Hey gang, I’ve been in insurance and human resources dealing with benefit plans. I’ve come to the conclusion that employer-based plans are a big part of the problem. Here’s why:
1-Employers buy the plan. Even if they give the employees several choices, and the employees pay a portion of the premium, it still keeps the employee in a position of being a dependent of the company. This does not foster taking charge of your own health.
2-It is a source of dissatisfaction. When the employer tries to contain costs, but the employee feels a need for more services (whether or not there is a good reason to believe these services will be effective), the interests of the employer and the employee collide. The employer can’t win this battle! Nor can the employee. As a result, it is one of the most non-productive investments an employer can make in their total compensation package. AND YET, it is a minimum requirement to get and keep a reliable workforce.
3-It desensitizes people to the cost of their healthcare. When they do not appreciate the cost, they often insist on irrational things (do we all know that the biggest real risk to public health are the drug-resistant bacteria from all the use of antibiotics given to people with viral cold/flu’s)
I don’t think the government will do a better job! Just being dependent on the larger group makes us even less powerful and less likely to take control of their own healthcare. It just relocated the big brother healer from one dependency relationship to another.
The government doing it won’t save money if we remain in a situation where there is one place offering the service and a middle-man taking care of the payment. Somewhere I read that around 40% of the price we pay for insurance is absorbed by the administration of claims and only 60% goes to the supply of healthcare goods and services. Since this doesn’t involve case-management (advice on how to get the best services from the system), it only involves claims processing, I’m thinking that this is a lot to spend on something that doesn’t add any value!
What we need are sweeping changes. The problem is that too much will get broken and many people will suffer while we work this out. Fact is, that’s already happening, so maybe we should just get on with it.
I like the idea of buying groups – for the practiioners, for the clients. The ancient concept of guilds comes to mind. Masons, artisans of every kind, each had their guild. They determined the standards of practice, the standards of training, and they looked after their members. People would be thrown out of the guild if they failed to meet the standard of performance required by their profession. They helped them find work, they provided community and support. They looked out for their own if someone became sick or injured. They were generally democratic.
Seems to me like the Screen Actorss guild and Actors’ Equity might be models for us to use. There are even homes for members to go to as they become old and frail, if I’ve got this right.
Now some members of society are on the fringe, and unable to qualify for a trade/profession related guild. In such cases, there could always be church-related and university training hospital-related charities. All of the best hospitals in our region began as charities.
Another part of our problem is with the following:
Lawyers
Insurance Companies
Medical Profession failing to monitor themselves for incompetant practitioners.
Demand for high profits from medical device and supplies and drug companies
Guilds for the docs and nurses self-funding and self-regulating would get us away from middle-men taking a profit on malpractice insurance.
Guilds for the lawyers throwing out the ones who bring down the profession by filing nuisance complaints – Guild would have to pay court costs out of their coffers for all health-care filings regardless of outcome
Guilds for workers who can bargain for healthcare buying-power - as democratic societies, with accountability to one-another, there would be peer-pressure to maintain healthy habits, use services wisely
Guilds for medical clinics to purchase supplies
Note, in 1975, I worked for a company that made a little test strip for in-doctor’s office dipping into urine – it turned a color to indicate the presence of a bad thing. The test strips cost the company less than $0.00003 to produce – including all of the research that went behind it, all of the wages of the people that handled it, and shipping. We sold it to the supply house for a dollar a test strip. The supply house sold it to the doc for five dollars a test strip. The doc charged his patients ten dollars for the test. I didn’t do the math to determine what the mark-up was, but it’s gotta be about a go-zillion percent.
Want to make health care more accessible? Making it more affordable is a good place to start. Pharmaceutical companies get a big black eye because they are the obvious ones. But there are a lot of places where this happens all up and down the supply chain. Putting our heads together to bargain for better pricing on all the things we use is a good place to start