The Health Care Dilemma

Michael E. Platt, M.D.

Michael E. Platt, M.D.

We have a new president elect who has promised to make America great again. Not an easy task when it involves undoing eight years of policies that have had the tendency to undo our prior leadership in the global community.

He has committed himself to making the undoing of The Affordable Care Act (i.e. ObamaCare) one of his first priorities. Certainly a daunting task when you think about it because you have millions of people receiving health insurance who have pre-existing medical conditions who would be considered uninsurable without it. And there are millions of people with low incomes who have been able to have their children taken care of. Do you take these people off the rolls of the presently insured?

But then again you have 20% of the population who are shouldering the costs for the other 80% of people on this program with the added burden of continually rising costs. So how does one go about deep-sixing this program, salvaging the benefits that it has provided, and at the same time ease the financial burden of the minority

For those of you who know me or have read my books, you are aware that I try to approach problems from the cause and to avoid the use of Band-Aids. Well the thing is, ObamaCare is a huge, unworkable Band-Aid. However, there is, to my way of thinking, a solution to this situation that I feel might be workable. It would allow those with pre-existing illnesses to have insurance, it would provide low or no-cost insurance to those families in need, and it would ease the burden of those paying for the present program.

So let us talk about the elephant in the room that people may not be aware of, namely, health insurance companies. A large number of people are oblivious to the insidious effect that health insurance companies have on the cost of every aspect of medical   care – the price of drugs, the cost of procedures, how much doctors get paid, the cost of medical supplies, etc. The system has learned that the prices have to be terribly inflated because the system is aware that they will only be receiving a fraction of what is billed. A small example: I used to draw blood from patients and a lab would pick up the samples every day. Since no insurance company was involved, they gave me special rates. The cost for thyroid tests designated as a T4,free or a T3,free were $5 apiece. The price to someone walking into the lab or the charge to insurance companies was $175 apiece. The insurance company would get some adjustment, of course, the person without insurance might have to pay the whole amount. But right away you can appreciate the added cost due to insurance companies.

To take advantage of the tremendous savings that can be obtained by eliminating insurance companies brings up the concept of ‘the single payer initiative’ – a situation whereby the individual states take over the job of providing health insurance. The state would negotiate directly with providers to determine costs, and with the elimination of the middleman (insurance companies) enough savings could be realized to possibly continue with many of the benefits realized with Obamacare but that were financially unsustainable. California had the opportunity to institute this program about 20 years ago, but the voters turned it down due to a huge campaign put on by insurance companies to defeat this bill. 

I think the time has come to look at this again.

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