more on that pesky subject: Healthcare

The following is a letter sent out to the New Orleans Tea Party participants. The author of the letter is an orthdontist in the Greater New Orleans area. His words hit several points I've tried to make time and again right on the head. The government makes things WORSE on a national level.:

Dear Tea Party Patriots, This one is a little long, so grab a cup of coffee or your favorite beverage as you read along.

As we approach the end of September, we know that, insofar as health care legislation is concerned, we are getting close to "put up or shut up" time for those we have elected to serve in Washington DC. I think we now all appreciate why it has been said that "laws are like sausages; it is better not to see either one of them being made."

What is it that people on all sides of the debate basically agree upon? Each of us would like to spend the least amount of our income on health care expenses. At the same time, we concede that having high quality care comes at an expense. That said, there are four things I hold with conviction:

(1) I believe health care and health insurance DOES NOT not have to be as expensive at it has become. (2) I belive that, with certain changes, health care expenses CAN be an affordable part of nearly every American's budget. (3) I believe that, when you break it all down, the biggest explanation for the rapidly escalating price of health insurance has been and continues to be.............government involvement. (4) I believe, with government out of the way, we can and will find a way to take care of everyone WITHOUT busting the bank. Allow me to elaborate. As far back as 1950, research shows that health care spending accounted for less than 5% of America's gross domestic product (GDP). By the early 1990's, it had reached approximately 13% of GDP and today it is close to 18% of the GDP. If left unchecked, it is projected to reach 20% of GDP by 2018 and will negatively impact the country's ability to fund other more pressing goals, not the least of which is national security and national defense. http://www.kff.org/insurance/upload/7692_02.pdf How did it get this way? Many people point to the great technological advances and improvements in prescription drugs over the last two decades. And while there is no doubt that newer technology and improved drugs contribute to escalating costs, they are just not enough to provide the entire explanation. The better explanation is how we now pay for medical care. In the "good old days," patients paid their doctors for services rendered. There was free competition amongst doctors, which helped control costs, and patients themselves behaved responsibly. They did not run to the doctor for every little sniffle or cough because (1) they figured they already knew what the doctor was going to recommend and (2) they knew there was a price to pay for an office visit. They used common sense to influence their decision of when to seek out a doctor and only went when they thought something might be serious.

Today, few people hesitate to run to the doctor because they know their own out-of-pocket expense is mostly (if not entirely) going to be covered by their insurance. Common sense plays no role in their decision. They figure "I've already paid for the insurance. I might as well use it." That kind of mentality, along with the way we pay for health care today, is at the very root of the problem.

I will get back to that issue in a moment, but there is another factor that compunds the problem. Several years ago in a faraway distant land, doctors used their diagnostic skills, training and experience to determine which limited tests he/she needed to establish a proper diagnosis. Again, this was paid for by the patient out of pocket, but NOT at an exorbitant cost. If it had been too expensive, doctors would have gone out of business because most people could not have afforded to pay their bills.

Today, that same doctor no longer relies on his/her training, but instead on a battery of unnecessary tests, scans, etc. to arrive at that same diagnosis. This, all at major expense not to the patient, but to the patient's insurance company. Why? On the off chance that the patient has a condition that is found in less than 1 - 5% of all patients, the doctors must literally rule out practically every known medical condition that might possibly be producing the patient's symptoms. And we all know why? The public used to understand and appreciate that (1) doctors are human and (2) treatment of the human body comes with no guarantees. A poor treatment outcome is NOT, in and of itself, a situation of medical malpractice. Yet today, patients with unfavorable outcomes often assume the doctor did something wrong. Or, even if they don't believe this to be true, they see it as a potential lottery ticket. They know that medical malpractice insurance companies will often settle out of court to avoid the time and expense associated with a trial. Yes, doctors make mistakes and doctors SHOULD be held accountable for poor treatment (as determined by their medical peers who set the standards for medical care). But malpractice lawsuits are OUT OF CONTROL and this most certainly drives up the total cost of medical care. In many instances, hospitals pay for their doctors' malpractice insurance and those costs are passed on to ALL of us via increased insurance premiums.

Now, back to the discussion of cost and how we got here. In 1965, the federal government stuck its inefficient and frequently corrupt nose into health care. It established Medicare for people aged 65 and older as a means of providing health insurance coverage to senior citizens. It simultaneously established Medicaid for low-income families and people with certain disabilities. I sincerely believe that the inflationary spiral in health care costs that we are experiencing today is directly correlated to these entitlement programs. Why?

The primary explanation is that Medicare and Medicaid essentially removed the doctor and the patient from cost-consciousness. If you and I win a gift card that allows us to spend as much as we want for a night out at Commander's Palace (for those of you NOT from New Orleans, it's one of our more fine --- and expensive -- dining establishments), we will probably order a great bottle of wine, appetizers, entree's, desserts, and perhaps an after-dinner liquor. If, however, the evening is on our own nickel, our wine selection might be a little less ambitious, we might skip the appetizers, and after-dinner drinks are probably out as well. In fact, we might not even go to Commander's Palace in the first place. Do you follow where I am going? Thanks to government's intrusion into health care WITH SEEMINGLY GOOD INTENTIONS, the unintended consequences have placed us in this untenable situation TODAY. The government, doctors and patients view it as "FREE MONEY" and the uninhibited spending habits learned from within the Medicare/Medicaid system gradually filtered into the private health insurance industry as consumers (patients) came to expect to have no additional out-of-pocket expenses for their health care.

And how ANYONE within earshot of this e-mail can place ANY confidence in government's ability to restrain spending and bend the cost curve downward over time is absolutely incomprehensible to me. You may twist the interpretation, but HISTORY DOESN'T LIE.

Medicare currently has just over $89 trillion in unfunded liabilities. An unfunded liability is the difference between the benefits that have been promised to current and future recipients versus what will be collected in dedicated taxes and Medicare premiums. If no other reform is enacted, this funding gap can only be closed in future years by substantial tax increases, large benefit cuts or both. In 1965, the government projected that Medicare expenses through 1990 would be $9 billion. Guess what?? Actual costs ended up being $67 billion !!! In 2003, the 10-year estimate for Medicare's drug benefit was $409 billion. Guess what?? Within just 3 years, it was re-calculcated at $1.2 trillion. The current estimate is that the President's health care reform plan will cost $800 billion to $1 trillion over 10 years. What do you think it will actually cost? And who do you think will end up paying for it?

Before Medicare was enacted, people understood that it was THEIR responsibility to plan and budget for basic health care and catastrophic health insurance, especially as they got older. But because government had not yet stuck its nose into the health care industry, basic health care costs and catastrophic insurance WERE ACTUALLY AFFORDABLE and would not break the budgets of people without active income.

Prior to government intrusion, the health care system worked fine. Patients had many choices amongst different types of doctors and they could find doctors they liked no matter what their budgets. Care was affordable. In the years following government intrusion, costs have gotten out of control, patients have less confidence in their doctors, lawsuits are out of control and medical costs are becoming unaffordable for the average person.

As a consequence, the government and, for that matter, the entire country is engaged in a bitter debate on how to "fix" the system the government screwed up in the first place. Our "leaders" believe that solutions include "cost-effective comparisons", government mandates, a government-run (public) option and various and sundry other GOVERNMENT solutions. Are we out of our minds?

And, for just a moment, let's ignore the cost aspect. When has ANY GOVERNMENT entity successfully run an entitlement program? Again, HISTORY DOESN'T LIE. In the United Kingdom, which has universal health care, there are an estimated 750,000 people on hospital waiting lists. And we've all heard about the horror stories of waiting to see a specialist in Canada.

Our government "leaders" try to use all the key words and phrases to make this all sound so reasonable, ethical and logical, i.e. "quality, affordable health care for all Americans." Who amongst you believes this will be the true end result? How can you possibly have such confidence when nothing in our country's history (or any country for that matter) demonstrates this will be the case in the future?

We MUST gradually phase government OUT of the health care industry and, yes, that means ending Medicare at some point in the future. The immediate gut-check response from some of you will be terror at the thought of losing your Medicare. But please remember that I said a gradual phase-out. Future generations must know, in advance, that the government will not be the primary provider of their health care funding.

But here's what you might be missing from my discussion. The reason surgeries and hospitalizations cost so much now is BECAUSE of government intrusion. With government out of the way, medical care would be as affordable as it was BEFORE. There wouldn't be many $20,000 surgeries because few people could afford them. Basic health services would be affordable and catastrophic private insurance would also be affordable. This notion that ONLY GOVERNMENT is able to take care of the elderly, the poor and the needy is PREPOSTEROUS. Get OUT of that mindset. That's what they want you to believe. Don't be a puppet.

And finally, this debate is about health care, but it is really more than just that. At its core is the debate of how much government is too much government. I, for one, have every bit of confidence in government's ability to bankrupt this system. If we do not put a stop to President Obama's plan, we are certain to face a future of increasing costs, an unparalleled appetite for "free" medical care due to the absence of cost-consciousness, an absolutely essential cost-controlling effort by government to ration care, government beauracrats telling our doctors how to practice medicine, an immense burn-out rate amongst those in the health care fields and a gradual deterioration in our overall satisfaction with the quality of medical care in America.

I believe the majority of Americans who are bothering to pay attention realize this. Hence, the current polls and the outpouring of emotion at town hall meeetings throughout the country over the summer. Now is NOT the time to get complacent. Continue to call your representatives until your fingers are exhausted and/or your voice is cracking. Tell your representatives to START OVER and make sensible decisions that REMOVE government intrusion and reward a free market system. And when the playing field is, once and for all, fair, America will figure a way (as it always does) to take care of those who are genuinely unable to take care of themselves. The outcome of this debate will shape the future of this country for generations to come. Make no mistake about it.

Best regards to all, Glenn Dubroc, Jr.

At http://www.ardocscare.com/ health care providers are asked to complete a survey that questions their thoughts on the current bills presented for healthcare reform. The results, I think say enough.