AN UNINSURED U.S. DOCTOR COMMENTS

Before I get into more details, remember that health "insurance" is not the same as actually getting medical needs met. Having health insurance is often very different from actually getting medical problems evaluated and treated quickly and appropriately.

Centralized or socialized health services always seem to end up delaying medical care for serious conditions or expensive treatment, such as cancer and joint replacements. The Soviet Union, England, Canada, and many other countries cause much suffering because the supposedly guaranteed rights to medical services were often not fulfilled in time.

Some of our uninsured brethren don't pay their bills for hospital emergency room services, forcing hospitals and doctors to make up the difference by overcharging those who can pay, such as people with insurance or uninsured people with money.

John R. Graham of the Pacific Research Institute based in San Francisco recently published "The Uninsured Versus The Insured: Who Subsidizes Whom?" (Go here.) He writes, "To back up this notion, Families USA, a self-styled consumer advocacy group, estimates that the uninsured used about $29 billion worth of health services in 2005 that the privately insured paid for through higher premiums." But there's more to the story.

Graham calculates that "the uninsured likely pay at least $150 billion extra in federal income taxes alone, by forgoing the tax savings associated with private health insurance." These dollars - five times the purported hidden tax - "dwarf the hidden tax of uninsurance." In terms of taxes paid, we uninsured are actually subsidizing the insured rather than the other way around. The insured are the ones getting the income tax break, not us uninsureds.

Graham claims there is indeed a real hidden tax, "but it is levied by the insured on their fellow insured. Because of bad incentives, insured Americans use health services twice as much, per person, as the uninsured."

Some politicians want to force us uninsured to get some kind of insurance so that they can claim that they have solved our "problem" of not having (or not wanting) health insurance. Graham notes, "political success in health policy now consists, basically, of ordering the uninsured to become insured."

We doubt that any such mandate will be any more effective than the laws in 47 states that require drivers to buy liability auto insurance. As Greg Scandlen, president of Consumers for Health Care Choices based in Hagerstown, Md., reports in the Baltimore Sun, "the notion that a legislature can wave a magic wand and change everyone's behavior is naive at best."

Although my own Washington state requires automobile owners and drivers to have auto liability insurance, about 18 percent of motorists do not. Even though health insurance isn't mandated, 16 percent of the Washington population has coverage, according to Scandlen. And speaking of mandates, most states have laws to force insurance companies to include pet coverages in health insurance policies. Although politicians often try to claim these mandates "protect the public" or are "good for you" mandates invariably reflect the medical and financial interests of pressure groups. If mandates did protect the public at the expense of special interest groups, those groups would campaign against them. Special interest groups, such as general medical or limited practitioners, back proposed mandates, not the other way around, to enhance their own power, income or both.

I am uninsured because health insurance is unhealthy for me. After diligently studying and promoting medical savings account (MSA) plans 10 years ago, I bought a policy from Anthem Health of New Jersey to cover my college-age son and me. To make the long story short, the insurance proposal of dozens of pages had a $2,000 individual deductible; but the 100-page insurance policy actually issued had a $4,000 deductible, causing a great deal of correspondence and dismay when medical services were actually used. I canceled that policy early in 1998.

I've been living uninsured and more happily ever since, until the Social Security bureaucrats foisted Medicare Part A on me. I could swear off Medicare Part A but the ever-so-wise Social Security Administration would then stop sending Social Security checks. I am currently "covered" for hospital services by Medicare Part A. I have sworn off Medicare Part B and D. (Don't ask me what Part C is.)

Health insurance can be a valuable financial planning tool. But insurance itself is not the goal; the goal is appropriate, timely and efficient care of medical needs, as judged by real patients and their families, not politicians or medical insurance bureaucrats.

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Update:

A reader writes:

"In reference to the statement: "Although my own Washington state requires automobile owners and drivers to have auto liability insurance, about 18 percent of motorists do not. Even though health insurance isn't mandated, 16 percent of the Washington population has coverage, according to Scandlen."

I think he meant to write that 16 percent of Washington residents DO NOT have health coverage. According to Scandlen (source: Consumer Power Report # 70 -- February 22, 2007): "In Washington state 18% of drivers are uninsured, while only 16% of the entire population under age 65 are without health insurance coverage.""




Another suspicious hospital death

The Queensland meltdown continues

Queensland Health is about to become embroiled in another medical controversy. The details surrounding the death of Deborah Burgen, 49, will be heard in a coronial inquest today. The Mount Isa hearing is the first significant coronial inquest since Queensland Health was embarrassed by the Davies commission of inquiry in 2005. Paramedics took Ms Burgen to hospital, but she died from surgical complications on February 28, 2005. She was operated on for a twisted bowel.

Ms Burgen's family told The Courier-Mail that: "She was a person who lived for her family. "We feel absolutely robbed, robbed of everything." Unlike the furore embroiling Dr Jayant Patel - who is wanted on several counts of manslaughter, grievous bodily harm and fraud - more than one doctor was assigned to treat Ms Burgen. At least five doctors looked after Ms Burgen over two weeks. One of the doctors who treated Ms Burgen was overseas trained and will give his evidence via video link in India.

Dell Burgen said her sister loved her family and "spoiled them rotten". "She had so much to live for," she said. "She loved to laugh. She would throw her head back and let out a big roar."

State Coroner Michael Barnes, who will hear the case, said the purpose of an inquest was to put on the public record the facts and circumstances surrounding deaths. "It has to consider any changes to policy or practices that could reduce other deaths happening in the future," Mr Barnes said. "The material produced from the inquest can be referred to prosecution authorities of disciplinary bodies for failing to take action."

In yet more embarrassing news for the department, southeast Queensland public hospitals yesterday ran out of psychiatric beds, forcing mentally ill patients, some suicidal, to wait for hours in crowded emergency departments. Australian Medical Association Queensland president Zelle Hodge said hospital psychiatric staff were "almost at the end of their tether" with the huge demand. "The psychiatrists are telling us that they have to work out which are the least sick patients in hospital that they can move out," Dr Hodge said. "People are being discharged not on the grounds that this is an appropriate time for them to go but because they're the person who probably needs the bed least."

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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