From: crosmun@crosmun.rtp.dg.com (William Crosmun)
Subject: Re: Perot can still win :-)
Date: Thu, 5 Nov 92 16:31:22 GMT
Organization: Data General Corporation, RTP, NC.

In article <Bx7IrF.1CM@news.cso.uiuc.edu> irvine@uxh.cso.uiuc.edu (Brent Irvine) writes:
>>
>> [claim that the 15% uninsured have chosen to be uninsured]
>>
>It is not an apathy or economic issue, (Medicaid can help PROVIDED YOU
>MAKE VIRTUALLY NO MONEY - well below poverty line even though most people
>could not shell out an extra $300 a week!) but one of insur-ability.
>
>I know the insurance agencies are private coimpanies that need to make a profit.
>But, how can we take care of these people?  

This is the 64000 dollar question, isn't it.  (or should that be 900
billion?)

>
>We can either *make* them insurable by law, or slow the rising cost of 
>medical care until incomes catch up, or work with all branches in the
>healthcare industry to manage costs and care.
>
>It really deptresses me when people ASSUME that the 15% uninsured are
>due to personal chinziness or apathy.  
>
>Insurance costs are too high (gap between Medicare/Aid and affordability)
>and there are a lot of 'un-insurables' out there (you can even be
>uninsurable if you are overweight!)
>
>Anyway, i didn't mean to sound too vindictive, but the 15% (my sister
>is currently TRYing to get insurance with diabetes for when she no longer
>qualifies under our father's plan) may not all be apathetic people, but some
>caught in the medicare gap, and others uninsurable!

My response here may seem heartless.  I don't mean it to be, but there are
hard questions that have to be asked and answered if we are truly going to
solve this problem.  First of all, there is no such thing as uninsurable.
There is such thing as not affordably insureable.  Your sister is either
unwilling or unable or both to pay the cost of health insurance for herself.
Your solution is to make me pay for it (I'm using "me" as a metaphor for
socializing the costs of healthcare).  The question that has to be answered is
how much of the cost of her healthcare is your sister to be responsible for,
and how much is my responsibility.  As I see it, the real problem with the 
health care industry is that too few people are responsible for paying the
costs that they incur.  By this I mean that, since 85% of us are insured we
have no incentive to find the lowest cost providers, and the lowest cost forms
of treatment.  As a result there is no restraint on the upward pressure of
health care costs.  Before we socialize these costs and assume that the
government can provide the restraint (the history of Social Security, public
education, welfare etc. makes me leery of this assumption)  I would rather see
market reforms introduced into the system.  Specifically, a) remove the monopoly
of the AMA in providing health care.  It doesn't take 10 years of expensive
schooling to learn to set broken bones, but only those with that much
schooling are allowed to do it.  The amount of health care that most people
need most of the time can be provided by nurse practitioners, emergency
medical technicians, etc.  at much less cost than by doctors but since they
are not allowed to provide this care at lower cost the doctors end up charging
monopoly prices.  b) Streamline the drug approval process at the FDA. Right
now it takes $250,000,000 to bring a new drug to market and approval is far
from guaranteed but is instead fairly arbitrary.   The problem is that the FDA
will approve a drug only if it is safe and effective.  Safety can be
demonstrated easily and quickly.  Effectiveness is much more difficult,
expensive and unecessary.  Lowering the expense and time involved in drug
approval would lower the costs of these medicines.  c) Require those who use
health care to pay for it.  Frankly, I would be happier if the proposal for
national health insurance required a $10,000 copayment before the government
kicked in.  Your sister could much more easily find insurance for the first
$10,000 and I would be willing to kick in if here condition became serious
enough to cost more.  d) Reform the legal system eliminating the need to
practice defensive medicine.  The legal tort system, with potentially
unlimited liability for the most minor mistakes is driving costs higher and
higher.  Limit the liability of health care providers to actual damages
assessable only in the case of willful malpractice.  

Government pressure on costs will never be as effective or efficient as market
pressure.  Too often government has become the first resort, when it should be
the last resort.  Let's try these other things first.

>
>-- 
>+-------------------------+----------------------------------+ ^  ^  ^
>| Brent L. Irvine         |  "Love is blind ... and stupid." | {\{|}/} CLAN
>| irvine@uxh.cso.uiuc.edu |                      -M.P.       |  {{|}} IRVINE
>+-------------------------+----------------------------------+  o/|\o OF DRUM


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William Crosmun
crosmun@dg-rtp.dg.com

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"Thanksgiving Day.  In the days of our  founders, they  were  willing to give
 thanks for mighty little, for mighty little was all they expected.  But now,
 neither government nor  nature  can  give  enough but what we think it's too
 little.  Those old boys  in  the fall of the year, if they could gather in a
 few pumpkins, potatoes and some corn for the winter, they were in a thanking
 mood.  If we can't gather in a new  Buick, a  new  radio, a  tuxedo and some 
 government relief, why, we feel that the world is against us."

												Will Rogers

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