Monday, October 3, 2011

About Health Care

Yes, risky behavior can lead to disease or accident, and it is not fair that those who are careless with their health should expect the rest of us to pay when they are not able to.

While not smoking, not becoming significantly overweight, not drinking too much or being a good driver lowers risk, it doesn't prevent bad things from happening. Accident and disease can happen to anyone, regardless of their choices.

And when accident or disease do happen, the cost is often catastrophic. A broken leg and one day hospitalization can break a family's budget if they have to pay for it. The cost of insurance can break a family if they bear the full cost of the premiums.

The "health insurance" everybody has is that emergencies have to be taken care of at the county hospital regardless of ability to pay. Which means that Lubbock County taxpayers are providing a kind of health insurance for those who can't pay;  it's already factored into our taxes.

Some can pay a little, and when they are threatened by a UMC lawsuit, they can get UMC to agree to accept a fraction, say 1/5 or 1/3 as payment in full. Which -- you guessed it! -- still leaves taxpayers in the lurch.

Other hospitals including "non-profits" like Covenant will transfer non-insured emergency patients to UMC if time permits, so that county taxpayers and not the "non-profit" will be stuck with the bill. (Thought non-profit hospitals don't worry about their bottom line? That they were in the harity business? Not necessarily.)

It's complicated. I'm tending to think that a big part of the problem has been government and health industry control of medicine and physician licensing.  We need less expensive alternatives to physicians and hospitals. Allow RNs and nurse practitioners to do more of what physicians do now. Streamline medical education for some medical fields, by having a 4-year medical program beginning with college freshmen, so that one graduates from college as a doctor, eliminating 3-4 years of minimally necessary and duplicative training.    Instigate price wars between doctors and between hospitals. And imo when a non-profit hospital turns away a patient who can't pay, they ought to lose their non-profit status.  In fact, non-profits ought to demonstrate that their fees are lower than those of for-profit hospitals.

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