Health Care in America

Most of us have the good fortune of never having to do much interaction with the health care system. We encounter little more than the basic cold or flu.

Unfortunately, as we age, we all will find our contacts with health care more frequent and more complex. Contrary to the conventional wisdom, our system is not all it's cracked up to be. Many western countries have health outcomes that surpass ours, and pay out substantially less than we do.

The latest trend is to increasingly shift costs of health care to individuals. For the 20 year old, that's not so bad. But when you are 45 or older, you have been paying in for many years without having made many claims. Now you are being expected to pay. In other words, they took your money and you assumed you'd come out even in the future, but that's not how it's working. You are getting ripped off.

Politicians and economists will hand you all sorts of free market justifications for the change and if you hadn't been subsidizing others for 20 years, they might be right. But the fact is, they took your money, now they want to act as if they didn't. This is just flatly theft.

Let's begin by eliminating a myth or two. The heath care market is not a free market. It simply doesn't meet the economic criteria to be considered a free market, and it's unlikely it ever will. To be a free market, I've got to be able to find the best deal and to do that, I've got to be able to know what is the best product, have multiple competitors, and be able to shop around. Anyone know where that can be done with respect to health care?

The second myth is that we can pin the rise in the cost of health care on some single factor such as lawsuits, needless use by consumers, over use of tests, conflicts of interest, or even just the fact that the population is getting older and sicker. The reality is not that simple. Health care costs are going up because of all sort of factors forming the perfect storm of rising costs. The fact is that the real cause of rising health care costs is greed. There are greedy pharmaceutical companies, greedy doctors, greedy lawyers, selfish consumers, greedy employers, and greedy shareholders. A pure free market will combat greed because competition drives it out, but the market of health care can't. Recent surveys of new doctors indicate they are not motivated by caring, but by money. You can't blame them, but don't look to them to suddenly find a sense of compassion. Employers are doing everything possible to shift costs to employees at rates that offset the slight raises that the average worker gets.

The profligate spending of the recent administration coupled with tax cuts that have benefited few average wage earners set us on a path where many of us will not be able to get the health care we need. The crisis may not affect you today, but it will in the next ten years.

Here's some things you should do:

• Ask to see the contract your employer has with the health claims administrator. There's a good chance that the contract does not put a burden on the third party administrator to ensure you get you care covered, but focuses on lowering the cost to the employer
• Find out who the consultants are that are guiding your employer. Most of them are charging needlessly large fees to provide cookie cutter solutions that don't benefit the employee, and many have conflicts of interest with the very vendors they are hired to monitor.
• Unionize because they only group that has the slightest chance of countering the bad deal be given to employee is an employee union. Unions are imperfect an have too often feathered their own nests, but they are part of the solution.
• Demand Congress step up and make investigations of the health care system part of its agenda. Congress has focused on those without health care, but done little to address the impending crisis facing even those who have limited coverage.
• When possible, and unfortunately this is a hard one, make your doctor give you a cost estimate and coverage evaluation every time they want to do something.
• Get healthier because you aren't going to want to be unhealthy in the future. It will be a bad time.
• Spend time now finding out who qualified specialists are and getting to know them. As someone who recently found myself needing a specialist over the Thanksgiving holiday, I can tell you that the vacuum is huge.
• Stop settling for inefficienct health care that makes you wait as if your time is of no value. It relfects an unacceptable arrogance on the part of health providers, and the reality is, they don't really have to behave that way. That you have to wait so long is a function of poor management.

Health care is about 20 percent of GDP now. It's time we as consumers starting have our rights considered. Don't think for a minute that because your employer pays a share of your costs that you are somehow not the purchaser. It is simply another form of compensation and you have earned it with your labor. It's not a gift.