THE INSANITY OF MEDICAL EXPENSE

Medical expense is an almost universal problem (except for those who are making a fortune on it).  You who are reading this essay have had to face outrageous medical expense.  You don’t need horror stories about them, but those stories are as common as fleas.  I recently had to pay $5000 for a test to see if I could get a new sleep machine to replace the one I had been using for twenty years.  The machine cost under $300.  Medical expense has become the most common reason for personal bankruptcy.  And then there are the hedge fund folks buying up medical providers and tripling and quadrupling the cost of life-saving devices like Epipen.

So we are all desperate to solve the problem, and yet a viable program to solve it has become a political football.  That makes no sense.  Republicans are suffering just as badly from the outrageous cost of medical care as Democrats or Libertarians or whatever.  Yet they yell at each other across the aisle, nothing gets done, and the folks profiting from this madness smile complacently and plan another price hike.

There is only one solution, because there is only one problem.  The cost of health insurance rises only because the cost of medical care rises.  The problem is the rising cost of health care, and the solution is to stop those rising costs.  We have to stop providers from building one hospital on top of another.  We have to stop drug companies from playing patent games to keep the cost of common drugs irrationally high.  And we have to streamline the insuring of medical cost so as to eliminate double and triple and even sextuple insurance premiums for the same bills.

So, smarty pants, you might well ask, what is this one solution you think you have?  Okay, here it is, but you have to think a bit here.  First, install truly universal coverage.  Cut the country into grids, auction off the sections to existing medical insurers, and let them provide the coverage for their sections subject to a public service commission to supervise their profits.  In other words, make health insurance a utility, like water and electricity and gas.  Then, take coverage for medical expense out of every other kind of insurance and every other kind of claim.  Since medical expense is covered for all, there is no need to provide for it in worker’s compensation claims or auto claims or products liability of medical malpractice claims.  There would be a sharp reduction in the premiums for these items.  Finally, allow the companies, either alone or in concert, to negotiate the cost of medical expense.  Let them negotiate with drug companies for a better price on drugs, with the providers of medical machinery for a lower cost for expensive machines like MRI and CT scan machines.  Let them negotiate the price of a hospital stay.  Let them, in other words, have the power of collective bargaining that will reduce the cost of medical care across the board.

The real insanity of the present situation is that the medical industry has control of both supply and demand.  It tells us what we need, and it supplies what it tells us we need, and it sets the prices without discussion.  It is as if a car dealer would call you and tell you that you need a new car, and then, after he delivers the new car, hands you the bill without ever having discussed it.  We are consumers with absolutely no rights as to what we are supposed to consume or how much we are supposed to pay for it.  That is nuts, and it is damaging all of us, regardless of our politics.  It is up to all of us to go pound on political doors left and right and tell them to stop playing this lunatic game and solve it together.

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