A Brief, Imaginary Interlude...
Imagine if you will that you live in a different world, on a different earth, and in a different America. In this America, health care isn't an issue as all people are healthy and prosperous. They spend all the time that we normally spend worrying about medical bills doing relaxing things like watching television and lounging around the house. This counter-America is so great, and recreational activities are so 'necessary' that certain apartment and condominium complexes start to offer cable television as a free service to all their occupants. All one need do to to receive free cable is live in their building and pay a minor 'recreation fee,' which allows them direct access to all the building's amenities.
As can be imagined, people take great enjoyment in these amenities, and before long free cable becomes a standard expectation for all citizens renting apartments in counter-America. Eventually all buildings offer this service to their residence. But, unfortunately for all the apartment companies, no one is regulating the cable companies, as they are privately owned companies whose sole goal is to make larger profits for themselves. Well, it isn't long before the cable companies start coming up with some pretty nifty packages. Packages that include NFL Game Day, Endless Movie Stations, Pornography, On Demand Viewing and anything else you can think of. Obviously, the more they offer the more they can charge, but no one seems to mind because as long as they are paying for their monthly 'recreation fee' the apartment complex is fronting the bill. Years go by and this problem is never addressed. Before long, cable companies are charging $4,000 a month for access to cable television. It sounds crazy, but people don't care... after all, they aren't paying for it! They get every channel they can, even ones they don't need and don't watch.
But, after a while certain people start to complain... people who don't live in apartment buildings who are being charged thousands of dollars every time they want to watch their favorite team play on Sunday. Furthermore, apartment buildings start going bankrupt because of all the excessive television bills. Finally people agree that something needs to be done. Someone needs to be regulating the cable companies to stop this madness! The government steps in and they decide that all citizens in counter-America should be able to watch TV and that people who live in apartment buildings must also pay, at least in part, to have access to cable television. As can be expected, all the apartment renters are outraged that now they must pay double, triple, or even quadruple what they used to pay for television, as before they only had to paid a small 'recreation fee.' If only all those non-apartment occupiers had just kept their mouth shuts and let the cable industry run reckless, charging criminal charges, and taking advantage of a flawed system. If only... Now, let's return to our America.
As it turns out, my wife and I don't have cable. We aren't Amish or anything, we just decided a long time ago that the cost of a cable television bill wasn't really worth the money. Paying over $100 a month for TV seemed ridiculous to us, so we did what many people our age are doing; we found different alternatives, like Netflix, Hulu, and stream in channels which typically cost us less than $20 a month. We even share these services with family members to keep costs lower.
Similarly, over the past year I have been without health insurance. I'm a young healthy guy, and I rarely go to the doctor. I knew that with the new healthcare system starting in 2014 I wouldn't have the option to go without insurance in the future, so I decided to opt out for the year to save some extra money. After all, if I'm not using the services, why pay a monthly premium? Well, much to my dismay I ended up requiring a hospital visit a few months ago. As it turned out, I wasn't sick; I was as healthy as ever, but I had developed a few kidney stones. Because kidney stones are so painful I was immediately rushed back to a room in the local emergency room. I was given a CT scan confirming that there were three stones logged in my kidneys, a morphine drip for the pain, and some fluids to help flush out the stones. All in all I was in the ER for a little over an hour, I never saw or spoke with a doctor, and was released after the pain subsided.
Seeing how this was my first visit to an ER uninsured, I was wondering what the bills would look like. Well, let me tell you. According to my bill the total charges for this visit were $7,668.51. I was not given an itemized list of charges, but so far the hospital is charging me $783.35 after adjustments, and the doctor who I never actually saw or spoke with is charging me $1,595 for... well, for being in his presence, I guess. I'm told I will also be receiving a radiology bill for the scan, which I can only assume will be several thousand dollars as well. Obviously, this is very troubling. But, it is also very illuminating. As a person who is normally insured, I typically had no idea what doctors and/or hospitals were charging my insurance company upon my visits. Honestly, I didn't care... I was insured! Wanna order some blood work? Go ahead, I'm insured. Wanna do a CT scan? Go ahead, I'm insured. Wanna use designer drugs that are 10 times the cost of the alternative? Why not... I'm insured.
Even more fun is how they never asked me if I wanted scans or blood work done and at no point did they discuss the cost of these procedures, even though I told them I was uninsured and they knew I would be paying out of my own pocket for these services. Can you imagine going to Walmart to buy school supplies for your kids and there not being any prices listed on anything!? You just pick everything you want and then they bill you $8,000 later! Does that sound ridiculous to anyone else? You see, the medical industry is behaving criminally, and we as Americans not only allowed it, we created it and encouraged it!
But, now things are changing. This criminal behavior is being called out by all those who don't have insurance, those who see what the actual charges look like and are expected to pay for these services out of their own pockets. It is being called out by those who don't have a $25 copay or a small deductible.
This is, understandably, a very upsetting situation! But, what is perhaps even more troubling about the America we all currently live in is the people who are most upset by this fiasco are not the poor people who have had to pay these ridiculous fees in the past; No, it is instead the very people who created the problem itself, i.e. the people who have had coverage in the past and therefore allowed the medical community to bill their insurance companies criminally large charges, who are now being held responsible.
This is, understandably, a very upsetting situation! But, what is perhaps even more troubling about the America we all currently live in is the people who are most upset by this fiasco are not the poor people who have had to pay these ridiculous fees in the past; No, it is instead the very people who created the problem itself, i.e. the people who have had coverage in the past and therefore allowed the medical community to bill their insurance companies criminally large charges, who are now being held responsible.
Now that everyone is seeing what the not so affordable Affordable Care Act looks like monetarily, they are upset and rightfully so! They are correct, the fees they are expected to pay are too high and are completely unreasonable. But, what they aren't understanding is that the reason the fees are now unreasonable is because they have allowed a private industry to take advantage of an imperfect system, and they have not only allowed it but they have encouraged it through their own behaviors and actions.
So, what's going to happen now? Well, probably a lot of things, and it is certain that this mess won't be fixed anytime soon. Yet, I can tell you a few things that will start happening immediately once these new plans do go into affect. For starters, people won't go to the doctor unless they really really need to. Once they have those high deductibles which mean those visits will be coming out of their own pockets they will start finding cheaper more creative and arguably more healthy alternatives to their own medical needs. Got high blood pressure? Stop eating steak for every meal and start eating something green. Anxious about the mother-in-law coming into town? Put down the Lorazepam and have a glass of wine. Having weight issues? Go for a jog. Injure your ankle? Put some ice on it. Get the point? This isn't to suggest that all medical needs are as elementary as these examples, but if we are all honest with ourselves then we know that the average American has become too dependent on the medial industry to solve their basic problems.
In short, the reason the medical industry can behave as it has in the past is because insured people didn't have to front their own bills. Now, at least in part, they do, and now, at least in part, they will. And, as a result, all people are going to start finding other ways to stay healthy instead of depending on the medical industry to dictate their well being. Eventually, over time, the medical industry will have to adjust too. If they want people to continue to pursue their services they will find a way to make their services more affordable to everyone, while still churning out a steady profit... because if the medical industry doesn't come up with a creative solution someone else eventually will. After all, there is no need to charge $100 for a pill that cost them nickles and dimes to manufacturer. There is plenty of money to be had, and in the future medical profits will eventually be based on affordability not marketability, and when that day finally does arrives it will be a huge step forward.
But... yes, the current situation definitely sucks! And it is probably going to suck for a long long time. But, let's be careful not to blame the poor people for pointing out the problem that we, the negligently insured, have created. If we and the medical industry had been responsible from the beginning these problems would not exist. It's going to take time for things to work themselves out, but recognize the problem for what it is. Don't blame others for a problem you helped create.
So, what's going to happen now? Well, probably a lot of things, and it is certain that this mess won't be fixed anytime soon. Yet, I can tell you a few things that will start happening immediately once these new plans do go into affect. For starters, people won't go to the doctor unless they really really need to. Once they have those high deductibles which mean those visits will be coming out of their own pockets they will start finding cheaper more creative and arguably more healthy alternatives to their own medical needs. Got high blood pressure? Stop eating steak for every meal and start eating something green. Anxious about the mother-in-law coming into town? Put down the Lorazepam and have a glass of wine. Having weight issues? Go for a jog. Injure your ankle? Put some ice on it. Get the point? This isn't to suggest that all medical needs are as elementary as these examples, but if we are all honest with ourselves then we know that the average American has become too dependent on the medial industry to solve their basic problems.
In short, the reason the medical industry can behave as it has in the past is because insured people didn't have to front their own bills. Now, at least in part, they do, and now, at least in part, they will. And, as a result, all people are going to start finding other ways to stay healthy instead of depending on the medical industry to dictate their well being. Eventually, over time, the medical industry will have to adjust too. If they want people to continue to pursue their services they will find a way to make their services more affordable to everyone, while still churning out a steady profit... because if the medical industry doesn't come up with a creative solution someone else eventually will. After all, there is no need to charge $100 for a pill that cost them nickles and dimes to manufacturer. There is plenty of money to be had, and in the future medical profits will eventually be based on affordability not marketability, and when that day finally does arrives it will be a huge step forward.
But... yes, the current situation definitely sucks! And it is probably going to suck for a long long time. But, let's be careful not to blame the poor people for pointing out the problem that we, the negligently insured, have created. If we and the medical industry had been responsible from the beginning these problems would not exist. It's going to take time for things to work themselves out, but recognize the problem for what it is. Don't blame others for a problem you helped create.
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