Monday, June 15, 2009

A Healthy Debate

Lately, President Obama has been traveling around the country proclaiming that he has the solution to the nation's health care crisis. This may or may not be true. What is certainly true is that we have a health care crisis.

We pay the most per capita of any country on earth for medical services. Yet, our system was ranked 37th best by the World Health Organization . While the results of this survey have been challenged, no matter whether we're number 37 or somewhere higher, it's clear that we're not exactly getting our money's worth when it comes to health care.

The people who have insurance have no idea what health care really costs as they are sheltered from the actual charges. The poor who have no health insurance are protected by laws that demand they be taken care of independent of their ability to pay (as long as they wait long enough before seeking care in a hospital emergency room to get really, really sick). The ones who are really shafted in our system are those who have no health insurance, but do have the ability to pay (or file for bankruptcy). They are charged outlandish fees for every procedure.

I can share one example from my own personal experience. I had an out-patient procedure to break up kidney stones. I was in the hospital for a grand total of four hours. The procedure itself took about 30 minutes. The bill was more than $56,000. Because I had insurance, I paid about $1000 and the insurance company paid about $1000. But if I didn't have insurance, I would have been on the hook for the full amount. This is insane.

I'm sure you've heard similar stories. The bottom line is that things are seriously out of whack.

I have no clue if a government run health system would be better. I suspect it would not. What is clear is that the present system which focuses on pay for services provided has exactly the wrong incentives. Instead of encouraging expensive procedures after we get sick, the system should reward doctors who keep you healthy in the first place. But if your doctor tries to provide preventive care, Medicare, today's model of a government-run health system, will not pay for it.

What a mess!