Tuesday, March 23, 2010

Concerns about health care changes

I'm going to be honest and admit that I'm being selfish and thinking of myself first here, but just to get it out in the open:

1)Long term unemployed: the health care law provides for people between jobs, lost jobs recently, or for people under 26 whose parents have a plan. Long term unemployed from the homeless to those living in relatives in friends homes are not even considered. I don't expect the government to pay for my health care. Ideally I get a job and that would provide my coverage. But how can the government mandate anyone who has no money to pay for health care and the charge a fine if they don't? Are we going to see police rounding up people in homeless shelters and throwing them in jail? "Sorry you didn't buy health care, what you have no money? thems the breaks!"
Realistically the mandate to purchase health care will just fall through leaving a big budget crisis.

How this could be fixed:

The easy way
: Mandate for health care only applies to those making over 30,000 dollars. This would still leave hospitals with the problem of providing care for the poor and paying for it, but it would be a reasonable law.

The hard way
: Mandate that everyone be employed in some way and that the employer provide the health care. This obviously wouldn't be a mandate on the people directly but the companies employing people. The provision would state that if companies did not increase the amount of employees every year as to erase the unemployment percentage down to two percent the government would claim the right to tax these companies enough to provide government jobs for every person these companies refused to employ (did I mention this was the hard way?)

2)Health care providers are off the hook:
Health care is not comprised of just insurance. we have 3 separate entities involved that affect health costs:
a)health ensurers (government and private)
b)health care providers (doctors and nurses and the institutions that employ them)
c)medical schools

The first two's effects are obvious. the more profit an insurance company makes or the more income a doctor gets the higher the cost of the health care. Doctors expect a high salary range often because many have had to take out hundreds of thousands of dollars in student loans to pay for schooling. If the schools were compelled to provide low and no cost education for qualified students doctors salary ranges could be greatly reduced and the doctors themselves would have more cash in pocket despite making less money annually.

But the real problem is in the health care providers. Without regulation providers can charge whatever the hell they want (pharmaceuticals as well) and let the health insurance pick it up. this is a subtle form of theft because no one notices what the provider is actual charging only when their premiums go up. I shutter when I think a doctor can charge a million dollars if they so choose for an physical and now the tax payers will have to pay it. the patient doesn't get better service the doctor simply gets richer. Why do you think the AMA LOVES this plan, they are thinking: "were all rich!"

3)End of life and quality of life
Everyone has a different opinion on quantity of life vs. quality of life decisions. One thing isn't debatable though: the country cannot afford to keep everyone alive till they're 90. the cost of health care is completely back ended. I'm not saying we should euthanize the old, I'm saying we return to the standards we knew 100 years ago when we new that if you lived to 70 you've lead a full life, and there is no shame in letting someone die natural, especial if they are in terrible suffering. we need to get over our own fears of death and realize that no one lives forever and their is no benefit to trying.