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Date:         Tue, 26 Jan 1993 13:52:44 -0400
From:         The Integral Differential <DEMON@DESIRE.WRIGHT.EDU>
Subject:      Re: Health Care Reform
Comments: To: POLITICS@OHSTVMA.ACS.OHIO-STATE.EDU

>>IMO, one of the major reasons health care costs so much
>>is that hardly anyone is spending his/her own money: thus there are
>>few incentives to economize.
>
>With all due respect to your opinion, it's wrong.

        I don't think so.  Take any transaction where the purchaser does not
bear the real cost of the product being bought.  Demand always exceeds the real
market equilibrium.
        Don't you think we'd be buying a lot less of certain goods if they
weren't subsidized?  (Bread, for instance.)
        When was the last time someone said "no" to a test because $275 sounded
too high?  They don't because insurance either pays for it, or charges some
nominal co-payment.  $10 for a test?  Sure, why not!

>Health care costs are skyrocketing because of some simple facts:
>
>        1. The unbelievable waste and inefficiency of private insurance
>           coverage.

        Private insurance is not inefficient in and of itself.  A health care
provider having to deal with N+1 different forms is inefficient.
        And it's private insurers that are leading the fight against
uncessesary and costly tests and procedures.

>        2. The incredible profit margin of private insurance companies.

        "Incredible"?  3% is incredible?

>        3. The outrageous cost of medical malpractice...not only
>           insurance premiums, but the plethora of unnecessary tests
>           and procedures to CYA in case of litigation.

        True, true.

>Our system is falling apart - but it's not from _over_ use.  It's from:
>
>A. Misuse (scarce family practice so ERs are filled with colds and flus).

        ERs are filled with people who don't have insurance.  There are a
plethora of 24 hour and 18 hour facilities around that provide such care, but
don't fall under medicare/caid/poverty regulations.
        I think it was 48 hours that did a story on a big-city ER.  The Dr and
LPNs said that over 80% of the people were there for routine care, but didn't
have insurance to pay for a regular doctor.

>B. Abuse (MDs ca't get insurance companies to pay full price so new
>   "costs and procedures" appear on the bill".

        That and your tests going on some medicare/aid patient's bill.

>C. Underuse (300,000 empty hospital beds in the US every day...more
>   MRI machines in the city of Houston, TX than in Canada...premiums
>   paid but basic preventative care inaccessible (problems easily
>   treated when they develop turn into catastrophic illness because
>   the insurance company bets that preventative care _may_ cost more
>   in the long run...i.e. gambling with your lives).

        I've seen a definite change in the past few years.  Almost every HMO
I've come across stresses preventive medicine/procedures.

>My contacts on the Hill and
>in the National Health Care fight seem pretty optimistic that they will
>come out with a full national health program (unlike what Clinton
>tentatively proposed during the campaign).

        If it appears with national legal care and real tort reform, I'll be
happy with the set :).

        But after we've established that health care is a "right", what next?
A job of our choosing with pay of our choosing? :)

>           averages about 26%...add that to profits!) AND.......
>           costing LESS than all the above programs!!!!

        I'll believe that when I see it.  And not some form of "we just will
stop treating patients when we run out of money" planned care monstrosity.

Brett'
Comments: Gated by NETNEWS@AUVM.AMERICAN.EDU