The Issues

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Stories of Canadian Health Care from Canadian Doctors... free health care or rationed health care?

Americans should be in control of their medical decisions, not government and third party payers who will ration care for politics and profit. The government is about to creating rationing and cookbook medicine protocols to save money for themselves and to increase corporate profits. Patients will be last and their doctors will be forced to comply or driven out of business.

Government should reserve public finding of health care for poor and provide tax breaks to all for private health care. The Government and private charities can provide a sound and effective public safety net. Only about 5% of Americans need that kind of help. A “public option” will increase the burden on taxpayers by about 100 million people. Medicare is already bankrupt with 42 million people and $86 trillion in debt that has no funding. The government should not mandate that Americans buy high priced, low value health insurance enforced by a tax penalty.

Patients should decide how much to pay for routine annual medical care and reserve health insurance for rare catastrophic events. When patients are financially empowered they can drive down costs and they can demand the time they deserve with their doctors to find out if tests, procedures and medications they are prescribed are really needed. When regulations are released or ended on health insurance and tax policy, health insurance will be affordable. Health Savings accounts should be expanded (tax free) and catastrophic accident and sickness insurance should be purchased for the few times in your life when needed by a patient. The government is not the solution and neither are insurance companies. People are the solution. 300 million payers are more effective at driving down costs than a handful.

Some Facts…

Medical Inflation is Caused by Control of Health Care dollars by Big Government and Big Insurance Corporations. Medical Costs are out of control due to payment of medical services by third party payers - parties that are outside of the patient physician relationship. Only by paying directly for routine annual medical care can Americans drive down the costs of health care. When Consumers tell doctors and hospitals to justify the need for every test, treatment and procedure – and their costs – medical costs will drop. When Patients rarely have severe sickness and accidents, they can be 100% covered by low cost, high deductible catastrophic health insurance. Also, citizens are forbidden from buying lower cost, but just as valuable, health insurance from other states. This drives insurance costs up and must be stopped. States should also refrain from mandating unneeded benefits like acupuncture, chiropractic care and hair prostheses into insurance plans as this drives up costs and make consumers buy coverage for things they do not want.

The Government is Making Health Care Coverage Promises it Can’t keep. The Government can’t afford the Medicare, Medicaid or SCHIP programs but is asking the taxpayers and their children (through debt) to pay for health care for tens of millions of more Americans. Medicare is effectively Bankrupt as there are not enough funds from Medicare taxes to cover costs. Since 2007, Medicare has required funds from general taxes to cover costs. Medicare would require $84 trillion to covered all American lives now to be covered in the future. This debt has nothing backing other than paper IOU’s in a filing cabinet in West Virginia. Americans will have to borrow from China to pay for their health care and leave their children, grandchildren and great-grandchildren with crushing debt. Against all Reason, Congress seeks to add substantially to this debt possibly through a “public option” to purchase health insurance which has bee estimated to drive about 120 million Americans from private health insurance to the government rolls. There is a better way.

Myths and propaganda are being used to justify the wrong kind of health system reform while real problems and real solutions are ignored. Of the “46 million uninsured Americans” claimed, 9.7 million are not even Americans. 16 million can afford health insurance but choose not to buy it while only about 8 million are chronically uninsured. Medical costs account for only about 5% of bankruptcies. Americans receive the best medical care in the world and claims of “1/2 the proper care” are based in pseudoscience and false definitions of quality. All Americans are guaranteed medical care if they go to an Emergency room regardless of ability to pay. Insured patients are far more likely to use an emergency room than uninsured. Myths and propaganda are designed to create a “crisis” mentality to give politicians and big corporations an excuse to take more power to themselves.

Rationing is the only way to control costs if third parties control all of health care financing. As more money for medical care is placed in the hands of government and big insurance companies, they will resort to rationing. Big Corporations are likely to gain near monopoly power and will have little competition to incentivize them to have only a fair profit. They will have big government on their side to keep competitors down and hand them more power over medical care. In the end, rationing will be used to generate profit levels that can’t be achieved in a truly competitive market. The Government will ration because they won’t be able to afford all the medical care that is demanded. This will occur through hard rationing created by the Federal Council on Comparative Effectiveness who will determine what treatments are justified based on cost. Soft rationing will occur as people die waiting for treatments that save and extend life.

Universal Coverage by health insurance is neither achievable nor necessary while Universal Access to medical care is. There is no need for every American to own health insurance. Efforts have failed many times in this country, most recently in Massachusetts where 3% of its citizens remain uninsured despite a mandate for all to buy health insurance. Proponents admit that they use the goal of “Universal Coverage” to justify expansion of government and corporate control of medical care and worry how to pay for it later. Far more important is the ability to see a physician or receive care in a hospital when needed. Many patients with “Coverage” (e.g. Medicaid) can’t access medical care because the plans don’t pay fair market value for the services sought. They thus wait to see specialists in remote cities and over-utilize the ER for basic medical care. When patients are economically secure and in control of their own health care financing, they are far more likely to be able to access medical care when they need it.

An Individual mandate to buy health insurance is a slippery slope to socialized medicine and leads to many unintended consequences. The state of Massachusetts has mandated all of its citizens to buy health insurance and applies a tax penalty to those who don’t. This has been accompanied by vastly prolonged waits to see a primary care doctors since the “low cost” plans created by government for coverage don’t pay for the cost of services. Public hospitals who see indigent patients are in severe financial trouble. The State is creating cookbook medicine and rationing protocols to control costs. They are requiring bailout money from Washington D.C. and placing increasing burdens on taxpayers to make end meet. This system is likely to be proposed by Congress this summer and can’t be allowed to pass.

Doctors will be forced to comply with government rationing protocols through use of cookbook medicine and electronic medical record systems. The government and insurance companies want to tell your doctor what medical care to provide and what care not to provide to patients. They are creating “best practice” and “pay for performance” protocols that don’t help patients. They are then creating “report cards” to grade how well doctors comply with the cookbook. They seek to financially penalize doctors who don’t comply with the protocols. To get good grades, for these cookbook protocols doctors and hospitals have been shown avoid sicker and riskier patients, “game” the system, and use the cookbook protocols for the wrong patients as they case a wide net. The poor and minorities are harmed even more strongly by these approaches. Doctors and nurses must take valuable time away from patients to enter data into computers for the third parties to create the grades. Pop-up computer windows will slow doctors down as they are programmed to force a doctor to follow the cookbook. These expensive Electronic medical record systems drain money from actual patient care and are security risks for private patient information.

Medical Care will only get better under a free market system. The many miraculous advances in medicine over the last century have arisen because they were motivated by seeking an honest profit for their creation. While scientific work and altruism motivated many initial discoveries, companies seeking to grow their businesses brought us things like: Miracle drugs, advanced medical imaging, spinal implants and joint replacement hardware, brain and heart pacemakers, cancer drugs and radiation treatment. More innovations in genetics, medications, surgery and early diagnosis can be ours if we let the free market engine of the American economy work its same magic. Under current proposals, government seeks to remove the profit motive for medical care and insurance companies seek to provide only basic medical care as they collect premiums and deny care. This will cause the science and technology of medicine to “Stall” at the year 2010. Furthermore, when patients privately contract with their doctor for medical care, they can force prices down and force doctors to spend more time with them. This will drive down costs, increase quality and patient satisfaction. Also, doctors and business should be granted the freedom to open up focused and lower cost medical facilities that patients want and “certificate of need” laws should change as they grant hospitals protection from competition that can drive down costs and increase variety and quality of services.

Government and private charities have the capacity to take care of the poor. What about the poor? There will always be those with lower incomes that need help to receive needed medical care. Americans are generous and – if freed from crushing tax and debt – will fund charity care which was common prior to the creation of Medicare. The government should also help pay for those of lower incomes directly and help others with government reinsurance of insurance plans for high risk patients.

The tax code needs to be changed to grant Medical financial power to Americans, not to force Americans to act against their interests or grow the size of government. Tax treatment of medical costs are a relic of World War II when the government fixed how much workers could make on the job. To retain workers, corporations were allowed tax breaks if they provided health insurance. However, since that time individuals have been forbidden from getting the same tax break for insurance if they bought insurance outside of work. This has caused insurance companies to sell insurance to employers –not directly to consumers. The tax code should be changed to ensure every American gets a tax credit for indivudal and family health insurance converage. Lower income Americans can have a more generous credit as a voucher to purchase health insurance. Tax benefits of Health Savings Accounts and high deductible health insurance should be protected and expanded.