I mentioned earlier that I think that there *is* a place for government involvement in health management, but providing a robust HMO isn’t it. I stand by my claim (like anyone’s argued with me), but I would like to expound on it a little.
In some ways, the government *is* already involved. The classic instance is that the emergency room *has* to treat you, even if you don’t have insurance. This is a good thing. I have several family members who have been sent to the emergency room, and come out fixed, and with a $1000 bill to pay.
I can’t find a reference to link, but it’s been argued, over at Ornery.org
that the government is somewhere involved in footing this bill. I have no idea if this is a true statement or not, or even in what way it might be true. Anybody want to check for me? It could be that hospital debt is like college debt, automatically subsidized by the government, so that the government pays the interest until you get the debt paid off. (corret me if I’m wrong, but the hospital doesn’t get to charge you interst for the emergency room, do they?). Or it could be that there’s some kind of statute of limitations that, if the person who owes the hospital dies before paying the difference (like, say, on the operating table), the government will then foot the bill.
Any way, the argument then goes that, since the government is already footing the bill for the emergency room, we could all save a lot of money with some form of socialized health care: The emergency room is the last shot for anything more complicated than a broken rib. If you go in there with breast cancer, saving your life is going to be a lot more expensive, in the long run, than if you had been visiting the doctor regularly and caught it when it was small.
This argument was already tenuous, and now it has some pretty huge holes: Even if the government were footing the whole bill for all uninsured emergency visits (which they aren’t), there are plenty of cases where the emergency treatment is going to be less *costly* than a long-term solution. For instance: a good friend of mine, Jordan Zollar, died a few months ago, about five years after a heart transplant. (Go here for an obituary comparing Jordan Zollar with Superman.) There is no way that his medical bills would have been more costly if the Zollars had had no insurance. You can’t emergency room a heart transplant.
The fact that people’s lives are at stake is obviously not a very good argument against universal insurance. If the argument is “saving a person’s life” versus “it costs too much,” it’s a pretty one sided fight. But it does show that the argument can’t be purely a numbers game.. You can’t say “we’d save more money if we had a government HMO.” It’s just not true–in any sense.
I do have an idea, though, about how the “ounce of prevention” adage **can** be applied to health care. Most people that I’ve heard who want to promote government health care want to provide a full package: cradle to grave health coverage. And the simple problem is that it just doesn’t happen. Even in countries that have that system, none of them get the kind of “yessir, right away sir” service that most people get with basic health care here. The fact that you have to wait for most kinds of health coverage defeats the best argument that we should be able to jump the gun on the emergency room.
Ok. Here’s my idea: how much would it cost to provide everybody just their annual visit? Not x-rays, not drug coverage, not hospitalization–just the annual? People would then be in a position where they *know* that something’s wrong, and they can get about the business of fixing it. Same question for the dentist. For most people, a trip to the dentist every year would eliminate the need for fillings, and it would empower them to know how to save for more extensive help.
Understand, I’m not crusading for that kind of change, on a nationwide scale, tomorrow. I’m just curious to see if it would be helpful. If an annual checkup is $150, then for 3oo million Americans, the cost would be $4.5 billion. That’s an expensive test. What if a small town took it upon themselves to try it? Charlotte-Mecklenburg county has 750,000 people in it. Assuming out $150 price, that gives us a budget item of $112.5 million. That’d be around half the cost of the local public schools.
That’s still an expensive test. My point, though, is to demonstrate that there is theoretically a level of government involvement in my health care coverage that I would be comfortable with. I think universal coverage of the check up would be about it. Notice that it’s really a federated argument, too. If a local government feels richer and wants to provide a higher level of coverage to its citizens, they can do that. And if I don’t like it, I don’t have to live under that government or abandon my US citizenship.
neumatikos 
I’m going to be really narrow-minded and fanitcal here: It seems to me that we are in that place mentioned in scripture where the difficulties are growing faster than man’s ability to deal with them. We personally haven’t had insurance for years because the truth be told we were paying more for insurance than we ever got in benefits [healthy lot that we are] — downside is that right now we can’t really afford to get even the basics taken care of. Of course the governmental option would mean that the choice of whether or not to have insurance would be taken away from us …..and don’t think that government health care would be free — taxes would be raised –you would pay and you wouldn’t have a choice.
The best solution that I can see would be for the church to begin to really operate in the resurrection power of Jesus Christ and begin to lay hands on the sick and see them recover. It would only take a few million John G. Lake’s to accomplish that, don’t you think?
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In Oklahoma, government funding of medical for the poor falls under title 19. I have a friend that is currently living at the Salvation Army shelter. (It has actually been a really good thing and their program is far better than I ever realized.) He collapsed at his fast food job and went to the hospital. They had to do an emergency surgery on his lower spine. When he went to check out, they started to talk to him about a payment arrangment. Being the dense person he was, he started to agree and they were going to bill him $120 per week, about 90% of his limited paycheck. I stepped in and informed the lady that he was living in the homeless shelter and had a modestly paaying job at McDonalds. With a simple “Oh,” she reached into a drawer and asked him to fill out a short form so that they could bill the county health department under the title 19 stipulations. The county gets their cash from local sales taxes and money from the state board of health. The state gets their money from state income taxes and federal health grants. The federal money comes from, you guessed it, income taxes.
Also, most hospitals have charity funds available. I had another friend that spent a month in the hospital und had 4 surgeries on his ear. He was working a temp to hire position without benefits, so he had no way of paying the $85,000 hospital bill. He filled out an application for the hospital’s charity fund and they wrote off 100% of his hospital bill even though he was considered a middle class white collar customer.
There are a lot more funds out there than people realize. If the government should do anything to fix the healthcare problem, they should execute 2 things. 1) Torte reform. Cap the lawsuits. Frivalous lawsuits account for hundreds of millions of dollars of healthcare costs each year. This is something Bush has called for, and I hope the federal government won’t bend to the trial lawyer BAR’s lobbying against this. 2) Re-write the tax code in regards to churches and charties. Right now churches are terrified to engage in anything that could even remotly be considered overlapping or interfering with government business. This includes charity work. Also, increase the benefit for giving to charities. Instead of an income deduction, try a bottom line deduction. They did it with higher education. For 2 years, you can take your college spending and deduct it strait from the bottom line. Say you make $20,000 and are taxed $2,000. If you have a $1,000 bottom line deduction, your $2,000 taxes are reduced to $1,000. Unchain the church and let it do what it historically has done well, treating neady people mind, body and soul. Increase the benefits for giving and watch charities flourish and help more people than they already are capable of helping. Don’t bog the system down in more beuracracy and expenses.
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All those things. Absolutely.
But as for me, I didn’t know I had cavities *until I went to the doctor.* People who don’t have the insurance just don’t go to the checkup in the first place.
I’m not particularly for a federal plan, and I’m definitely not in favor of full coverage by a federal HMO. But it would be interesting to see a local group giving out checkups to any who ask. Whatever the cost for a checkup, it’s a flat rate. Girl checkups are more expensive than boy checkups, but other than that, they’re all pretty much the same.
I’d love to see a million or so John G. Lakes running around, but unless they operated in an incredible gifting of the word of knowledge, alongside the gift of healing, there would still be a lot of unnecessarily sick people out there. You don’t usually pray for healing for people when you don’t know they’re sick.
Heck- by all means, let’s start up some charities that provide basic annuals to everybody that comes, too!
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I see where your coming from. I know our doctor is a little out of the norm. He has the standard office rate, but if someone doesn’t have insurance, he cuts his portion off and only charges a minimal rate to cover the cost of the materials and his assistant’s labor. He said that he felt it was his ministry to help anyone to afford a doctor visit anytime they need it.
As for a way for everyone to get a annual checkup? The simplest answer would be to set aside $7 per paycheck, assuming a 26 pay-period year. That would give $156 annually for a checkup. The assumption is that someone has the strength of will to save the money and not use it elsewhere. If we relied on a federal program for this, I can assure you that we both will see more than $7 per paycheck dissappear in taxs.
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One of the things that I would love to do after I get my MD is be in a primary care practice with a group of Christians and have some sort of rotation of the physicians doing charity work on a weekly basis. In other words, we would rotate who would give time when with every doctor contributing to working with patients who couldn’t pay the regular cost of the visit. We would probably have a system similar to the one outlined above with a flat rate for supplies and the RN’s time, but everyone in the office would rotate instead of just one doctor doing all the work.
One of the biggest problems with doing this would be the astronomical cost of small practice or even personal medical insurance (which I personally think should have a cap and that the lawyers shouldn’t get such a large percent of when the physician gets sued). It really bothers me to think that I will be hindered in what I am called to do on the basis that, “I might get sued” by a patient.
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Cool. Christie and I consider ourselves blessed to have found a Godly doctor who believes that he is living his ministry and calling, not working a career. On top of the above mentioned, he also volunteers 1 day a week. Half the day, he does OB work at the Indian Hospital and the other half he is volunteering at an ER center in the middle of farm country. So on top of living his calling in his own office, he takes his calling into the world and shares the gifts God gave him with those who can’t afford to even pay his low office rates.
You sound like you have your calling and career minded in the right order. Follow the calling and God provides a career. Follow the career and you run the risk of missing God. You are truly blessed!
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