UPDATE #2: And thanks to Lynn Vincent at WorldMagBlog for the link as well. As she told me today, I'm "world famous and totally unknown." How true!
Just a quick note to let my regular readers know about my article published today by The American Thinker, "Governor Schwarzenegger Should Go To Nashville". In light of the Govenator's plan for universal health care scheme for all Californians, I note:
But before riding the universal health care train too far, Gov. Schwarzenegger might want to make a stop in Nashville to see exactly how such a plan has actually worked for Tennessee, where that state's abysmal TennCare program has forced dozens of hospitals out of business, pushed thousands of doctors and other health care professionals out of the state, destroyed any semblance of competitive health insurance market, and nearly drove the state government into bankruptcy.This is based off my experience dealing with TennCare while I was a policy analyst for the Tennessee Institute for Public Policy. My published study of the TennCare system can be found here (though it is quite dated at this point, but the first section about the failures of Tennessee's experiment with universal health care are still valid).
For my previous articles at The American Thinker, go here.
12 comments:
Great article in the American Thinker.
Being from Canada originally, I can testify to the disaster that universal health care is. First, its not cheaper, it just means higher taxes or bigger deficits.
Second, a great illustration is to imagine the DMV being the emergency room.
Such socialistic policies always function on the lowest common demoninator, not the most efficient processes and innovations.
Patrick, great article on AT. One question though....what drove the doctors and hospitals away from TN? How did TennCare impact them in such a negative way?
Jack,
In response, the doctors left because the TennCare reimbursement rates were so low that a number of them could no longer afford to operate. Much like the hospitals, TennCare shifted the cost of the program onto the provider. That's what they considered "managed care". Those that could raise their prices did; those that couldn't left or retired. Some would say that's the market at work, but TennCare was an artificial and profoundly negative force in the market.
Thanks for stopping by.
Patrick,
Thanks for the answer. That is what I suspected, but wanted to be sure.
Jack
As one of the uninsured in California, I think I can relate to both sides of this issue and reach the same conclusion.
The problem is not a lack of care for the uninsured or employers not providing benefits, the problem lies with the Health Insurer. I will use my situation as an example.
I had an individual health insurance policy with Pacificare, now owned by UnitedHealth Group. I am in my early thirties and incidently found a tumor in my kidney. Pacificare canceled my policy and of accused me of fraud because according to them, I knew I had kidney cancer. My lawsuit was recently filed for this problem.
Being diagnosed with cancer makes me uninsurable. My only option is to try to get coverage through the State High Risk plan which has a 2 year waiting list. The problem is that I am ineligable for the State plan until my lawsuit gets resolved because the State plan disqualifies anyone who lost their insurance due to fraud.
So here I am, one of the statistics of uninsured in California with no place to go for relief. The insurer was eliminated an expense and increased their bottom line so that the UnitedHealth CEO can backdate his stock options to the tune of 1.6 Billion dollars. Something is definately wrong here.
The same culprit can be found in the way doctors get paid to provide care for the Health Insurance Company. This goes by the name of "Capitation" which pays the doctor a fixed sum per month, per patient, for all care provided to the patient. The same problem you discovered with TennCare happens with Capitation. In fact, a portion of the Capitated rate is withheld and put into a pool. At the end of the year, the money will be released only if the expenses were kept to a certain level. This is where the Medical Group comes into play since as a Group, they have more patients and receive a bigger portion of the pool money.
Those in charge of the Medical Group make sure that the costs of providing care are kept to a minimum. Some have been known to force doctors to provide less care or risk being thrown out of the Medical Group because they are making the entire Group suffer with less income.
I find it interesting that whenever you read about the current crisis in HealthCare, the problem is always the uninsured and never the Insurer. Until something is done to reign in the Health Insurer and their practices, nothing will change. The Health Insurance Company owes its duty to it's shareholders and that duty is to increase profits and reduce expenses. Everyone needs to take their blinders off and stop pretending that the Health Insurance Company has any duty to the insured that is over and above that of their shareholders.
SBD
I don't have high expectations for the governer, but obviously he's an example of not learning from the past. "The State" is not the answer to all of our ills.
SBD,
Your case is yet another example of the epidemic problems with our health care system and shows how complicated the situation really is. The uninsured are a real problem (I will have a follow-up article at The American Thinker tomorrow discussing my experience as an uninsured American) and the absense of any solutions is wrecking the system for everyone.
But my main point has been that more government intervention into the health care market will not fix the problem, it will exacerbate it. Most of the distortions in health care have been caused by government involvement in health care through mandates, tax policy, etc. If we want to kill off our world-class health care system, getting the government more involved is the exact prescription.
Thanks for stopping by.
Your recent article on American Thinker was very much on point with the reality of the situation. The sad part is that there are a lot of people out there that have not had a major health issue and those people will simply say that it was your fault for not paying for insurance. I was actually told this because I dropped Cobra coverage back in 2004 and I should have paid premiums instead of trying to start my own business. This, inspite of the fact that I did eventually buy coverage that got canceled.
I also agree with you that Government involvement will not help and will make things worse. Is there even one Government run program that anyone can point to and call a sucess?
The Government, especially the Federal Government should only be allowed to mess things up in DC as originally planned.
About those medical bills, I currently owe $40,000 to the providers and $25,000 to my parents who had to give the hospital a downpayment so that I could have my kidney removed and free myself of cancer.
Even though I offered the hospital a lien on my lawsuit, they simply ignored it and sent the amount to collections. You would think that the collector would send me one collection letter for the entire amount of my bill, but that is not what they did. Instead, yesterday I received 10 collection letters in amounts ranging from $100.00 to a few thousand dollars. They didn't do it this way so that I could pay it off easier. They did it this way so that my credit report will now show 10 accounts that are currently in collections.
Since this practice is illegal under the FDCPA, I will now have to get involved in another lawsuit on top of everything else. Did they expect this action to make me pay them quicker when my FICO score will probably go down 250 points and into the 400-500 range??
SBD
I forgot to add one more item. Since I am and will continue to need care, I have had to be more resourceful in managing these unethically high priced bills.
I now demand to be charged the same price as the providers other customers pay. Specifically, I agree to pay the same rate Blue Cross pays. So far, I have only had to do this once and it worked.
Right when I receive the first bill, I send them a Notice and Demand letter informing them that their one sided contract is a contract of adhesion. Then a make my Good Faith offer below:
I have good reason to believe that your charges are not the same for every patient placed under your care, and that if I were a third-party payer and/or large insurance company, you may have charged me considerably less for identical services.
Further, you have never provided me with a list of services and/or materials rendered which is understandable to me, a layman. I don't even have a copy of the Contract.
Accordingly, the “AMOUNT DUE” listed in the above-referenced Invoice is hereby refused for cause, without dishonor, and I hereby make the following good faith demands with which you must comply prior to making further
demand for payment:
1. Provide me with a true and complete copy of the Contract underlying this Account;
2. Provide me with a list of charges which is reasonably understandable to a layman;
3. Agree on a reasonable third-party standard upon which these charges will be based.
Notice is hereby given that due to the nature of the Contract, and the appearance of bad faith with which it was drafted and presented to me under circumstances of duress, I must consider the Contract voidable. However, it is
not my intention to void said Contract, provided you comply with my above-stated Demands.
In fulfillment of Demand #3, I hereby offer to accept your currently agreed schedule of fees with Blue Cross Blue Shield as a reasonable third-party standard.
SBD
My email to Mr. Warshawsky regarding his challenge and your story on American Thinker.
Mr. Warshawsky,
I agree with you that the Federal Government shoud stay out of the Healthcare business, or any business for that matter. My reading of our Constitution seems to also agree with this contention. I believe that the best place for these matters to be addressed are at the local or county level. There are two reasons that lead me to this conclusion.
The first reason has to do with politics. At least in principal, politicians at the local level are much more held accountable for their actions and they can get booted every four years because of it. When some sort of political scandal is exposed on the local level, everyone hears about it through the local newspaper, local tv news, and local radio talk shows. There is much less opportunity for Corporate interests to bribe and corrupt the system. I am not saying that all corruption is eliminated, only that there is less than on the Federal and State level.
The second reason has to do with the current problems faced by local and county government. One of the biggest problems has only recently surfaced due to the recent Sarbane-Oxley regulations that now require local and county governments to disclose the costs of healthcare to the public. These liabilities have been reported to be in the Billions of dollars. Billions of dollars that would not have accrued if a healthcare system were to be setup on the local level.
The biggest example of such a system is the healthcare system in Denmark. Although the numbers should be taken with a grain of salt, 93% of those polled were satisfied with their healthcare system. That is absolutely astounding don't you think?
From The U.S. Health Care System: Best in the World, or Just the Most Expensive? which is based on various information including the OECD Health Data 2000: A Comparative Analysis of Twenty-nine Countries (Paris: OECD, 2000), the infant mortality rate in the US was 7.2 and the life expectancy was 70.0. The Denmark system has an infant mortality rate of 5.2 and life expectancy of 69.4.
If the information is accurate, then how can the US claim to have the best healthcare system when the final outcome is relatively the same. Compared to cost, the problem becomes more apparent. The per capita 1998 dollars spent on US Healthcare was 4,178 while in Denmark it was 2,133. The US spent almost double of the money that the Denmark system spent with relatively the same longterm outcomes.
Maybe the source data is incorrect or something, what do you think of these results?
Sincerely,
SBD
There are plenty of
individual health insurance plans in Tennessee . Actually, I think there are too many right now. But that is a good problem to have. Much better off than the New England states which are so tied up with legislative mandates.
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