Tuesday, April 17, 2018

I’m With Stupid

Every week it seems as if we’re hearing news reports about the rising cost of health care. Those who oppose it blame it on the healthcare legislation passed into law by President Obama and Congress. Others blame it on the healthcare industry arbitrarily raising rates in anticipation of the impending healthcare law. The industry blames it on consumers for using the services too much. Everyone is pointing the finger at someone else; in meantime, the individual keeps getting screwed.

So, yeah, I’m with stupid.  And all the stupid other entities that are playing Russian Roulette with my health and at my expense.


Even forces that would normall be on the same side of an issue are pointing at each other and saying, “It’s their fault!” In a recent New York Times article, it was clearly shown that really no one knows what the true drives of healthcare are. Costs keep rising, premiums keep going up (astronomically) and there is not a single reason that makes it happen.

GOP lawmakers and insurers disagree what the root causes are for the increases. The easy soundbite and scapegoat answer is the federal healthcare legislation (it’s Obamacare!); or the “greedy” insurance industry. Truth is, nobody knows. Anybody who publicly says they do know and tries to look smart by spitting out statistics and studies and experts are biggest liars of all. Stats lie. Studies lie. People lie.

In some cases, premiums are rising as much as 50%; more in extreme cases. A lot of these are small businesses with fewer than 500 employees. Owners of these companies are doing everything they can to lessen the impact upon their employees. Some are changing plans to increase deductibles (in order to lower premiums), others are cutting pay to offset the increased cost of healthcare. A few have just stopped offering healthcare at all, because of the expense.

Studies have been done (yes, I remember what I just said about studies) that show only about 1% of the increased cost of healthcare can be attributed to federal legislation. Most of that is because of the requirement to totally cover preventive care.

Although no one has been able to pin down a specific number, the amount of use by patients contributes to the rising cost. It’s a catch-22: the more you use the coverage, the more you contribute to the rise in coverage. When you have a health plan that covers nearly everything with very little out of pocket to you the individual, the natural tendency is to use more without thinking about the consequences.

It parallels recycling and environmental efforts: before we were made aware of how our behavior was harming the earth with trash and natural resource usage, we just did what we did and didn’t have a care in the world. Now, people are much more educated about the consequences of our actions.

We’re beginning to see early stages of that in healthcare. More responsibility has been put on the individual to be responsible for their health. By putting financial consequences on specific healthcare choices (i.e., paying more for each doctor visit or certain type of test) it does force you to think twice about if you really need to go see the doctor because you have a runny nose.

Only time will reveal if this approach really makes a difference. It will slow down the unnecessary doctor visits, but then that negatively affects the doctor, as they are already compensated less per visit by the insurance companies; fewer patient visits leaves them scrambling to cover overhead costs on less revenue per patient. Not good. This is why you are seeing huge numbers of doctor practice groups selling out to larger hospital organizations (if you’re paying attention). The days of the individual doctor remaining independent are going the way of the DoDo bird.

As all of the major entities in the healthcare circle (insurers, hospitals, pharma, doctors, legislators) hire lobbyists to protect their positions and tilt the playing field in their favor through obfuscation, misdirection and outright lies, the individual is left to twist in the wind and take whatever is handed down.

There are small measures of relief in the federal legislation, but the bulk of it doesn’t take effect until 2014 at the earliest. Until then, the other players in the system are raising rates, building new facilities, stealing market share from each other and doing a bunch of other things that ultimately require the individual to pay more to be covered.

Individuals, be diligent in your pursuit of fair healthcare. Do what you can to keep yourself healthy and always, always, always (!) question what’s being told to you or done to you regarding healthcare. It’s the only way to fight this rising tide of special interests, one person at a time.

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