by Ted Noel, MD
The very idea that having health insurance is what allows you to have health care is simply wrong.
There are times when I want to scream at the radio. One commentator or another has just declared that, according to the CBO, 22-million people will lose their health care. In response, the senior Democrat in DC declared that “hundreds of thousands” will die. It's a lie. Fake news. Made-up hoax. Dezinformatsiya. Pick your favorite term.
The very idea that having health insurance is what allows you to have health care is simply wrong. Our first step has to be EMTALA. This alphabet soup statute makes it illegal for any hospital to put "Do you have insurance?" between you and medical care for an emergency. That means that every hospital in the country will fix what's wrong with you. Afterward they may try to get their pound of flesh back, but there are a host of programs, including the American Health Care Act-protected "Pre-existing Conditions" provision that will take care of things. Notice I did not say the "Obamacare" provision.
Now that we've debunked the first big lie, let's consider the purpose of insurance. When Blue Cross was invented by doctors and hospitals, it was a way to make sure that they got paid. If they could convert some charity work into profit, what was not to like? It wasn't about making sure that people could get care. It was about their wallets.
Then, during World War II, insurance became an untaxed fringe benefit to get around wage and price controls. It looked cheap to employees, so why not? But something changed. As doctors and hospitals lost control of insurance companies, the companies figured out ways to entice more people to buy their products. And Obamacare made it the law that lots of people have to buy it. You had to put your hard-earned coin into the pocket of the big insurance company. The federal government used the law to hand their rich friends a big subsidy. That's why the insurance companies supported Obamacare in the first place.
Now this house of cards is falling down. So what is the new argument?
In 1971-82 the Rand Corporation did a large study to look at the health benefits of health insurance. They didn't find any health benefits. Then in 2006 Dave and Kaestner looked at people moving from no insurance to Medicare at age 65. They didn't find any health benefits to being on Medicare. But they did find an increase in risky behaviors like smoking and overeating leading to obesity.
The real gold mine is the Oregon Health Insurance Experiment. In 2008, Oregon had enough money to add a number of people to their Medicaid program. Because they couldn't add everyone, they drew names by lottery to pick who could participate. And being really smart, they realized that this was a perfect randomized clinical trial. So they hired statisticians and got busy.
By now, you can guess the outcome. And you'd be right. There was no health benefit to having Medicaid versus no insurance at all. And it wasn't because Oregon paid doctors badly. They paid significantly better than the national average. The only "health" benefit they were able to find was a reduction in depression.
There was one significant benefit, but it wasn't medical. It was in personal finances. There was a reduction in financial stress, primarily due to coverage for catastrophic illnesses. The risk of bankruptcy was gone. Note that this wasn't a benefit from preventive care or wellness therapy. It was a roof that prevented disaster when the sky fell. Nothing else mattered.
What about costs? Patients who had Medicaid overused medical resources without any health benefit. Their costs were 40% higher than people without insurance at all, and there was still no improvement in health. Put bluntly, health insurance, as we think of it now, is worse than worthless. If it were a new drug being presented to the FDA for approval, it would be rejected out of hand because it does no good and costs more. The only good form of insurance is catastrophic-only coverage, which is cheap because it only covers the rare disaster.
Will anyone die after Obamacare dies? Yes, but it won't be because Obamacare went away. It will be because everyone ultimately dies. Obamacare didn't provide health care to anyone. It provided a large subsidy to insurance companies and regulators. That subsidy was taken from every taxpayer's pocket and given to rich people who did nothing to earn it.
The Law of Subsidy states that "When you subsidize something, you get more of it and it gets more expensive." Obamacare is the logical result of the Law of Subsidy. Unlike a statute, you can't repeal the Law of Subsidy. And the recipients of the subsidy will lie, cheat, and steal to keep you from taking it away from them. But it must be eliminated. We may not achieve this in one fell swoop, but we have to work toward a true free market in medicine. That ultimately means no government mandates and no tax benefit for buying "health insurance."
If we re-create a free market in medicine, we'll see more inexpensive surgery centers like the Surgery Center of Oklahoma. Nearly unlimited family care will be as little as $50 a month for adults and $10 for kids, with medicines at cheap wholesale prices. And that's just the beginning.
It's time to shout from the rooftops that "insurance" does not equal "health care." Insurance as we know it is not a good thing, and the sooner all those first dollar "benefits" disappear, the better. They are only benefits to the insurance company. We'll have money to spend on real care that will be far less expensive than at present.
We may not be able to repeal the Law of Subsidy, but that doesn't mean we have to ignore it and continue to sell our souls to the unholy alliance of big insurance companies and big government.
The very idea that having health insurance is what allows you to have health care is simply wrong. Our first step has to be EMTALA. This alphabet soup statute makes it illegal for any hospital to put "Do you have insurance?" between you and medical care for an emergency. That means that every hospital in the country will fix what's wrong with you. Afterward they may try to get their pound of flesh back, but there are a host of programs, including the American Health Care Act-protected "Pre-existing Conditions" provision that will take care of things. Notice I did not say the "Obamacare" provision.
Now that we've debunked the first big lie, let's consider the purpose of insurance. When Blue Cross was invented by doctors and hospitals, it was a way to make sure that they got paid. If they could convert some charity work into profit, what was not to like? It wasn't about making sure that people could get care. It was about their wallets.
Then, during World War II, insurance became an untaxed fringe benefit to get around wage and price controls. It looked cheap to employees, so why not? But something changed. As doctors and hospitals lost control of insurance companies, the companies figured out ways to entice more people to buy their products. And Obamacare made it the law that lots of people have to buy it. You had to put your hard-earned coin into the pocket of the big insurance company. The federal government used the law to hand their rich friends a big subsidy. That's why the insurance companies supported Obamacare in the first place.
Now this house of cards is falling down. So what is the new argument?
"22 million people will lose health care!"The real goal is to preserve the subsidy for insurance companies so they can make campaign contributions to their friends inside the Beltway. It doesn't have anything whatsoever to do with your health. How do we know that? I'm glad you asked.
In 1971-82 the Rand Corporation did a large study to look at the health benefits of health insurance. They didn't find any health benefits. Then in 2006 Dave and Kaestner looked at people moving from no insurance to Medicare at age 65. They didn't find any health benefits to being on Medicare. But they did find an increase in risky behaviors like smoking and overeating leading to obesity.
The real gold mine is the Oregon Health Insurance Experiment. In 2008, Oregon had enough money to add a number of people to their Medicaid program. Because they couldn't add everyone, they drew names by lottery to pick who could participate. And being really smart, they realized that this was a perfect randomized clinical trial. So they hired statisticians and got busy.
By now, you can guess the outcome. And you'd be right. There was no health benefit to having Medicaid versus no insurance at all. And it wasn't because Oregon paid doctors badly. They paid significantly better than the national average. The only "health" benefit they were able to find was a reduction in depression.
There was one significant benefit, but it wasn't medical. It was in personal finances. There was a reduction in financial stress, primarily due to coverage for catastrophic illnesses. The risk of bankruptcy was gone. Note that this wasn't a benefit from preventive care or wellness therapy. It was a roof that prevented disaster when the sky fell. Nothing else mattered.
What about costs? Patients who had Medicaid overused medical resources without any health benefit. Their costs were 40% higher than people without insurance at all, and there was still no improvement in health. Put bluntly, health insurance, as we think of it now, is worse than worthless. If it were a new drug being presented to the FDA for approval, it would be rejected out of hand because it does no good and costs more. The only good form of insurance is catastrophic-only coverage, which is cheap because it only covers the rare disaster.
Will anyone die after Obamacare dies? Yes, but it won't be because Obamacare went away. It will be because everyone ultimately dies. Obamacare didn't provide health care to anyone. It provided a large subsidy to insurance companies and regulators. That subsidy was taken from every taxpayer's pocket and given to rich people who did nothing to earn it.
The Law of Subsidy states that "When you subsidize something, you get more of it and it gets more expensive." Obamacare is the logical result of the Law of Subsidy. Unlike a statute, you can't repeal the Law of Subsidy. And the recipients of the subsidy will lie, cheat, and steal to keep you from taking it away from them. But it must be eliminated. We may not achieve this in one fell swoop, but we have to work toward a true free market in medicine. That ultimately means no government mandates and no tax benefit for buying "health insurance."
If we re-create a free market in medicine, we'll see more inexpensive surgery centers like the Surgery Center of Oklahoma. Nearly unlimited family care will be as little as $50 a month for adults and $10 for kids, with medicines at cheap wholesale prices. And that's just the beginning.
It's time to shout from the rooftops that "insurance" does not equal "health care." Insurance as we know it is not a good thing, and the sooner all those first dollar "benefits" disappear, the better. They are only benefits to the insurance company. We'll have money to spend on real care that will be far less expensive than at present.
We may not be able to repeal the Law of Subsidy, but that doesn't mean we have to ignore it and continue to sell our souls to the unholy alliance of big insurance companies and big government.
Ted Noel, MD
Source: http://www.americanthinker.com/articles/2017/06/democrats_are_insulting_the_public_with_dire_claims_of_deaths_from_obamacare_repeal.html
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1 comment:
Good article, well written, but it ignores the issues of basic medical pricing. Insurance companies negotiate prescription and hospital and Dr. pricing to keep it from ballooning in the hands of avaricious accountants or marketing staff. I had a major procedure done that was billed at $260K to me, but settled by my insurance Co. for only $29K. This is why insurance is needed---
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