STATE OF HEALTH CARE
by Michael Tye

I have been called by my business coach a “truth teller,” so I might as well just jump right into it here.

The Problem

A couple of years ago at a professional association luncheon I attended, a Canadian doctor made a statement about their health care model – “Everything is free and nothing is readily available.”

Solutions to high health care costs and dealing with the uninsured will be sought with ferocity by a new, ambitious Presidential administration. Much of what is being proposed is either direct or incremental movement toward a nationalized health plan.

While there are several different models in Europe, many of the references made are about the Canadian system. Regardless of which socialized system is studied, there is a beginning premise that is common to all of them – a fixed budget that results in rationed health care. Now, understand that I firmly believe there ultimately will be rationed health care (stay with me). We cannot continue to spend 16% (and rising) of our GDP (Gross Domestic Product) on health care. After much study and consideration, I have come to the conclusion that there is a shortage of desperately needed health care in the socialized systems and an outrageous overabundance delivered in the USA. 

Assuming my conclusion is right the only question is WHO does the rationing? It concerns me more than a little if it is to be a national or state governmental bureaucracy. I see too many examples of these well intentioned systems put in place that have run amuck and you and I, who pay for them, have no say about whatsoever. It would be the largest monopoly in our history.

Twenty years ago, Kaiser was an inefficient, rather heartless system compared to the rest of the medical providers. Enter dozens of competitors into the HMO business. Guess what? Kaiser is now one of the best systems around! It took competition. Without it, there is no motivation for performance or innovation. 

Solutions?

There is no simple solution to “fixing” these issues, but I am considerably more confident in allowing the private sector to come up with what it will. I can fire the ones that provide less than optimal solutions and hire those who arrive at better ones. If I trust a bureaucracy to do it and they fail, I have no recourse and good luck retrieving control.

I am also convinced that the burden of keeping costs in line is on you and me. I don’t order the lab work, MRI, CT scan, hospitalization, drugs, so how can I be responsible? If it were not for insurance, you and I would be talking with our doctor about the cost of these items. As it is, doctors are paranoid about NOT ordering the tests and/or the drugs, fearing we will sue them if they don’t throw the kitchen sink at our complaint. A large percentage of our medical care cost is diagnostics and treatments that are done “in hopes” of them helping. There are many anecdotal examples as well as studies that make it clear that if we are more engaged in the purchase of our health care, it will result in considerable savings. 

Another reason I say that you and I are responsible is due to our lifestyle choices. No one can argue that poor eating habits, lack of exercise, smoking, and substance abuse result in a huge portion of our medical care. In addition, we allow medical providers to go to extreme lengths when it has become clear that they will not extend, let alone enhance what few months or years we have left once diagnosed with terminal illness.

Something Has To Give

Health care will change. Who do you trust to do it? A few short years from now it is likely you will wonder where the freight train came from that ran over our current system. The engines are stoked and the destination is in sight for those on the train that want to take over almost 1/6 of our economy. If we do not make our voices heard, we will have no one with which to lodge complaint.

The Challenge

My purpose is not to convince you which way is best as much as get you engaged so you will be represented as decisions are made.

Michael Tye
Health Insurance
Advanced Benefit Center

 

If you would like Michael to speak at an event or for more information please contact Frances J. Harvey at 800-998-6329 or info@turningpoint.org. You may also learn more about the Speakers group at http://www.tpspeakersgroup.com/