I would like to start with a personal story..

In 2010 I went to a skating rink.  It was a friend of mine’s birthday and she wanted to have a nostalgic-type birthday and wear a leotard and a sweat band and skate in a circle to new wave.  It sounded like fun but it only took me a few laps before I fell on my left ankle.  It looked like this:

Broken ankle from roller skaingI spent the night in the ER.  About 8 hours.  They had to realign some of the bones which they gave me powerful drugs in advance for.  Cast, Xrays, it was an ordeal.  My bill for just the ER was around $7,000, but since I was uninsured at the time they automatically dropped the charges down to a realistic $1,300.  There were doctor fees and x-ray lab fees but everyone dropped the prices since there was no insurance company to bleed.  I could have carried insurance at the time, I was employed, but the coverage wasn’t particularly great and I could have saved about $1,000 over a year which I wanted to apply towards our wedding.

It is traggic, I know.  We got married and had a wonderful wedding about about a year and a half later I find myself back in the ER again, in a hospital within the same system.  It was much less severe this time, I had dropped a heavy object on my big toe and blood was pooling under the toenail.  It was painful and I sought ER treatment where in about 20 minutes a doctor came in, punched a hole in the nail, squeezed out the pooling blood, put a band-aid on it and gave me a script for some ibuprofen and sent me on my way.  The charges, again, $1,300.  But this time I have health insurance.  However, this time since I had not met my $3,000 deductible, the hospital would not negotiate charges with me.  I was being penalized for having health insurance.  I pay approximately $2,000 per year for my insurance.

Now having insurance would have helped when I originally broke my ankle.  I needed reconstructive surgery that placed 11 screws and 2 plates in my ankle, costing $27,000 or $12,000 to the uninsured.  This is where I start to have a problem with how this whole system works.  My friend in the medical field explained how this works to me.

Let’s say you go into the doctor for some small procedure that costs the doctor’s office $50 to perform.  Well this procedure has a name and every insurance company has a book where this procedure is written down with the maximum amount they are willing to pay on it.  One company will pay $150, where another won’t pay more than $110.  The doctor’s knows this so they shoot high and send out a bill for $200.  The insurance company says well we are only going to pay less than that, and the doctor’s office writes off the remainder.  The problem here is that if you have a large deductible, your insurance company isn’t going to bargain for you, and the doctor’s office won’t negotiate either.

The whole system is broken, and the government would have you believe that they are trying to reform healthcare.  They aren’t doing that though, they are expanding coverage by subsidizing people that can’t really afford insurance, but the costs stay the same.  Or it seems quite possible that it will instead go up, depending on which news source you believe.  Nothing is being done to correct the cost of health care to fix it to where people pay what it actually costs.

What most people are under the delusion though is that it will mean free healthcare.  They think we will be like Canada or the UK where health services are a free service provided by the government.  I don’t think many understand that they will be required to purchase health insurance.  Perhaps it is possible that the lowest of earners, or those that don’t work at all, will be fully subsidized.  If you don’t buy, then the government will fine you and take money out of your tax return.  If you don’t pay taxes, well you certainly might find yourself benefiting the most from a health system that does not turn away a patient because they cannot pay for the services.

I see a missed opportunity during the beginning of this to where the cost of healthcare could have been corrected.  Insurance is a profitable business, and they didn’t make billions of dollars by making it more affordable to those that pay for it and covering the costs of those that need help from it.  If you are in the 20% that need it, then it is good for you, but for the other 80%, it is a tax.  You would only have to look at something like the public school system to see how poorly the government can operate.

The government shutdown is merely political theater.  Whether Democrats cave and meet the compromises of the Republicans or the Republicans retreat and look like fools in doing so, very little will be accomplished no matter the outcome.  I don’t trust either, and have confidence in neither.  As comedian Lewis Black put it, one says, “I have a shitty idea!”, to which the other replies “and I know how to make it even shittier!”

Broken ankle from roller skaing

~ by matttschwartz on October 9, 2013.

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