Healthcare Crisis

If you watched or saw highlights of the recent GOP debate on CNN, you heard a few (crazy) audience members cheer and yell when they wanted to confirm that someone without insurance is critically injured or ill should be left to die. Disclaimer: I do not believe the candidate (as he stated) wants this, or any caring member of society does. There are a few people, though, at least in that Florida crowd that think lower taxes are more important than human life. That is sad, and I know almost everyone (regardless of political affiliation) disagree with those few. Maybe they were just trying to show up the Texas crowd that cheered the execution of more than 230 people while Gov. Rick Perry has been in office, but that's a whole other topic.

So. Everyone can agree that our current healthcare system is not working. I don't know many people that are happy with it. So the issue becomes what to do about it. Fixing it requires looking at the problems and the root causes. As someone who has recently spent over a decade working in healthcare from different points of view and with different companies, I figured I would share some thoughts.

• Problem #1: Rising Premiums for Insurance Policies.
• Why is this a problem? It hurts everyone financially, including the economy. The more money people are spending on insurance premiums the less they are spending on things to circulate and stimulate the economy. Businesses are also affected by this, and usually more than the employee. Companies many times absorb some of the rate increases that the insurance companies pass. This means they have less money to reinvest into the companies, restock supplies, or they may have to cut jobs so that less benefits are paid out. All of these things hurt the economy. 
• Why are the premiums rising? The premiums rise for many reasons, but costs of procedures and breakthroughs in medical technology are part of the reason. More directly, an insurance company determines an insurance premium specific to a company based on a plan of benefits. For an insurance company to grow, it has to make money, so it needs to take in more money in premiums than it has to pay out in claims. Each year the insurance company looks at company ABC and checks to see if it made them money or lost them money. If a company had a few employees have a bad time with illnesses or injuries, it could cause the whole company to have more claims than it paid in premiums. This insurance company tells company ABC that this year the premiums are increased to recover the money. Lets say this companies' employees have a more common year of claims and the insurance company makes record breaking profits due to the better health of company ABC. The insurance company will definitely not be lowering the premiums the following year, and a new standard is set with that insurance company. This new record will become what the next year is measured from. Fair: no. Capitalistic: definitely. Insurance companies are not non-profit organizations and have never claimed to be, but some believe they will do just about anything to get out of paying claims they are due to pay if they can find a loophole, knowing the costs wouldn't be absorbed by the billing facility, but by the patient who thought they were covered. Being required to receive pre-authorization for certain services, hopefully those don't include an ambulance when you are being driven from a car accident to check for major injuries. Most people don't think to call their insurance company between 8am and 5pm Monday through Friday during an emergency (probably during the weekend).
• I know people are against Universal Healthcare because it is socialism and our country will be swallowed up by the devil of communism if he had it, but if insurance companies are increasing the costs of everyone to make up for a few at your company, what's the difference? It appears my premiums help pay for a coworkers child who is diagnosed with leukemia. I don't have a problem with that. I'm not mad at the coworker or the child, I pray that the child will recover and support the family in many ways. (This is hypothetical by the way.) Wouldn't Universal Healthcare be the same thing except instead of spreading the costs over one company, it's spread throughout the country. The other major difference, is when more taxes are collected than paid to healthcare providers, the money can be used to fund other services or given back when people file their taxes. 
• We can't do anything about the costs rising due to the increased technology, it's probably going to extend your life at some point. 
• Problem #2: Higher Bills for all Patients regardless of Coverage.
• The other reason healthcare bills increase are due to making up for patients who do not/cannot pay their bills. This is the same principle I learned in fourth grade. People who steal baseball cards from the supermarket, will lead to the rising prices of baseball cards or possibly other items like apples at a supermarket. The business has to recover costs. So, who is stealing healthcare? The uninsured and the under-insured. This is a separate problem I will discuss.
• Problem #3: Increasing costs for long-term care/incurable diseases.
• Many of our senior citizens are learning that getting sick is the easy part, paying for medications and supplies on a fixed income was not part of their retirement plan. Diabetes comes with many costs on a daily basis, not to mention the pain. It is also not fatal if treated and monitored properly. This should be the good news, but for most people it is another out-of-pocket expense to live. They also were afraid to go to the doctor for a little cough a few years ago (not wanting to pay the copay for the office visit or the copay for the prescription), but it never went away and each week, month and year it has gotten worse. The patient finally goes into the doctor at the nagging of his wife to find out he has stage 3 lung cancer and is spreading throughout his body. The next months or years of his life are spent in pain, trying to beat cancer, but eventually he will succumb to the disease and his family he leaves behind will also have a large medical debt to remember him by. Sad. Trying to extend a life of a loved one is a common reason for people to have their home foreclosed on. Is this the society/culture of LIFE?
• Problem #4: Insuring Everyone / Mandating coverage for all.
• It is true that healthcare insurance costs can be cut if everyone had insurance. It is also true that many people have a problem with something that mandates they purchase something (I too am not sure about the constitutionality of that). I believe this to be the biggest issue in the President's health care bill that was passed. Here is the solution: You can't make every citizen buy health insurance, but you CAN give it to him/her by being an American citizen. Heck, you don't have to be a citizen, just pay taxes. Undocumented workers would want to become documented and pay taxes for free healthcare. Easy choice. Yes taxes would increase, but probably no more than what would be offset by not having insurance premiums. Honestly,  if there is any money left over after all claims are paid, I would rather have it added as a tax credit when filing my taxes, than buying some insurance company executive a new $300,000 car.
• As far as what would be covered? Start with Medicare and go from there, the beauty of it will be that when changes are made, it affects everyone in America, not just the wealthy, not just the poor, not just the congressman. Everyone. Coverages will be better, and things like Aflac would still be there for those who wanted that extra protection against lost wages, etc.
• I don't buy the arguement that the government can't manage it as well as a private company. Yes, the govt has issues, but if you think some money is not wasted at these insurance companies, you're nuts. They hire people, including physicians (not cheap) to try to find ways to deny claims and weasel out of paying bills. I have worked for a non-profit hospital and a for-profit healthcare service. Patient care is more often the top priority of the non-profits. Not to say it wasn't a priority of the private company, it was just usually stressed day-in-day-out that the business needed more patients, more numbers. It's just the nature of it.

I hope this doesn't come off like a rant, just something I think everyone should think about. Take your emotion out of it. Take the politics out of it. Take the fear out of it. No system is perfect, but we are nowhere to being even good with our current system. As many Christian preachers say every Sunday across this country: "What would Jesus do?"
I'm probably not the best "Christian" when it comes to my beliefs, but I do believe in the Golden Rule and that we should take care of each other. All of us deserve to be cared for when sick or injured, and those that cannot afford it shouldn't live what life they are given after the ordeal worrying about the debt they have collected, many times even after having what they thought was "full" coverage.
Let's turn the United States into a country leading the way in Healthcare, not just the one with the advancements. (Not the same)

Love you all,
Mark