Constructive gadfly
Published on July 19, 2004 By stevendedalus In Health & Medicine

According to Washington Post article by Dina ElBoghdady, who defers to a New York Law study, 80 percent of those with health insurance are nevertheless in bankruptcy owing in the main to medical bills. Until then it was presumed that those of the 43 million uninsured were mainly affected by catastrophic bills. Moreover, the writer points out that it will be even worse as health care cost are rising at a 10 to 14 percent rate in contrast to wages at 2 to 3 percent. Of course, this is nothing new: ever since First Lady Hillary’s controversial proposal in ‘93 the chaos in medical coverage has been looming, yet swept under the rug.

Insurance companies compete for hospitals by offering huge discounts and then stick the patient with the loss or continually raise premiums on all of the insured. The hospitals, on the other hand, continue to plague the patient with esoteric billing codes not covered by insurance, consequently ending up in the hands of merciless collection agencies. Not only that but the bills are deliberately inflated to offset the losses of emergency treatment of the uninsured.

In my view, there is simply too much stealing from Peter and Jane in order to pay Paul and Mary in the field of medicine from pharmaceuticals to hospitals. There are some cases wherein co-payments exceed the cost of fees for service. Some doctors negotiate discount fees just to avoid the hassle of insurance red-tape, which in the long run, what with excessive time involved and the hiring of extra help, costs more. Moreover, the crucial aspect of insurance is that it shortchanges catastrophic illness for the sake of normal, routine check ups which should be done by a family doctor for a direct payment from the patient who, in spite of, refusal to accept such an obligation spends more for annual automobile check ups.

Naturally, as in the old days of the GP, there are the poor who are unable to make these payments and should be referred to clinics or put on an easy payment plan. If the practitioner suspects from a check up that a more serious medical problem exists and requires further service, only then would insurance kick in.

Malpractice lawsuits against doctors, hospitals, and insurance companies should be placed in the hands — mentioned several times on this site — of localized human services board to determine damages if any. In an egregious case worthy of appeal, only then should it be referred to trial lawyers.

Those against national health coverage should at least favor an IRS revision of the more reasonable medical allowance of costs above two percent of gross income, regardless of what return the taxpayer uses, and in this way ward off the controversial medical savings plan on the drawing board. In addition the recalcitrant should favor a massive plan to train paraprofessional for neighborhood clinics and walk- ins, administered by nearby hospital interns and residents. Rather than perceived as declining quality, status-quo advocates should be reminded of a marine in battle with his gut torn open doesn’t ask the corpsman for credentials before receiving morphine.

Whatever the approach there is the overriding parameter that profit and cost of health care must be held to moderation.

Copyright © 2004 Richard R. Kennedy All rights reserved. Revised: July, 19, 2004.


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