4 comments

1. Mark Sweeney Says:
   

   February 7th, 2008 at 5:44 pm

   I am a free-market advocate, but I also believe in “truth in advertising”. There are rather disturbing threads that are common to some of the Op-Ed pieces, including yours. Perhaps you could clarify your position on this comment in regard to the ‘crisis of the uninsured’:

   “Moreover, millions of people who are unwilling to pay for their own medical care have figured out that it’s free-for-the-taking at any hospital emergency room.”

   This is amazingly similar to the comment by David Hogberg (I’m not asking you to defend his comments – just using this as another example of the ‘thread’):

   “Furthermore, everyone in the U.S. can get care regardless of income. In 1986 the U.S. Congress passed the Emergency Medical Treatment and Active Labor Act. This requires emergency rooms to treat any person who shows up seeking medical treatment, regardless of their ability to pay.”

   So I am left to wonder whether your lack of concern for the size of the uninsured is due to the enormous cost-shifting that occurs when uninsured individuals show up in emergency rooms, often with symptoms that could have been treated at vastly lower cost in out-patient settings.

   You really don’t believe that for-profit hospitals will willingly eat those costs, do you?

   Also, do you think cost-shifting is a solution to the problem of uninsured workers and their families?

   I’ve read David Gratzer’s proposals about how to begin fixing the mess we’re in which included, interestingly enough, reconsidering the Emergency Medical Treatment and Active Labor Act. The problem with *his* particular proposal is that it lacks any specificity. Perhaps you could elaborate on any thoughts you may have on revisions to this particular law.

   Lastly, free market approaches work only in the context that individuals have choices. Another comment by Mr. Hogberg (please, I’m not asking you to defend; these are just useful reference points) states that “In a free market, producers make a profit by providing services that consumers find useful.” I think that is true only to a point.

   Consider the example of Microsoft’s operating systems. They release new operating systems not because the majority of their users find the new features “useful”. In fact, many of the users refuse to adopt the new operating system for a variety of reasons, but the most common is that they are perfectly satisfied with the one they are using. So Microsoft creates artificial expiration dates for their existing systems to force the migration of their userbase to the new operating system. They are not making a profit by making their software more useful to the majority of their users. They are making a profit through software churn. This is not a free market principle.

   The same lack of focus on customer service can also be found in the medical industry. So the ideal of the free market, that producers create products in response to customer demands, can be manipulated without some form of regulatory control. Insurance companies cherry picking their customers by dumping the sickest and keeping only the healthiest of their clients is only one example what can happen in a completely laissez faire health care system.

   Just a couple of things for you to chew on. I still believe the free market is the best choice, but there is no way for a *completely* free market health care system to exist without some form of Social Darwinism kicking in. Compassion doesn’t factor in too well into a spreadsheet.

2. David McGillis Says:
   

   February 8th, 2008 at 5:48 pm

   Health care reform has become a “Big Ticket” topic with most politicians, and a free market practice seems to be our best choice. I don’t think changing Health Care is the issue. The costs for medical services have been driven up so much over the years due to the huge cost Malpractice Insurance. Legal Reform is what we need to make happen. It is absolutely ridiculous the amounts of money that are being paid out on malpractice cases. Tens of millions of dollars being paid because someone dies in the hospital because an artery in their heart explodes, but its the hospitals fault because they treated it as a heart attack and not an undiagnosed heart defect… It’s not right. Sure, if the hospital or doctors are at fault, they should be held liable. However, it should not be like hitting the lottery if service providers who live their whole lives trying to help people have to pay billions every year for insurance. Judges uphold GIANT restitution amounts because the Attack Dog Law Firms flamboyantly present a good argument in court. This should not be like High school or College Debate classes where the good argument wins. That crazy! Common sense judgments need to be made. I’m sure the doctor is sorry if he operated on the wrong leg. He should not have to pay millions of dollars because you now have another scar. It’s not the lottery, its life… People make mistakes, and should not be crucified for trying to help.

3. Siegfried Roehm Says:
   

   February 10th, 2008 at 4:36 pm

   Having grown up with Universal Healthcare I’m a firm advocate for it and this and is the only solution for the convoluted US system ,a shame for the richest country in the world with Aappx.45 mio.uninsured and ranking 34th in the world in that department.Why is the Canadien system mentioned and never any European countries healthcare setups ? Nothing is perfect but nobody gets ruined financially or loses his house in Canada due to medical expenses.The main opposition in the US are the Insurance Companies because in a single payer system the govenment(politician) set the drug cost,doctor,surgery fees eliminating any further billing.

4. Ken Richards Says:
   

   February 11th, 2008 at 1:54 pm

   Just another response to Adele Roberson’s comments quoted above:

   I had a brain tumor about the size of a golf ball removed two months ago, and just received a copy of the bill, which is just over $13,000 – less than half of the $28,000 the Canadian had to pay to have his tumor removed. That’s nowhere near $150,000 or $200,000 Roberson claims such surgery costs in the U.S. The amount actually paid by my insurance company will probably be less than the amount on the bill sent to me. Total cost to me so far: about $30. I was seen for the first time by the neurosurgeon on a Thursday afternoon, and had the surgery the following afternoon. Since then I have had several follow up visits to the neurosurgeon, and endocrinologist, an ophthalmologist and general practitioner. That’s healthcare in the U.S.

   A little over a year ago I told my doctor I thought I had a hernia. I had an ultrasound that afternoon, which showed that I had three hernias. I saw a surgeon two days after that, and had the outpatient surgery to repair the hernias the following week. The cost to my insurance company was under $6,000. The cost to me was $250. That’s healthcare in the U.S.

   I’m a Registered Nurse and I have cared for many Canadian patients in American hospitals in Spokane and the Seattle area. All were here for conditions that needed prompt treatment that was not available to them in Canada without a long wait. Some were paying for their treatment out of their own pocket, and some were referred here by the Canadian healthcare system. Some would have died if they had not been able to seek treatment in the U.S.

   Several years ago I was doing some work at a homeless shelter for families. I encountered many people at the shelter with untreated health problems. I found healthcare providers willing to see these people free of charge. There were social workers willing to help them apply for Medicaid and other services. I found charitable organizations willing to pay for prescription drugs, and even drug companies and pharmacies willing to provide medications for free. I made appointments and arranged free transportation. Most of the people I made these arrangements for did not keep the appointments, didn’t want to bother with filling out an application for Medicaid, and wouldn’t bother to go to the pharmacy to pick up their free medicine even if a taxicab was provided for free. They would not bother to seek medical care until a problem became acute and unbearable. Their primary healthcare provider, by their own choice, was the most convenient hospital ER.

   During the same time I was helping out at the shelter, I also worked in the ER at a nearby hospital. We treated many people there, at great expense, for problems that did not require an ER visit – things like sore throats, coughs, stuffy noses, headaches, minor injuries – things that could be self treated or treated at much less expensive places. For many of these patients, I had previously arranged free services at outpatient clinics, community clinics and doctors offices. But following up with the services made available to them was apparently not worth the effort.

   Healthcare is available to everyone in the U.S. But you have to seek it out. It doesn’t seek you out and offer itself.

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