To begin with, medical care needs insurance like a fish needs a bicycle. All the angst over the government getting between you and your doctor ignores the fact that the insurance companies are between the doctors and their bank, a more meaningful relationship than any government program. Doctors recommend a procedure or treatment, then call the insurer to approve payment before they sharpen their scalpels. If the company denies coverage the whole affair goes to appeal and many patients die in the extended interim. You not only have to pay for treatment, but the doctors want guarantees in advance from the companies they depend on to support the unforgivable costs of white coat repairs.
Without the insurance collusion of the industry the medical profession would never be able to protect itself from the market process of our free market society. In every aspect of our economy, we are told that demand drives supply and controls costs. Shortages of tech workers for the silicon industry triggered the import of south Asian low-wage workers, the industry expanded but wages dropped and the digital designers had to adjust to being reduced to skilled workers in an industrial labor force.
In medicine, a combination of torture and greed are used to foster a shortage of doctors. The workload in pre-med, the rigors of med school and internship are all calculated to weed out any but the most altruistic and the greedy. Dedication and personal ambition drive the survivors of the process, spitting them out into an economic crisis of college billings come due and start-up costs for a practice. And here comes the insurance gang again, charging huge premiums for malpractice coverage, forcing doctors to order redundant medical tests and procedures, driving up costs yet again.
The combined influences of the medical professional societies and the insurers have created a market for health care that is overpriced to a degree that only insurance can cover. Doctors are scarce, and well paid for in an increasingly technical trade. The advances in medical tech are incredible over even the last decade. Digital imaging and real-time internal scans, micro-surgical robots, neurosurgery under local anesthetic and super glue for closing. Today the skill set for doctors is less demanding than the practice of two decades ago, much less the fabled days of house calls where your local doc smelled the child and examined throat and fever to make a diagnosis.
In countries with national health care and free education for all, including medical school, doctors are paid a decent worker's wage, but nobody gets rich or Wednesday off for golf. There are small clinics every few blocks in the city and in every village in the countryside. The average doctor sees half as many patients as in the U.S. where pay per visit profits are the incentive.
With the impending surge in elderly baby boomers and increasing demands for health services, America needs to produce lots of doctors who work for less and cut the costs of the current practices such as disposable instruments and devices that could be sterilized and recycled. The medical industrial complex needs to be trimmed back to basics, and the first element needed is the removal of the insurance companies profiteering.
Until that occurs we will continue to tinker with the details of a system that fails its mission for profit.
“Travus T. Hipp” is a 40-year veteran radio commentator with six stations in California carrying his daily version of the news and opinions. "The Poor Hippy’s Paul Harvey,” Travus is a member of the Nevada Broadcasters Hall of Fame, but unemployable in the Silver State due to his eclectic political views.
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