Tuesday, March 2, 2010

Socialism In Medicine

Medicine is a business! Healthcare providers provide an essential service. Why then are so many people uncomfortable associating healthcare with business and profit-making?

According to Wikipedia, business is defined as follows: "A business . . .is a legally recognized organization designed to provide goods and/or services to consumers.. .The owners and operators of a business have as one of their main objectives the receipt or generation of a financial return in exchange for work and acceptance of risk. Notable exceptions include cooperative enterprises and state-owned enterprises.."

The healthcare system is NOT a free market system. Insurance companies and governmental agencies impose significant restrictions on the healthcare industry. If it were a free market system, healthcare would be forced to focus keenly on the relationship between healthcare consumer and healthcare provider. Satisfaction and competitive, quality service would be critical to financial success and would become standard. Costs are naturally constrained by monetary influences. This is the for many who propose socializing healthcare.

For obvious reasons, there will be a wide range of services that healthcare consumers will be able to afford. A question often used in the context of healthcare is whether individuals have an inherent right to healthcare. A rarely discussed extension of that question then becomes, how much healthcare does an individual have a "right" to access, and who makes that determination?

It is ludicrous to mandate any business to routinely provide services for free, or at unrealistic prices that make their business unsustainable. Yet, the government controls how much physicians and hospitals may charge for their services, then determines a "fair" price, and pays only a percentage of that "fair" price! For example, a healthcare provider may be legally allowed to "charge" no more than $100 for a service, but the government insurer deems that only $60 is a "fair" price, and then proceeds to pay only 80% of $60, or $48! This is why the current healthcare system, based on an artificial government imposed limitations is a financial failure! The current healthcare system has not failed because of healthcare providers. It has failed because of governmental interference.

Ironically, veterinary medicine is a free market business. Perhaps more ironic is the acceptance of a free market system in the production of weapons of mass destruction, ammunition, tanks, planes and military vessels! According to the publication, Government Executive (August 15, 2002), in 2001 more than $92 Billion dollars of taxpayer money were spent on the top 100 government contractors.

Healthcare consumers have been removed from the financial process of healthcare delivery for so long, and have become so reliant on a third party payor system with deep pockets that there has been little accountability for healthcare costs. Government handouts have created a dependent society. Healthcare consumers do not ask, or in many cases care, how much healthcare costs. Advances in healthcare mean that much can be done, but at what cost personally and economically? Because everything can be done, should everything be done?

Congress knows that healthcare is a business, and one that costs a hefty sum in tax revenue. The government is essentially the largest health insurer in the nation. The Centers for Medicare and Medicaid Services provided healthcare insurance to nearly 100 Million U.S. residents (2004,2005) at a cost of $577 Billion, according to the Henry J. Kaiser Family Foundation. The problem, as we all know, is that the number of people utilizing government funded healthcare insurance has increased while the number of people paying taxes has decreased. Medicare/Medicaid is an unsustainable business.

Congress has now mandated reduced payments to healthcare providers in order to offset the national budget. This merely shifts a significant burden of healthcare costs to individual healthcare providers, forcing them into an unsustainable business! On January 1, 2010 Medicare stopped paying for specialist consultations in the clinic or hospital, shifting to a reduced payment similar to what primary care providers receive, resulting in a reduction of approximately 11%. Despite the fact that specialist physicians have more advanced training and treat more complex healthcare problems, Congress has deemed that all physicians be paid the same. On March 1, all healthcare providers received an additional 21% reduction in payment, thus effectively cutting specialist payments by 25%.

Now Congress wants to bundle healthcare payments by paying only hospitals for all healthcare provided. Hospitals would then be in control of determining how much to pay physicians! Where will the accountability be? How will a physician's worth be determined? Physicians will be completely at the mercy of hospitals. Hospitals can effectively force out private practice physicians, and hire cheaper labor. Many hospitals already hire doctors from other countries because they can pay these physicians less money!

What can the motivation be to impose such limitations that effectively force physicians out of business? The socialization of medicine! Creating a socialist society where the government, or the most elite of the wealthy will be in control of healthcare. Are we ready for conglomerate medicine that is insensitive to local or individual needs? Do we want the government knowing in-depth medical information about each of us? There is a frightening conflict of interest here! The government will have the capability of determining who costs "too much". The government could then begin limiting individual benefits based on cost. Sound familiar?

What is next? Eliminating everyone who is not a valuable contribution to society? Imagine the impact of losing geniuses like Stephen Hawking because of healthcare costs! Imagine legislating who has the right to reproduce, or what fetus to carry to term to eliminate disease carrying genes, or to create a more perfect race?

Congress does value profitability in some medical businesses. The pharmaceutical industry has had substantial influence in legislative decisions preventing Americans from purchasing medications outside the U.S. at a cheaper cost. These companies have agreed to provide expensive medications at a cheaper price to some consumers. But, it comes at the cost of Medicare agreeing to not pay for alternative medications that are just as effective, but cost less.

What is the solution? Free market! The government needs to get out of the business of micromanaging our lives, and let the free market system influence the healthcare market.

Stop Congress from crippling healthcare and micromanaging every one of us!

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