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Medical costs, along with medical insurance premiums, are out of control in this country! Why is this, and who’s to blame?
Why is it that when I have a 10 o’clock appointment with my doctor, I end up sitting in the waiting room for 30 minutes. Next, I wait on the butcher paper in a smaller waiting room on an uncomfortable table for another 15 minutes. Finally, the opportunity comes to see the doctor who barely has five minutes to spend before rushing out the door.
My bill ends up only being $25 dollars because that’s what the copay is on my health insurance. I go to the pharmacy to get my prescription filled and it costs me $10 for a pharmacy copay
This is exactly what is wrong with our health system – in this and many other countries. With any other transaction, if the professional was 45 minutes late for our appointment I would have left never to return again. However, with our medical system there seems to be no penalty for failing to provide top level service.
Let’s look at the problem a little further and how we can fix it…
The Present Situation
The consumer has no direct decision-making in most medical transactions. In other words, if your doctor prescribes a drug that costs $10 or $250, you don’t care because your co-pay is $10 at the pharmacy regardless.
What if you were forced to pay that $250? Would you look to see if there was an alternative medication that was just as effective for a lower cost? Of course you would!
When you visit your doctor, do you know how much he or she actually charges for a routine office visit? I’m willing to bet you don’t! That’s because your only obligation is a $25 copay, and that’s it.
The Bigger Picture
The reason our economy works so well is that our free market system adjusts for inefficiencies.
For example, if Suzy makes bagels and charges $5 per bagel she won’t be in business very long. Why? Because Tom knows he can make those same bagels and make a profit by charging only $2 per bagel.
These built-in checks and balances to our free market system help to ensure that businesses operate efficiently, otherwise someone else will step in and offer the same product at a lower price.
So why then do medical costs keep soaring year after year? The answer is that we, as consumers, do not have enough participation in the decision-making process of which doctor, procedure, or medicine we use.
We are simply told, and so we do. Copays are largely to blame for this disconnect between the consumer and the decision-making process. We have become disengaged from our medical purchasing decisions.
Another problem with our medical care is that most people are dependent on their job to provide access to medical insurance.
This means that if you change jobs after 15 years and have a medical condition, you may not be able to qualify for your own health coverage. You may be forced to greet folks at Walmart in order to have access to a group health plan.
Many people cannot get health coverage because of pre-existing conditions.
We do away with health insurance as an employee benefit. Your employer can pay you a higher wage equivalent to the cost they were subsidizing on your work health plan.
Individuals can now use this increase in wage, along with some of their own money, to purchase their own private health care policy.
Moving forward, we make it mandatory that from age 21 to age 28 companies must accept applicants regardless of their health status. Education in both high school and college then informs people of the changes that have been made.
New health plans that are offered do not contain co-pays but rather deductibles, which the individual is required to meet before any coverage kicks in.
This may sound very benign but let’s look at what effect it would have with these simple changes.
No matter where you work, at a Fortune 500 company, or your own cleaning business, you will have access to health coverage!
If you choose to be irresponsible and not take coverage during the open enrollment period of ages 21-28, then it is YOUR FAULT if you don’t have it.
By eliminating co-pays everyone is impacted by the medical care decisions they make. We are forced to become engaged consumers in our medical care choices and decisions.
Can you imagine a health care system where everyone is given an opportunity to participate regardless of their occupation?
Also, this system would operate more efficiently and health care costs would be lower because the efficiency of the free market would correct price gouging by the medical community as consumers become engaged.
I realize there are some flaws here. What do you do with people who are over the age of 28 presently? We would have to create a solution for that.
Also, some type of tort reform would have to take place in order to limit the cost of malpractice insurance. However, doctors must still be held accountable for their actions to ensure proper care.
We must have a solution to our health care problem. We need to take care of those who can’t care for themselves. And, at the same time, we need to force those who can to stop milking the system.
The government and “universal health care” is NOT the answer! This would only disengage the consumer more, cause prices to rise, and give doctors no incentives to improve the quality and efficiency of their care.
Become an informed voter! Don’t vote based on rhetoric. Demand real solutions to the real problems facing our country!
I’m a Financial Consultant and Personal Financial Representative with experience in financial analysis, strategic planning, presenting, & financial advisory services.