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Wednesday, August 5, 2009

A Real Health Plan Reform

According to the Obama administration and his ideas for "health care for all", most Americans are going to go broke with this idea.

Obama's plan is to make insurance a requirement that all Americans will have to carry and of course pay for. Lets look at this for a moment.

1. If "all" Americans could afford health care they would cover themselves and their families.

2. If all businesses could afford to pay for health care for their employees most would do so.

Now as stated, according to Obama's plan it will be mandatory for all businesses (even the small ones) and all individuals and families to have health care. The problem is...for an individual it will cost approximately $90-120 a month. I for myself cannot afford to pay this out. As it is I am required by law to carry car insurance and that in itself kills me.

Small businesses barely stay afloat as it is ...otherwise they would not be "small". To require a small business to dip into the small amount of profit they generate to cover the cost of health care for their employees will break them.

So the question is ...Why is it that most people do not have health care? Of course we know it is due to the money. But what if we put a cap on what insurance companies could charge? What if we put a cap on what the pharmaceutical companies could charge? How about a cap on what Dr.s can charge?

An example: You go to doctor "A" for a yearly check up. Dr. A charges $90 for the visit and then an additional $30.00 for the exact reason you were seen. (I have been a medical biller and know what I am talking about). Now you go to Dr. "B" for the same yearly check up and Dr. B charges $190 for the visit and then an additional $75 for the reason for the visit.

Anyone else see a problem here?

Now while seeing Dr. A you wait for 1 hour to be seen, but when the Dr. does see you, he or she spends quality time with you and listens. While Dr. B you wait also (AS ALL DOCTORS MASSIVELY OVER BOOK) yet Dr. B comes into the room and is out of the room in approx. 5 minutes.

You know what I am talking about!

Then every Doctor wants to send you for lab work and yet when you tell them you just had this done you are told.."yes but not by me". As if what they will do will be any different. In fact I just had this done to me. The Doctor told me his lab work is more inclusive and therefor needed to be done. Ironically I was sent to the same place "Quest Diagnostic".

The reason: to get paid more.

Then there are the numerous "prescriptions" you need to purchase. Here is how that works. In a Doctors office, "drug reps" come by all the time and "smooze" the Doctor with food and treats. The Doctor is then given a percentage for each "script" he or she writes with that particular drug. Thus the Doctor makes money by giving you drugs. The drug prices then go up because once again someone else has to be paid.

Example: The drug Lipitor cost about $5.00 to make per person per month. However, to buy Lipitor costs about $270.00 per month per person? To many "greedy" hands in the mix. The drug company sells at a higher price, the drug reps get a cut, the Doctors get a cut, the pharmacy gets a cut and everyone who handles this along the way gets a cut.

Who gets screwed here...we do.
Why do you need a "drug rep"? Isn't that like pushing drugs? Which I believe is illegal...but not for these drugs. Why does the Doctor get paid to write out the scripts to people who really need this? And better yet why does the Doctor get paid to write out scripts to those who don't really need it. Why do the pharmacist need to get paid $50.00 and hour?

Based on the above what really is going to change with Obama's plan? Not only will I have to pay the above fees anyways but I will have to cover the required plan also.
And then you know full well that Doctor's fees will continue to rise, the pharmacist will get paid more, the drugs reps will push more drugs and still there will be no end. And in the mean time the independent insurance carriers will continue to jack up their prices.

So why not put a stop to this jacked up inflation? What if the Doctor could not charge outrageous fees? What if the Doctor had to treat you with respect and not just as a dollar sign? (ever go see a Doctor when you only had medicaid? which by the way is a state/government run program) I can tell you first hand, number one good luck finding a Doctor who will take this and if you can ...good luck getting good care!

What if the insurance companies were across the board...meaning why do you pay $700 plus if you live in Texas and yet from the same insurance company with the same policy in New Mexico you only paid $187.

Once again we need to put a cap on things.

Why couldn't we get a script from the Doctor and get our prescriptions filled directly from the manufacturer. We do that all the time with everything else...wholesale product direct from the maker. Cut out all the middle men and we would be ok.

If you saw a Doctor once or twice a year and they only charged $90 people could afford to cover their own expenses. If every Doctor did not have to repeat the same tests over and over again...

You see where I am going with this. Now with Obama's plan once again those of us who cannot afford this will be screwed and in the mean time the Doctors, Pharmaceutical companies, Pharmacies, Insurance companies and drug reps will continue to raise prices.

My proposal for a real health plan reform is to CAP this madness and stop letting the "big wigs" rip us off. All insurance should cost the same.

Yes I know you are saying...but some people have lots of health care issue and it costs a lot of money to take care of them. But my question to you would be this...
If there were caps on the amount of money Doctors and hospitals could charge...would it really cost that much? Why is it that a CAT SCAN cost 1000's of dollars? Why is it that when you are in the hospital and ask for an Excedrin they charge you $8.00 a piece? For $8.00 you can buy your own huge bottle of Excedrin. Why is it that a bandage in the emergency room costs you $800.00

Lets get real here. Again think of who is making the money. And think of who is paying out the money.

It used to be Doctors cared about their patients, now it is pretty much a money game. I recently was sent to a surgeon who found that I have a mass by my belly button on the inside. When I asked what he was going to do about this he told me " I am going to send you to so and so and let them deal with it". I spent 3 months seeing this surgeon just to be brushed off? Only a month after this, this same Doctor was in the paper as he turned his gastrointestinal practice over to gastric bypass totally.

Makes sense now...why do a procedure to help me at only a few thousands dollars when you can see Joe Blow and charge $50,000?

Again as always I ask:

Did you Agree to this? Did you say this? Did you vote for this?
I never said that! Did you?


  1. Well, the doctors don't make any money off of the lab work. And all the doctors I know - and that is a considerable amount - don't get up each day and go to work saying, "Now what tests can I charge to make the most money today?"

    You see, you have a vicious circle casper. In 1942, tax breaks for employers to purchase health care were created. That started the downhill slide into the 3rd party payer system we have now. In the '60s when Medicare was created that began the meteoric rise of health care costs. Insurance companies saw the Government as deep pockets and began raising prices. Today doctors who have their own offices have enormous overhead. Malpractice insurance alone could be upwards of a half million dollars a year for premiums. In my state it is and that is why there is a shortage of doctors in downstate (downstate meaning everywhere except Chicago) Illinois.

    So putting a cap on things will only create more problems.

    True health care reform will only occur when the consumer (you and me) begin to be the ones who control the purse strings. When you have to pay for your own insurance and you have to worry about your premiums going up, then you are compelled to shop around, as it were, for the best deals. That is not done in this day and age. When the doctor says you need an MRI, you just go, okay. And go get one. If you were paying for it yourself, or paying the co-pay based on the actual charge, then you would stop and ask where the best, lowest cost test could be obtained. That happening millions of times a day, every day of the week would be a driving force behind bringing costs down. When you don't have to pay, say your employer provides your insurance, you don't think twice about the costs. That is the downfall of the 3rd payer system. Let's get health care back into the hands of the consumer.

  2. Great eye opener. It is true that we should be in control and we should do more to find the best price. That is what I was meaning by putting a cap on things. Why should healthcare cost so much for everyone? As you stated even the Doctors must pay so much etc. Great point!


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