Backing up a long way to when I was raised in a thriving middle class family in a small town, I will just say this: medical care was accessible and affordable, insurance was mostly for catastrophic circumstances, nursing care was wonderful, medical care was personal, and we knew who our medical professionals were. People did not go to the Dr. or the hospital unless there was a real need. By real, I mean something that could not be fixed with homeopathic remedies. The only checkups required had to do with schools for athletic participation. Vaccinations were required to participate in schools for the sake of eradicating infectious diseases. I knew of no one who could not afford or access healthcare if they needed it.
Flash forward to the 1970's. After Johnson in the '60's enacted Medicare and Medicaid, insurance rates rose and government regulations began to intervene in the medical profession. Granting that medical technology advancements would cause prices to rise somewhat, and inflation would effect the prices as well, the costs to families was still mostly within reach. The birth of my first child cost $185.00 for three days in the hospital in 1973. The entire price of bringing him into the world, including the preliminary pregnancy checkups was under $500.00.
Flash forward to 1986 when I had two young children and went through a divorce. From that point on, for 13 years, I lived without health insurance. By 1991 I owned a small business with 3 part-time employees, 2 full-time employees, and 50 independent sales reps who were commission only reps. There was no way at that time my business could afford a health coverage policy for such a small pool of employees. Insurance rates were escalating yearly. Even then, one could still afford, out of pocket, regular checkups. As I recall, during those 13 years. it was $18.00 to $24.00 to see the Dr. for a virus or a cold with a nasal infection. During those years I had a broken leg (can't remember the cost of that with emergency room and follow up care) and a minor surgery that cost around $2000.00. The most difficult of costs for me at the time were dental crowns that cost $300.00 per. I needed 3 of them during those years. I would have loved to have a "catastrophic" insurance policy with a high deductible of $5,000.00, or something like that, but could not find one that either existed or that I could afford. ( Being a person of faith, I'm sure the Good Lord protected me from that "catastrophe," so I could continue to raise my children and take care of my family.) Other than that concern of an unaffordable catastrophe, I was perfectly willing and happy to pay for all of my medical care out of pocket. I would still be happy to do that if the costs were still as affordable as they used to be.
Flash forward again to the early 2000's. The cost of going to the Dr. for a cold, infection, virus treatment, or non-life threatening events had gone up to over $60.00. (Now I think it might be $80.00 or more.) I married in 1999 and due to my husband's employer policy, I once again had insurance coverage. Dental crowns today are $800.00. (From $300.00 to $800.00 in less than 20 years' time. Whew!) Insurance rates are high and higher. What I could not pay for insurance earlier in my life is now only affordable because of employer co-pays in a larger insurance pool.
So what has caused the cost of medical care to go out of reach for most people? Someone please tell me? I'll give you my opinion.
One would expect some inflationary rises in medical care just because that exists in all of our monetary policies. You could look at supply and demand, with more people and fewer medical professionals. Those two aspects would increase prices to some degree, no doubt. Nothing costs the same as it did even a few years ago. But what would make healthcare unaffordable for most people. As you can tell from my story above, insurance was already out of reach for a relatively young small business owner by the 1990's. But in the 1950's, 1960's, and 1970's my Dad was a small business owner with under 4 employees and he could easily afford health insurance for his family.
Throw in all of the advances in medical technologies, the increasing population (demand), but then, throw in Medicare and Medicaid. Every medical bill you and I pay has built in it an increase to cover the costs of patients who are under those two programs. Every use of equipment has that built in cost as well. Yes, you might say, wait a minute, "Aren't people paying into those programs through taxes and withholding?" Obviously government programs have skewed the patient cost ratio because the answer to that is, "Yes, paying, but not covering enough." Why? We were in much better shape on medical expenses before Medicare and Medicaid. The government (Lyndon Johnson and Co.) wrecked the system. Medicare is a disaster in much the same way Social Security is a disaster due to demographics. The government socialist program of Medicare has done what all socialist programs do, i.e. intervene in the market in such a way as to make everyone miserably poorer.
Article from the Clinton era debate on government run healthcare.
Reason TV article on how Medicare and Medicaid caused the rise in health care costs."Let's go back to 1965, when Congress passed Medicare and Medicaid.
Most of the elderly already had health insurance. The poor were treated at city, county and charity hospitals. The right to emergency treatment, regardless of insurance, had been enacted under Eisenhower. Medical care was available to only slightly fewer people than now. But medical costs were less than half today's level - 5.9% of the economy.(1)
Since 1965, health costs have more than doubled, to 14% of GDP, and are projected to triple by the year 2000 (2). Government now pays over 43% of all medical costs (3) - and shifts billions more to private insurers. From a 1991 CBO report: Medicare was underpaying hospital average costs by 12%. Medicaid was underpaying hospitals by 12%., and paying doctors 31% less than Medicare rates. (4)
When government underpays, providers shift their costs to private insurers and cash customers."
"The rapid rise in health care costs is primarily the consequence of government policies."
It makes me think of the shopping admonition: "You break it, You own it." The progressive leftists live by that phrase. They break everything and then they own everything. But my healthcare is mine. I don't want some progressive leftist government bureaucrat making those decisions for me, or even knowing anything about me. They broke it. They should never be trusted with your healthcare or mine. Ever. They break everything. And they will break you and me and our nation with government run healthcare. They already have. The answer is to get them out of it. Pray for the Supreme Court to at least begin dismantling Obamacare and the progressive leftists' take over of your life and mine.
Excellent analysis. I work in Healthcare, and I can tell you it is not the uninsured that is causing the rate increases, but the Medicaid mainly that is the problem. A bare pittance is paid. Medicare, a slight loss if we do not kick them out of the hospital fast enough, but for the most part a break even. It is the paper work that is the issue. Now Docs need a whole bevy of assistants. Growing up, it was the Doc and a nurse. No appointments, you just showed up.
ReplyDeleteThanks, Bunker. I didn't know you were in that field, but you would have a good perspective on this since you are. I am amazed at the amount of assistants in the Dr.'s offices and often you get shoved to a PA and never see a Dr. I hear there will be a shortage of Dr.s as time goes on. As it is we are importing them. The cost of medical school has overwhelmed the Dr.'s ability to pay for it, the cost of doing business has escalated out of control, and then add the Medicaid problem you mention. Medicare will get worse thanks to aging baby boomers (me included) and Obamacare. You can't run a business on losses.
ReplyDeleteIt's another mess created by meddling politicians. How do we make them stop?