We have no idea what health care really costs. I know this for a fact. Last semester, I sat in a Georgetown University classroom conveniently located right across the way from Georgetown University Hospital. The class was about the political economy of delivering health care. The professor looked at all of us, pointed out the window and said, “Do any of you know how much it costs for one night over there?”
Silence. Even though we all have a sense of how it works. Even though some of my classmates work there. Even though we’re all sitting in one of the best health studies schools in the country.
“Anyone care to hazard a guess?”
“$18,000. It costs $18,000 for one night in Georgetown Hospital.”
Hot damn, Georgetown Hospital is expensive. And yet the waiting list for doctors and surgeons is miles long! It’s expensive because the waiting list is miles long. High demand drives prices upward.
But you can’t change demand for medical services, right? If people are sick, people are sick! Out of all the doctors’ visits in America, 80% of them are for either people who are not sick, or for issues that typically resolve themselves within two weeks.
If we knew the real cost of health care – threw out copays and paid a doctor what he charges – we would demand health care services differently. It might be worth a $20 copay to me to be told I have strep throat – but it’s not worth $200, which is closer to the doctor’s actual fee. If we had to pay what health care actually costs, we would all use CVS, WebMD, and home remedies a whole lot more often. And we’d probably get similar results at a much lower cost than what a doctor would provide. If the market were really free, we’d be buying insurance policies only for catastrophic care.
Instead, states require insurance companies to cover all kinds of services that most people don’t want. If you’re a dude, you probably aren’t super concerned about getting your maternity care covered. If you live in Georgia, you and your employer are going to be paying for a hypothetical birth to a hypothetical child. Live in California? Don’t mind the dentist? Well, the government requires insurance to cover general anesthesia for some procedures.
Let’s say you’re a Vermonter and you’re about to have a new baby. Your insurance is required by law to cover you popping out that new baby lumberjack at home, which might be riskier than having your baby in a hospital. The insurance company is required by law to take on the added risk of home births, as opposed to hospital births that take place with some of the best technology for both mothers and babies that the world has to offer. (Fact: I was raised in the Deep South and believe that everyone in Vermont is a lumberjack. Humor me.)
Instead of letting the free market do its free market thang, Big Government cooked us up a nice hot steaming plate called the Patient Protections and Affordable Care Act.
There are a lot of things to hate about this bill. For starters, the cap on what an individual or household must pay is determined by their distance above or below the poverty level. So now, if you’re sick – it’s in your best interest to also be poor. If you live in a low- or middle-income, two-income household and illness hits, the best thing you can do is split up that household so your income gets cut in half and your health care costs decrease sharply. It’s kind of awful to ask people to slice-n-dice their homes and assets as a means of lowering their healthcare costs.
That’s an obvious issue with the bill — the constitutionality (or lack thereof) of forcing people to buy something they don’t want. People have argued this before and I’m not going to rehash that fight here. There are huge issues with this bill, but the devil’s in the details.
According to Section 1302, Subsection 3, any healthcare plan must cover “essential health benefits.” Who decides what’s essential? Not me. Not you. Big Government.
This bill, which was supposed to punish those awful greedy insurance companies who, you know, make it their business to keep people healthy (the horror!), actually provides a deduction for Blue Cross Blue Shield (Section 9016).
The bill also includes a tax on voluntary cosmetic surgery (Section 9017). Oh, and it gives the Secretary the power to allocate an unlimited amount of money to local grant programs (Section 4201). Nothing says affordability like taxes and unlimited government spending, am I right?
This 1,000-page whopper of a bill may be a little hard for ‘sheeple’ like you and I to understand. Government knows best, so they established a “ready reserve corps” (Section 5210) to be deployed in case of a health emergency. Still no word on what the government thinks a health emergency is. But get excited because, when things go wrong, now there’s a FEMA for your body!
And for when there’s not a health emergency, government still has us smothered covered. They’ll be establishing a website where people can go to get their health questions answered (Section 1103). This is totally great because we definitely don’t have private sector websites, like MayoClinic, LiveStrong, and YahooAnswers to answer our questions!
Our terrible, terrible questions…
It’s only a flesh wound.
What this bill does to healthcare is terrible. For your average doctor’s visit, or even in the event of a medical catastrophe, this thing doesn’t do much good for anyone besides the government. But things like websites, grant programs, and the health reserve corps all deserve some outrage, too. They’re all symptoms of a sick government trying to regulate its way out of problems caused by an overreach of insurance regulation.