Health Care Reform

The papers today say that Obama's universal healthcare plans are foundering, which is a son of a bitch. I was looking forward to universal healthcare. Every country in the civilized world has it, except for the US. The one I came from, Britain, does, and spends a lot less per person than the US does for its supposedly optimized-by-the-free-market private system.

If you're worried about "rationing", rest assured it already goes on in US. Everyone who has no insurance has their health care "rationed" to the amount of cash they have in their pocket. For some reason no-one seems to mention that 45 million Americans have healthcare rationed this way. Even those in the US who have insurance are, of course, rationed. Most insurances have maximum yearly payouts, and most insurances have lists of 'experimental' drugs and procedures they will not pay for. Those who love scaring people by saying that a European country would not give a drunk a liver transplant are obscuring the fact that a US insurance company often will not give a drunk a liver transplant either. Livers are scarce - it's not like there's a warehouse full of them in Poughkeepsie and if only the meanie on the security desk would let you in, you could go grab one off the shelf.

The costs of government-provided healthcare are far lower than private, too. In 2006, the US spent 6,714.0 per capita and the UK spent 3,361.0 per capita. Don't know where this strange fantasy comes from, that people working for profit - to pay their shareholders a divided and keep their stock price high - will do something more cheaply than people working in a non-profit. It's not even logical. Paying the CEO $124 million a year also might eat into the amount available for caring for the sick, too, don't you think?

What really chaps my ass, as they say here, is the fact that insurance companies, being the 800lb gorillas, make part of their profit by not paying providers enough to perform the procedures. The providers then carve enough money to live on out of the hide of the uninsured. Here's some facts and figures I know well, because they're *my* facts and figures.

In 2006, I had a cancer operation. The hospital, which apparently has a billing section staffed by hallucinating wallabies, sent me the 'uninsured person's bill', about $27,000. I sent it back with a note to the wallabies to shape up, and they billed the insurance instead. The insurance paid $2,118 and asked me to co-pay $250.

The hospital wrote off the other $24,000+.

Later that year I had reconstructive surgery. The hospital's first bill was for $29, 550 (approx.). The insurance this time paid $1,424 and asked me to pay a whopping $356 out of pocket.

Once again, the hospital wrote off the rest, a staggering $27K or so.

Since similar operations for cosmetic surgery purposes cost somewhere around $9,000, I'm pretty clear on the cost of the procedures. This hospital spent about $18,000 on me and got about $4,000 back from me and my insurance - not enough to stay in business. The remaining $14,000 it no doubt dug out of the flesh of the next uninsured person with a blunt spoon - by charging them almost three times the actual cost of the procedure, as they tried to do to me.

This is a system badly in need of reform.