Laughing at “Dilbert” and a Public Health Care Option

I used to work in a corporate environment.  I knew that it was time to leave when I lost the ability to laugh at the comic strip Dilbert. It wasn’t only that I could not laugh; I would sometimes cry.  You can laugh at something stupid when it doesn’t affect you, but when you have to live with it day in and day out, it’s not funny anymore.

I’m still at the point of laughing over a “Public Health Care” option because I still have hope that it will not go through.  I hope that we don’t get public health care insurance as they have in Canada or public health care providers as they have in Great Britain or even mandated health insurance which is state subsidized for the poor as they have in Massachusetts.  All of those approaches seem to create similar, real events that sound like punch lines in jokes.  Did you hear the one about the lottery to see who gets on a doctor’s list in one Canadian town?  Did you hear about the traffic jam in the London hospital parking lot from all of the ambulances idling for hours so they could comply with the guarantee that patients will be seen within a certain amount of time after entering the waiting room?   Did you hear that Boston Medical Center is suing Massachusetts because they’re going out of business due to the universal health care law?

Anyone who thinks that our government can run a comprehensive public health care option any better than they have run the ballooning, fraud-infested Medicare and Medicaid must have eaten some of those magic mushrooms or Obama supporter brownies.

Now, Representative Nancy Pelosi has said that we could get health care reform that has a public option without any additional revenue needed.  She said on July 17, 2009, “In fact, I believe that all of the cost of the healthcare reform bill can come from squeezing more savings out of the system.” WHAT?? Ok, if they can do that, why aren’t they “squeezing” now to make up those hundreds of billions of dollars coming out of the budget for Medicare and Medicaid?  Come on, Nancy, you’re kidding, right?

Here’s the underlying rocket science.  Let’s say a procedure costs $60 to perform.  The 800 pound gorilla of a government can say to the health care provider, “We will pay $40 for you to perform that procedure on Medicare and Medicaid patients.”  That does not reduce the cost of the procedure—it only means that for some patients, the health care provider will be getting less than it costs to perform that procedure.

Ms. Pelosi seems to think that by extorting a $40 price tag for a $60 procedure, the cost of health care has been reduced.  What it has done is transferred the cost.  Right now, the health care providers take a loss for the Medicare and Medicaid patients, and pass that loss on to other patients.  For example, other patients may be paying $70 or $80 for that same $60 procedure that costs $40 for Medicare or Medicaid patients.  Every time you go to a health care provider that has Medicare and/or Medicaid patients (which is essentially everyone), you are subsidizing Medicare and/or Medicaid in addition to taxes you already pay.  The money that we pay for Medicare and Medicaid is actually higher than just the taxes that go from the government to the health care providers.

If Congress passes a bill which includes a public option for health care, the government will be underpaying for services for a lot more people.  More money will have to be made up by overcharging private insurers.  Private insurance rates will go up.  Increased private insurance rates means that it will be harder for employers to provide private insurance, starting with the smaller employers.  People who lose their private insurance will be chucked into the public option, which makes the cost imbalance worse because more people will be underpaying.

Wait just a minute!  I seem to recall a similar situation in the late 1800s.  Some of the big companies were artificially lowering prices below what a commodity actually cost.  The big companies could operate at a loss for a short period of time.  The little guys couldn’t and went out of business.  All that was left was the big guys.  It was called a monopoly.  Congress passed antitrust laws to fix this problem.  In this case, the government is the big guy that will be setting costs artificially low to introduce “competition” into the marketplace.  Will they come under antitrust scrutiny?  I wouldn’t put my money on it.  The federal government these days seems to think that they are above the law.

President Obama says that if you like what you have now, you can keep it, he needs to add, “.  . .  if you can afford the increased cost.”  Many small business owners have said publicly that they will not be able to provide private insurance under the proposals they have heard.  You yourself may have little say in keeping what you have.

OK, I guess I’m wrong.  I said that I could still laugh about a “Public Health Care Option.” I can’t, even though I avoided thinking about the really depressing, heavy duty, life-and-death stuff involved.  I just hope that there are very generous psychiatric benefits under any public health care option that is passed—Americans are going to need it even more than now.

Published in: on July 18, 2009 at 11:03 pm  Leave a Comment  
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