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Capitol Ideas
When the Luck Runs Out
A trip to the hospital has a way of clarifying the problems in our health care.
I DON’T BELIEVE I EVER WROTE an article about medical care. Now I will, mainly because my own health became an issue overnight. First I’ll say something about that, then I’ll take a quick look at the new health care law.
Early one morning, still in bed, I knew I had to go to the bathroom—quickly. But it turned out to be blood, and a lot of it. Then more of the same about an hour later. Then still more. I called 911 and was taken to the emergency room of a nearby hospital. More bleeding and I was admitted, although that took hours. Then more problems, including fainting when I went to the bathroom. At that point I was put into the intensive care unit, and I stayed there for two and a half days.
I don’t want to identify the hospital, but I was well taken care of. I have no complaints. But intensive care is not something that I can recommend. You are hooked up to gadgets that ring and ding more or less whenever you move. So sleep, indeed rest of any kind, is hard to come by. At least I was alone in the room and I didn’t have to listen to someone else’s television or snoring. My wife brought me a couple of C.S. Lewis books from home. A visiting doctor saw them and immediately said that The Great Divorce was his favorite Lewis book. I was impressed by that.
I began to see how much the trial lawyers have added to the cost of medicine. Everything is double and triple checked. But nothing in the tort law department is likely to change any time soon. Charles Kraut hammer has commented on this but liberal columnists and editorial writers generally ignore it. “The trial lawyers own the Democratic Party,” Krauthammer said.
It turned out that I had diverticulosis (not “-itis”), characterized by “pockets” in the colon wall. Sometimes you get one near a vein, which is why I had a good deal more bleeding than is normal. They gave me a colonoscopy—unpleasant because of the jugs of fluid you have to drink beforehand. But I was drugged and was hardly aware of the actual operation. I’m glad to say that nothing more serious was found.
I felt weak and tottery when my wife picked me up and drove me home. I slowly recovered—then I received the hospital bill. It was over $53,000. The bill said “for information only,” and I hasten to add that I do have Medicare. My wife, who knows much more about these things than I do, says she thinks that Medicare will cover most of it. Most? Not all?I’ll find out in due course.
NOW FOR THIS LITTLE DETAIL: As far as I know, except for a few brief intervals, I had no medical coverage for 35 years, between the ages of 30 and 65. As they say, I “got lucky.” I never had to go to the hospital in that time, except once, briefly, and on that occasion the doctor’s office that I had visited had to pay, for reasons too complicated to explain. I have also been fortunate enough to see doctors only rarely.
According to recent estimates, about 50 million U.S. residents lack medical insurance. Some put the figure higher. The number is often used without qualification to urge the nation to enact reform. But according to Carpe Diem, a blog by Mark J. Perry, an economist with the University of Michigan and a visiting scholar at AEI, surveys show that about 18 million of those uninsured had incomes over $50,000. Most of them could afford basic health insurance. In Michigan, Perry said, people aged 18 to 30 could get insurance through Blue Cross starting at about $50 per month—about the cost of a basic cell phone plan. Individuals under 65 could get coverage for $138 per month—comparable to a cable TV and Internet bill. Perry added this:
Since most households making $50,000 or more can afford multiple cell phones and cable TV, it would seem like they could also afford basic health insurance, and choose not to buy it. If they say they can’t afford health insurance, they should consider canceling their cell phones and/ or their cable TV service. If they choose cell phones and cable TV over health insurance, that’s a voluntary choice.
That was in 2009, so the numbers may have changed since then. But it’s certain that the uninsured include many who are voluntarily so. About 56 percent of the uninsured are under 35. The young often make a rational calculation that they don’t need health insurance because most young people in this country enjoy good health. That was my own reasoning.
As to the Affordable Care Act, otherwise called Obamacare, most of us know by now that the new law obliges us to have insurance. Those who refuse will be penalized. According to the Supreme Court’s recent controversial ruling, that penalty is a tax, which renders the law constitutional. Citizens will now be “taxed” if they don’t have health insurance by 2014.
The reason for this, of course, is to make premiums of younger people subsidize the growing ranks of the insured, particularly those with “pre-existing conditions,” who will now be covered.
Here’s Mark Perry again, this time in 2010:
The federal government wants to require young, healthy people to buy insurance because if they don’t, premiums for everyone else will go up. Insurance companies need low-maintenance, young customers on their rolls so they can raise money to cover benefits for lesshealthy people the health care bill will require them to insure.
Inevitably, this mandate will be shot through with exemptions. Native Americans and undocumented immigrants are already exempt, and more exclusions will no doubt follow. Congress is good at this kind of thing—passing laws with “afterthought” loopholes.
About the Author
Tom Bethell is a senior editor of The American Spectator and author of The Politically Incorrect Guide to Science, The Noblest Triumph: Property and Prosperity Through the Ages, and most recently Questioning Einstein: Is Relativity Necessary? (2009).
Letter to the Editor View all comments (24) | Leave a comment
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Aristocat| 9.24.12 @ 8:37AM
Forcing us to pay for those with pre-existing conditions will raise the cost of health insurance tremendously. It's like forcing auto insurers to cover pre-existing car damage. If you must, put people with pre-existing conditions in Medicaid and leave the insurance companies out of it.
Republicans have a health reform plan that includes being able to buy insurance across state lines and being able to buy only the insurance we want and not things we don't want, like breast implants, etc. etc.
Von Mises Jr| 9.24.12 @ 9:43AM
The irony my friend is that the regime passed the law rationalizing it with the free rider argument. If you don't buy insurance and go to the hospital, others might have to pay.
But if people can get reduced costs for coverage for bad behavior, then are we not subsidizing their bad behavior?
If you are very obese or suffer from smoking or drinking and had to qualify for a plan, you would have to lose weight, stop smoking or quit drinking. But if ObamaCare guarantees you coverage, why stop?
Of course insurance and treatment are two different things, but fat drunks smoking Camels probably won't figure it out until too late.
Jacob McCandles| 9.24.12 @ 3:19PM
Yes, we will soon find out that coverage does not equal care. We will get fewer doctors taking government plans. Then long lines for care. Then mandating doctors to accept 'care and 'caid to remain licensed to practice. Then more government rules allowing nurses to do the work of a doctor. Then relaxed rules about foreign doctors practicing here. And so it goes...
Long story short: if you are lucky enough to get care, it will be from a nurse or from someone who you cannot communicate with.
John786| 9.24.12 @ 8:56AM
The writer disparages the British NHS. A system that works well for the fraction of the US health system. If he was in britain there would be no waiting time for emegencies and he would not be presented with a ruinous bill. Of course if you are member of the 1% you're not going to like the NHS. These people can continue to buy premium (!) Healthcare as they do know. For the rest of us mere mortals a national health type system is the best thing.
C. Vernon Crisler | 9.24.12 @ 9:33AM
So given how well the public schools are doing, or the post office, you think national health care in America will be just as inexpensive and well run?
PolishKnight| 9.24.12 @ 9:45AM
Comparisons of the costs between Canadian or British Health Care system and the USA are apples and oranges because the US's healthcare costs include a form of socialist medicine already (Medicaid/Medicare) and vast numbers of undocumented immigrants dumping costs on the rest of the system (although that is changing quite quickly in New Britannica.)
Regarding the 1% in the USA: That's actually government unionized workers and their Cadillac plans reminiscent of the former Soviet Union and party bosses' access to GUM stores and special VIP lanes on the roadway. I would guess that the same probably applies in Britain but the unwashed masses are too brainwashed, or afraid, to publicly notice.
Dai Alanye | 9.24.12 @ 10:04AM
NHS works well... compared to Third World systems. I'm quite sure the NHS is superior to the Cuban medical system, the one for ordinary Cubans not celebrities. Based on a recent article by David Asman of Fox News- http://www.foxnews.com/story/0,2933,243439,00.html -I doubt whether any American would wish for the type of care available in the UK.
Asman does his best to make excuses for the NHS, but as his wife's experience makes clear, only by going into private care in the UK was his wife able get the type treatment we take for granted in the US. And our system doesn't deny treatment to those whose "quality of life" is considered poor. When his wife collapsed they were in a minor town, one called London. My wife has obtained far better treatment from local hospitals in towns with populations under 50,000, backed up by major hospitals in Cleveland, Ohio.
Read Asman's article and weep for the people of Britain. Socialized medicine is a gamble no rational person should make. Of course, Asman's experience was back in 2007. Perhaps the NHS has dramatically improved since then. You know, the way government programs always become more efficient, more humanized over time.
Denver Todd| 9.24.12 @ 10:31AM
If Britain's NHS is so great, why does private medical insurance still get sold in Britain? Private medical insurance gives people quicker access to private hospitals and doctors. It can be bought in Britain by individuals and offered as a benefit by businesses, exactly the same way it is sold in America right now. No matter how socialized a product is, no matter how much the governement tries to make people equal, people will still elect to put their dollars in places that meet their individual needs. If you want to see examples of the NHS and why people buy private medical insurance in Britain, go to youtube and search for "my experience with NHS." Here is one: http://www.youtube.com/watch?v=GOQ4T17eP3M.
Jacob McCandles| 9.24.12 @ 3:24PM
"a system that works well..."
Not if you have any of the most common cancers. Not if you need a knee replacement to continue to be active. Not if you want the most effective medicines.
Look, if you mean relative to Ethiopia, yes the NHS works well. If you mean relative to the US of A, not so much.
I can tell you from first hand experience that uninsured "undocumenteds" get better care for cancer here than the poor Brits do with the NHS. All they need to do is show up to the nearest Emergency Room. You obviously do not know the facts.
John Navratil| 9.24.12 @ 3:39PM
John786,
As one who has first-hand experience of the "care" provided by NHS, especially elder "care", to my aunt and my grandmother lets me dismiss your assessment that the system "works" out of hand. You don't know what you are talking about. The hospice care is tender and the bill is paid by the taxpayer, but your typical Medicaid recipient would pitch a screaming entitlement fit if forced into the NHS.
JD| 9.24.12 @ 10:09AM
There is nothing more sacrosanct to Democrats than laws that they support. It will make no more sense to them to question ObamaCare when its negative consequences become known than it makes sense to question gravity for causing someone to call down the stairs. They will argue, with straight faces, that we're crazy for even suggesting that such an unalterable fact of life should be criticized, and that blame "clearly" must lie in various conservative ideas that they blame for people's inability to afford ObamaCare's costs.
We all know the feeling. It's like arguing for the end of any social program. They say "you're insane - what would happen to all the people it helps?" They won't just disagree; they won't even take you seriously.
Denver Todd| 9.24.12 @ 10:12AM
It is likely that in the future, people will get their medical care in the exact same way that Obamacare was created to solve: in the emergency room.
Denver Todd| 9.24.12 @ 10:16AM
Most people think that Britain's medical system is the only game over there, but private medical insurance is still available and it give you access to private hospitals and doctors. I suspect that a similar secondary system will spring up in America. But it will be a bitch to have to double pay for medical insurnance, the same way one pays for private school when public is available.
Kingofthenet| 9.24.12 @ 10:35AM
Young people get sick ALL the time and stick Hospital and RatePayers with the bill.Besides how is this different than Old People complaining about having to pay for schools? Those gravy young people will someday be old, so what goes around, comes around.
BTW: ANY plan that costs $135 a month, much less that crazy $50, that isn't subsided by your employer isn't worth the paper it's printed on.Quality Health insurance for a 40yo costs $10,000 a year MINIMUM.
Dai Alanye | 9.25.12 @ 2:27AM
Has Kingofthenet ever said one sensible thing on this site? He's yodeling through his chapeau here, of course. The major costs to our medical system have to do with keeping the elderly alive and somewhat healthy. Costs for the young are slight by comparison.
In the final analysis the only system that makes sense is a form of medical savings plan that encourages the young to invest for their later years, and gives the patient an incentive to be cautious about spending his own money. As it stands now, every procedure is "free," or so it appears to the patient.
Something must also be done to change malpractice suits from a form of the lottery, where a cheap ticket can win the lucky bettor a big prize, thereby requiring unnecessary procedures and increasing costs for everyone.
Casabianca| 9.24.12 @ 10:50AM
I'd REALLY like to know where one can get a decent health plan for $135 a month. My spouse and I are under 65, we have a $10,000 (yes, TEN THOUSAND DOLLAR) deductible, and we still pay over $900 per month. We're both in good health, BTW. If the premium is raised again (no reason to think it won't be, it happens every year) and goes to $1000 per month, we have agreed to drop the coverage altogether. I suppose there's something out there with an even higher deductible, but at that point it's just ridiculous.
Kingofthenet| 9.24.12 @ 11:09AM
I feel for you, that really isn't 'health Insurance' you have but instead a Catastrophic Event policy.NeoCons are desperate to make it look like the 'Free market' in Health Care is working, and it is...if your wealthy.
PolishKnight| 9.24.12 @ 12:01PM
That's total BS. Catastrophic Event policies go for about $135 a month, but the more expensive plans in the $900 a month certainly are standard plans with deductibles and set rates.
I like the Doctor Evil double quotes around "Free Market". Yes, you have a point but not perhaps the one you intended to make: The left has broken the free market in healthcare via trial lawyers driving costs up, undocumented immigrants flooding the system, and regulations giving out freebies to some groups while dumping the cost on the rest of us. In the world of the left, there's the "l percenters" and their (current) special interest groups: Radical Islam, man hating feminists, non-white males, and then those who aren't in those groups or are politically powerless are dumped. Working class white males, and working class black men, aren't even on the left's radar except with those laughable ads from Obama directed towards "the middle class" featuring white people in their kitchen (probably government DMV workers union members pretending to be "middle class"). Nice try. Good luck with fooling enough voters this cycle!
f111a| 9.24.12 @ 2:55PM
No medical insurance from age 35 to 65? Wow; Tom has definitely used up his "Green Stamps"! This senior citizen (73) learned shockingly, at age 14, (while working at his family's large funeral home) that life doesn't end well for most of us, and, suitably impressed, acted accordingly as an adult, making sure there were adequate medical insurance provisions for himself and family. Hope Tom's starting to "get real", medically speaking; he's one lucky guy.......
obadiah| 9.24.12 @ 8:24PM
Regardless of the system operating in America, "medical costs will be held down the same way they were with Britain’s nationalized health: by rationing, queuing, and postponing care." The reason is that Insurance Company and Big Phrma executives must compete with those who belong to Oil Companies and Defense Contractors. Nothing but the best for minions of Companies and Contractors. National policy requires that Big Phrma must return high profits. Have to really scrimp elsewhere if we're going to balance the budget.
jdmeth| 9.24.12 @ 10:58PM
I'm 60 and have had insurance for only seven years total in my life. I am lucky and have good genes. My dad is 82 and has spent one night in a hospital and my mother last saw a doctor in 1972. I have been unemployed for three years so I am more likely to die from starvation than anything else.
Clara| 9.24.12 @ 11:14PM
What the hell are they talking about? Our insurance has gone north of $12,000 per year. We have had a lot of health care needs in the past few years so we have got our money's worth. If this levels off we will most likely be paying much more per year in insurance than what we need in care (unless we face a health crisis, which is reall what insurance should be for). I live in a state that requires everything under the sun to be covered, I guess that is why the cost is so high. I wish I could get a plan that just covered catastrophies and real medical interventions, procedures, and diagnostics. Not the fluffy crap like acupunture or predictable things like birth control. It would be awesome to have an affordable plan. Don't see it happening though. Premiums are likely to continue rising. Oh and I don't have a cell phone or cable, but then again I'm not on the dole.