Jim Hughes

Feeding Madi, watching Ben. Am I the good Papa or what?

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Healthcare in the United States is incredible in many ways.  For many major diseases, your chance of a favorable outcome here is multiple times what it is in other first world countries.  For some things, like infant mortality rates, we lag some first world countries.  Healthcare innovation in the U.S. has been driven by a free market, both in treatment protocols, drug development, and new technologies.  There’s a reason that people literally from all over the world come to the U.S., and Houston in particular, for treatment.  So know that I’m a major fan of and grateful for our medical system even as I make the following statement.

I believe that healthcare in the U.S. is broken in some major ways.  A few of the problems I see are:

1. Insurance , including Medicare, strongly dictates what treatment an individual can receive.  What’s allowable varies from plan to plan and from company to company.  Often people don’t receive the treatment that’s available because of this, and it seems unjust.
2. The cost of bringing new drugs to market is almost prohibitive, so only drugs which will have a sufficient payback are even tested and put through the approval process.  Drugs which have been shown effective in clinical studies for rarer diseases often are not submitted for FDA approval.  Unless they are also effective for more common diseases, they will not be available.  Even if they are available, Medicare and often insurance companies will not pay for them unless they are specifically approved for the specific disease you have.
3. A portion of our population is uninsured, and their treatment is often paid for by the taxpayer.
4. For a variety of causes, emergency rooms end up handling a lot of primary care cases.
5. Then there’s malpractice insurance necessary because of malpractice lawsuits.  This also dictates how doctors, hospitals, etc. practice medicine, and adds significantly to the cost.  Risk avoidance has become a driving force in providing healthcare.

There is no doubt that changes are needed to address these issues.  But the question is how these changes should be caused to occur.

The healthcare bill currently being pushed and debated is to some one way to attempt to cause these changes to occur.  If you haven’t looked at the bill, you can by following this link.

If you at least scan the bill, you’ll see that many of the things I’ve listed above are addressed in some fashion.

But as I read through the bill, I became increasingly uncomfortable with what I was finding.  Here are a few major things that I find very disturbing:

1. It creates a whole new new level of bureaucracy to create regulations, to enforce regulations, to gather information, and on and on.  Since this bureaucracy will be overseeing one-sixth of the total U.S. economy, it will have to be very large.  Think about the size of the IRS, and then multiply it several times.  Bureaucracy has never been an efficient way to fix things, and there is no reason to believe that it would be for fixing the complexities of healthcare.  And it will create a huge tax burden just for the bureaucracy.
2. It requires an incredible amount of reporting and compliance on part of every segment of the healthcare industry.  This will carry a hefty price tag, which in turn will increase the cost of healthcare significantly.  Think Sarbanes-Oxley.  It will be a boon for lawyers and accountants, as all such government programs are.
3. It doesn’t address several of the major issues that currently are driving the healthcare cost crisis — tort reform and FDA approval.
4. Relatively little of the funding will actually address providing healthcare for those currently without insurance.
5. It drives all coverage to the lowest common denominator, and also drives care to the lowest possible denominator.

And my final objection is a simple one.  The government itself is broken.  Creating more government will create more brokenness.  How can something that is so broken, that does such an inefficient job of its own functions, think that it can fix something else?

Let him who has a beam in his eye remove it first before trying to remove the splinter from his brother’s eye.

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Don’t worry.  The adults are around somewhere.  I saw one of them early this morning as well.

 

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Both my auto and homeowner policies recently renewed.  They were with the same company, and have been for several years, so they’re on auto renewal.

As I was paying the premiums, a little voice said, “That rate for the cars seems high.  I think I need to do some checking to make sure I’m not paying too much.”  That voice has spoken to me before several years ago, and I had gone through the process of getting some quotes and going back to my agent, who had been able to make adjustments.

So I used my friend the Internet and got some quotes.  Sure enough, the auto policy was about twice what I was quoted by one of the famous companies that sells primarily through the web.  The homeowner policy quotes were a mixed bag, but it appeared that I could save several hundred dollars a year there as well.

So I gave the information to my independent agent, who has been a close personal friend for 40 years, and asked him what they could do.  Sure enough, they were actually able to beat the auto quote by a few bucks, and managed to save me several hundred dollars a year on the homeowner policy.  Both had to be written on another company, but that’s fine.

He and I had a long discussion about the difficulties of the insurance business.  The company that was providing my coverage won’t write homeowner policies for him, but have struck a deal with the famous Internet company to write policies through them for substantially less than what they are charging established customers for renewals.  And auto rates are constantly fluctuating, making it hard to keep up with who can provide the best rate for their customers.

There’s not a real satisfactory solution for any of us.  The situation with the consumer insurance business is a lot like how the telephone business used to be.  The phone companies would have all kinds of special deals that could save you money, but they wouldn’t offer them to established customers unless you called and threatened to change providers.

Doing the same thing with electricity service providers is next.  They play the same game.

Unfortunately, we now live in a world where there is no reward for loyalty.  Insurance companies, phone companies, electrical service providers, and on and on are only looking out for themselves.  They are not going to take care of our interests, no matter how many ads they put out there about being in good hands.

I think it’s sad that the world has changed in this way.  It adds to our distrust of big business.  But it’s increasingly true that the only person that’s going to take care of you is you.  Good luck out there in the jungle.  And let me know how you’re doing.

 

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