Monday, September 14, 2009

Every Conservative Should Have a Liberal Friend

I, like most conservatives, have strong opinions about how healthcare reform should be approached. Because I was raised conservative, I just assumed liberals had very little to contribute due to the preconceived notions I held. (I.e., Every liberal is a secret, card-carrying communist, etc.) I figured all liberals really wanted in the healthcare debate was power and control. I saw them as ideologues who wanted to use society as a petrie dish for their philosophical theories. I may have been assuming a little too much.

I had a conversation with liberal friend I hadn't seen since high school. I also had another conversation with a liberal acquaintence from high school. In the course of these conversations, I was inspired to investigate and research the healthcare problem as a whole, partly out of anger. Based on the information I uncovered, I am beginning to realize why both had such a passion about the issue.

We, as a generation, are on the cusp of one of the most overwhelming moments in healthcare history. The baby boom generation are entering the retirement years, just as the healthcare industry has morphed into a multi-billion dollar industry. While I understand this is precisely what made America the most advanced country for medical care, it is also the most expensive. The two trains are speeding towards each other at top speed, and they are on the same track.

Aetna, one of the largest healthcare insurance providers, recorded 1.3 billion in profits for 2008. M.D. Anderson, one of the largest private "non"profit hospitals recorded $310 million in net revenue (aka, profit...called net revenue for tax purposes)just in 2008 alone, and they paid their president well over 1.8 million in salary last year. This is a NON profit hospital...ergo, no taxes. They claim to spend the rest on their charitible endowments, while at the same time, demanding cash up front for share of cost from their patients. This seemed incredulous to me, especially given the whining both groups have done recently about not being able to stay financially afloat. Obviously, they are gearing up for a long winter.

For those of you preparing the traditional Free Market Mantra of "the laws of supply and demand...yada yada yada," hold your breath a second. This was my error at first as well. The problem is we are facing the recession/depression (lower disposable incomes) coupled with the baby boomers entering the age of highest healthcare demand.

The first Boomers will turn 65 in 2011 and, according to today's report, more than 37 million of them—six out of 10—will be managing more than one chronic condition by 2030. Also by 2030:

*14 million Boomers will be living with diabetes—that's one out of every four Boomers.
*Almost half of the Boomers will live with arthritis and that number peaks to just over 26 million in 2020.
*More than one out of three Boomers—over 21 million—will be considered obese.

As patients live with multiple chronic diseases, demand for services will increase. The number of physician visits has been increasing for all adults, up 34 percent over the last decade, and this trend is expected to continue. By 2020, Boomers will account for four in 10 office visits to physicians. Over the next 20 years, Boomers will make up a greater proportion of hospitalizations as they live longer but with multiple complex conditions. At the same time, the number of registered nurses, primary care and specialty physicians will not keep pace with demand.

This comes from , a caregivers website.

In other words, the hope for supply and demand to regulate down the price of healthcare, with or without insurance, is pretty slim to none.

OK, now prepare for something to hit you on the side of the head.

Bearing all this in mind:
1. Healthcare costs are going to skyrocket with the increased demand,
2. The Medicare plan is ALREADY paid by the government, only the government also pays a middleman (the insurance administrator) to process the claims, and
3. Healthcare demands are going to limit access NO MATTER WHAT HAPPENS, even WITH health insurance for every American...

Doesn't it make sense to CONSIDER a direct pay option? Why are we giving a middleman (Aetna and their 1.3 billion in profits) the power to limit our care further? What about an HMO system provided just for seniors? Set up a managed care system for the retired Americans, and allow the non-profits to manage them. (They DID say they were non-profit.) Medicare payments to providers must be reduced to stay solvent. Wouldn't it make more sense to create a salaried position for a doctor to work exclusively with an HMO rather than leave it arbitrary? As unpleasant as it sounds, it may be the only way to control the enormous costs.

By removing the seniors from the private system (as they already are) it frees up the doctors and hospitals to provide more care for the regular insurance paying patients. In other words, we push down the demand, freeing up the supply. Allow the rest of the system to remain intact, with a few tweeks, like allowing the purchase of prescription drugs internationally and lift the restrictions on medical savings plans so it doesn't penalize the people who save but are healthy. A mandated purchase of health insurance will no longer be necessary when doctors lose 40% of their patient load. Or premiums will go down, as the insurance industry no longer has to subsidize the high utilization of elderly patients.

Also, how about focusing on prevention, such as naturopathic medicine (chiropractors, allergists, etc.) who advise adjusting food consumption and increasing activities rather than go on medication to manage cholesteral, diabetes, etc. For example: I had skyrocketting cholesterol and was borderline Type II diabetes. Instead of using Lipitor ($75 a month) and other diabetic controlling drugs, I went to a doctor who tested me for allergies. After eliminating the offending foods (wheat) from my diet, my blood sugar went down to that of a 20 year old, as did my cholesterol!

I'm not suggesting we need to all go organic (although I'm sure my eldest would be happy if I did,) or that the government will fix everything, but we can't just stick our heads in the sand on this one. It will sneak up on us while our heads are buried and bite us in the butt.

Oh, and to my liberal friends (you both know who you are) and my liberal leaning children, thank you for your patience. Debate is a painful process, but well worth the effort. If we are patient, we might just get through this mess!

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