would draw a line at some place on a list
of medical conditions covered; for the person who has a condition not covered,
it is as if there is no coverage whatever.  Will a proposed national procedure
be any better?  Government bureaucrats are opposed to innovation, as are the
insurance company bean counters.  Medicaid requires that one be almost broke
to receive the benefits.  Elderly people have been advised to divorce their
spouses so as not to lose their savings; the spouse will, under present
circumstances, be comparably treated.

>Which is an argument for people having some form of catestrophic health
>insurance rather than insurance which covers 'all medical costs'.  People
>wonder why insurance is so high.  Imagine how much auto insurance would
>cost if it covered fill ups, tune ups, oil changes, etc.  Insurance should
>be just that, insurance.  Minor medical procedures, check-ups, etc.,
>should be covered by the individual.  Doctors fees can be increased
>simply because the customer (patient) isn't paying the bills.  When
>you intervene in a market transaction so that the customer doesn't
>realize what the good or service he is buying costs, its not surprising
>that the market 'fails'.

Very definitely so.  My current doctor suggested something, and said,
thinking that I was concerned about the expense (I was not), that Purdue
would pay for it.  

Now the individual cannot do much about the problem.  The only choice I
have is how much of a deductible, and the upper limit is not high. 
Furthermore, an individual, whose actions will have little effect on
the system, must consider personal costs, not the societal costs if
everyone does it.  I could just not use the insurance system, and pay
out of my pocket.  But what good would this do?

In the meantime, doctors' fees are substantially regulated.  Anyone who
thinks that doctors in a particular form of practice are of equal abilities
is nothing more than a fool.  Also, doctors are only paid for procedures by
the various coverages.  A doctor can send a patient to a specialist, and 
this will be covered.  But for a doctor to confer with the specialist, or
(horrors) to consult the medical literature, frequently no mean task, to 
find out what the unusual condition is, or what unusual treatments are
available when the standard ones fail, is not covered at all.  Cases have
been posted to sci.med where referrals to 30 physicians failed to get
anywhere, but a single knowledgable physician solved the problem quickly
and cheaply.  In this national system, the 30 physicians ended up with
their full fees--there is nothing in these socialist schemes to achieve
quality work by intelligent people.

Real catastrophic insurance is very hard to come by.  Most policies have a
limit which is far too low for catastrophes.

||> I was without insurance one time for 3 months during a job change.  It
||> completely changes your life-style.  Stopped playing racquetball becuase I
||> couldn't afford it if I got hurt, not to mention the possibility of pre-
||> existing conditions not being covered.  Used two forms of contraception,
||> because there's no way we could afford to pay for a birth.


>Gee, personal responsibility.  What a concept.  Of course, judging by
>your comments you would prefer if someone subsidized your life-style.

In fact, I would suggest that normal expenses of pregnancy not be 
coverable, but that complications, etc., be covered with no waiting
period.  Again, this should be above the deductible.  But what we
have is exactly the opposite in most coverages.
-- 
Herman Rubin, Dept. of Statistics, Purdue Univ., West Lafayette IN47907-1399
Phone: (317)494-6054
hrubin@pop.stat.purdue.edu (Internet, bitnet)  
{purdue,pur-ee}!pop.stat!hrubin(UUCP)
Newsgroups: alt.politics.clinton,talk.politics.guns