Surgery Center of Oklahoma Blog

September 28, 2011

He Who Pays Controls Your Healthcare

Filed under: Uncategorized — surgerycenterok @ 10:24 am

I think the best way to do this one is to start with the punch line and then back in to it.  You should provide for your own health care, not your employer, not the government.  This is not going to happen until the tax laws change and you can purchase health  care with pre-tax dollars just as your employer does for you now.  Otherwise, you are not in control, as those paying for your care are not the ones receiving it and are always going to minimize their cost/risk/exposure in every way they can.  I don’t think I need to tell readers of this blog why it is a bad idea for the government to control your health care.  They just want you to die when you get sick.  You represent a liability to Uncle Sam as long as you are alive and sick.  Better for you to be dead.  Ok…enough for Uncle Sam.

Why does the government care if I smoke?  Why do they care if I’m fat?  What business is it of theirs?  Money.  As the risk and payment of unhealthy habits has been socialized, one man’s disease becomes everyman’s problem.  You say,”’s none of anybody’s damn business whether I wear a motor cycle helmet or not!”  O.K. I’m with you.  But if you have no health insurance or any ability to pay, do you expect others to pay for your mashed skull when you wreck?  If you answered “NO” to this, then you are a true libertarian and I am sympathetic to your desire to wear no helmet.  Otherwise, what is the answer?  Helmet laws?  Certainly not.  Why not give the free market a chance?  Let everybody take care of their own problems and leave everyone else alone.  If someone with nothing gets into trouble, let churches and charities (who would be loaded with funds were we not fleeced by government at all levels) handle it.  The way things are now, we actually subsidize risky behaviors.

Why does your employer care if you are fat or unhealthy?  Money.  Your employer is either self insured and pays medical expenses for you directly or they buy expensive insurance, the premiums for which increase to the extent that the employees are unhealthy (smoke, fat, etc.).  That’s why employers set up wellness plans and have gyms and workout areas handy.  They are trying to minimize their cost.

You can buy insurance on your own.  This is expensive, however, particularly if the purchase of the insurance is made with “after-tax” dollars.  There is some talk of allowing associations to purchase group insurance.  For instance, you could buy insurance through your church or soccer club or bridge club or rotary  and receive the benefits of group discounting.  You would therefore not be subject to whatever cost saving measures your employer might be entertaining that year.  Maybe you want to buy a policy with no obstetrical coverage, because you and your wife are finished having children.  Maybe you want to take the risk of not covering certain diseases like lung cancer because you don’t smoke.  Maybe…you get the idea.  The market would respond (if it was allowed to) with insurance policies that could be customized for individuals or even groups.  As it now stands, Uncle Sam dictates to insurance companies what must be included in the policies and therefore dictates what you must buy.  This is one of the reasons that health insurance is so expensive.  This setup is great for insurance companies because people are mandated to purchase insurance that they don’t need….insurance companies charge the premiums without the risk of payments…sounds like a money maker to me!

This stuff is so obvious, I have to wonder why, if people are really serious about the cost of health care, doesn’t the tax law change to allow for the deductibility of health insurance purchases?  Why can’t the association health insurance co-op thing become a reality?  The answer is that too many folks with gobs of money and power benefit from the way things are right now and they purchase protection from market competition from legislators, state and federal.  As the market provides even more obvious solutions, the bribery of legislators becomes even more intense.  As Dr. Tom Coburn has said, “…political careerism has trumped good policy.”

I think that things are going to get better soon because economically our backs are against the wall.  The current model of government/corporate medicine is not sustainable, regardless how many fat cats get spayed/neutered.  The opportunity for individual responsibility is here.  I just hope that the policy makers understand that it may finally be in their best political interest to embrace these market innovations.  However, there is always the possibility that the bribery will escalate and they will prove themselves to be unprincipled human trash.

G. Keith Smith, M.D.

G. Keith Smith, M.D.


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