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Re: Health Care --> "everything free"From: DoctorJoe@aol.comFri Jul 31 16:46:37 2009
I guess I should start a new direction and see where everyone stands on this. It's been discussed in a few places I've seen so far . . . Especially since Medicare/Medicaid have come into being, a significant portion of the population began to expect everything free. This was aggravated by the so-called HMOs. By "everything free" I mean each visit is free (except for maybe a miniscule co-pay), prescriptions are free or very cheap, and you basically don't "see" what you're spending (and with Medicare/Medicaid, YOU may NOT be spending anything -- some other taxpayers are paying for you). You don't pay anything at the site of care -- someone pays it in the background, basically transparently from your point of view. This is a dangerous set-up and it's caused the problems we're having now, IMHO. When I was a kid, we were in one of the first HMO-type organizations, certainly one of the first in Louisiana. It was a medical organization for employees of the Exxon refinery. I remember going there for everything -- glasses, medicine, doctor visits, shots, vaccinations, everything. And the cost was either nothing or very nominal. But SOMEONE paid for it -- the company did, in effect giving you less paycheck and providing you "free" medical care. It looked like a great perk. [As an aside, I ALSO remember that the doctors we saw in that system were some older doctors -- semi-retired? -- and some younger doctors who worked there for a while and then went out and opened a "real" practice. I also remember some scheduling issues, although I was young and I don't want to say anything about that and get it wrong.] The expectation that we have a "right not to pay" for doctor visits and medications and etc. is what is ruining the American system. We expect our "insu rance" is going to pay for just about everything. The concept of insurance is a mechanism by which you INSURE against some catastrophic or rare expensive event -- like car insurance in case of a collision. You don't (usually) have auto insurance for routine maintenance. But in healthcare, that's what we have gotten used to. Basically, we want insurance for routine health maintenance. We need to reset the system so that "insurance" is for the big-ticket expenses that occur from time to time. The day-to-day maintenance should be paid for out of pocket by us. My thought is, if the system reset that way, day-to-day maintenance items (for us, how about Pap smears, urinalyses, vaginal cultures, etc.) should be cheap enough to afford. On the other hand, surgeries and hospitalizations are the big ticket items that insurance should cover. Otherwise, we can look at medical care as a giant entitlement. I don't even want to pay for aspirin. It's my health -- it should be free from the government. Joe P.
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