Health
January 31st, 2006 | by Dr. Forbush |If you don’t have your health, you don’t have anything.
This seems pretty obvious. I’ve written about health and wellness from time to time, but I continually get frustrated when I read and listen to people who have no idea what they are talking about. Once again, people are talking about health care and once again the conservatives are telling us that a capitalist system of health care provides the best health care for the country. I disagree, and I will explain why this can never be true.
In a capitalist system you get what you pay for. This seems to be a fair way to divvy up goods when money is somehow related to work. If you spend 10 hours in the fields and you are paid $30/hour you should certainly be entitled to $300.00 worth of food. That makes sense, you did the work and you eat the food. If someone else is working as a CEO of a bra manufacturing company, and he works 10 hours and is paid $30/hour he should certainly be able to trade some of that money for food, right?
But, in a capitalist society we also value work differently. So, since we value bras more than food the CEO at the bra company makes about $100,000 per day and the farm worker makes about $100 for the same ten hour day. That makes sense, right. So, this means that the farm worker can buy enough food in one day to feed his family about 35 meals if he is very careful. The bra maker could buy about 35,000 meals with his one day of work. So, since we value bras more than food this makes sense so far, right?
But, the bra maker can’t eat all of those meals, even if he tried really hard, and we all know some of these people who have tried. So, the bra maker will have money left over to do other things. He might decide to make more money buy purchasing other companies that make other important things like tassels or garters. He could also purchase a couple of places to live in various locations near each of his companies. After a couple of days of work the farm worker will have enough money to pay for food for the whole week and he will then use the money to pay for a place to live, perhaps he’ll rent a room or maybe a trailer in a migrant workers camp. And, hopefully before the week is out he will have a bit of money left over to save for a rainy day. On most days the CEO has already paid for food, housing and essentials in the first hour of work. He can save the extra money by loaning it out to those who might need some extra cash, like the farm worker. In this way he gets his money back, and a bit extra for doing no work at all.
So, now we came to health. Both the farm worker and the bra maker are people and they will both eventually die. But, before they die they will most likely get sick multiple times. As they get older they will get sick more and more often. Each time they get sick they will want to be healed so they can enjoy their healthy lives.
The farmer in a capitalist society will go to the doctor and ask to be healed. The doctor will see him if he has the $100, one day’s pay, the doctor charges just to look at him. If he pays for that then he will need to pay another $100, another day’s pay, to buy the drugs to heal him. If the doctor doesn’t succeed in healing him then he will need to go to another doctor and another until he is healed. If the bra maker is sick he pays the same amount, $100, 0.1% of a day’s pay for the bra maker job, 0.0001% of a day’s income including other sources, for the doctor to look at him. This seems fair, right?
However, in the real capitalist world market forces control the prices of goods and services. And, doctors only want to work as much as they really need to. So, the doctor can raise the price of his services. The farm worker may decide that a $1000 is a bit high so he will go to church and pray to God. After all He works miracles and miracles are free. The bra maker can barely notice the difference in cost, and he wants to get well at “all cost.” This is because if you don’t have health you don’t have anything. In fact, the doctor and the drug companies and the HMOs and the hospitals can all ask for an increase and the bra maker will still pay the price for quite some time before he is willing to give up and go to church.
This is the reason why market forces will never cure the health care problem. The wealthy will pay whatever it costs in order to be healed, but the poor can only pay so much before they are forced to go without. Therefore the capitalist society rations health care based on wealth. The higher your income the better your health care will be. And the Republicans were afraid of rationing health care in England? Its actually ironic that the Christian Fundamentalists that live in trailers voted to have ration away their health care to the wealthy. They voted to give tax cuts to the wealthy. They voted to give their pension funds to Ken Lay and Enron. They voted for higher oil prices so Exxon could make record profits this year. Who owns Enron and Exxon? The wealthy! They sure love the wealthy, don’t they? But, they’re Christian and money isn’t everything, your health is. But don’t worry, if you pray to God He’ll work that miracle and you’ll be cured for free.
6 Responses to “Health”
By BYOC on Jan 31, 2006 | Reply
The inability to make healthcare affordable is the thing that is ultimately responsible for the out sourcing of jobs and as a result sacking American captolism, why is there not some entrepenaur out there who can find a way to take advantage of this situation and make affordable health care a profitable venture? Any isurance company that could honestly offer lower rates to employers and individuals stands to make a mint from every buisness that would turn to them for lower rates. My belief is that the current system of health isurance is so intrenched that there is no longer any thing infact capitolistic about it. Who is actually really competing in the marketplace? I think its time to review anti-monopoly laws.
By Dr. Forbush on Jan 31, 2006 | Reply
In reality, the AMA has a strangle hold on the number of doctors that go into the system, which controls supply but not demand, therefore driving up prices. The FDA takes to long to approve drugs. Creating new cattegories of drugs in experimental, or limitted clinical stages would allow Pharmas to get more bang for their research buck. Then some type of tax encouragement to license patents to multiple manufacturers would make equipment more affordable for testing. And, I could go on….
By Bonnie on Jan 31, 2006 | Reply
The insurance companies also have a lot of say on who gets the business. I’m an alternative healthcare provider. In Washington State many insurers cover acupuncture. There’s a sort of middle panel that screens alternative healthcare providers (ie checks our licenses and felony records) and charge the healthcare provider a fee to go on the panel and agree to accept a set wage (even if it’s lower than our standard wage.). We WILL get referrals from this because people want to use their health insurance. However their health insurance is paying us below our customary wages (acupuncturists are not getting rich, trust me) and then they are telling our patients that they only have 6, 10, 12 or 16 vistis a year (most common numbers). We get these patients so that we can practice.
This really isn’t bad as far as it goes. I argue with my own insurance companies as I have a small practice. My office partner sees 50 patients a week. Perhaps 80% of them are insurance patients. We have a therapist who shares receptionist duties and she sees perhaps 35 patients a week. Both of these health areas see the same patients weekly, sometimes more than once a week. So our receptionist bills insurance for a combined total of about 70 patients a week. Calling insurance to find out why claims are denied (when we were quoted beneftis) or why something is incorrect and trying to collect and resubmit to thier satisfaction takes her about 25 hours a week. Imagine a doctor who sees 70 patients a day and 95% percent of the patient load paying with insurance. Processing online is fine for larger companies but we don’t have a dedicated line (not available in our area with all the HIPAA stuff we have to have). However even when things are processed online, sometimes payments are reported as having been made but they never make it to the account… So again, someone is on the phone trying to track down the problem.
I think the insurance industry as it stands now often has just as much stranglehold over the doctors as the AMA, Doc. It’s very scary and I feel for the people not in alternatives. Many of us can still opt out and people will still pay. We’re sort of fringe and it’s just an added bonus to a patient if they happen to be covered. In the case of traditional medicine, people with insurance (and everyone wants it) EXPECT that it will be covered and WANT to use it (they paid heavily for it).
By Dr. Forbush on Feb 1, 2006 | Reply
Bonnie,
You make some very good points about how US health care is rationed. But, the point is that we need to admit that US health care is being rationed. People with “good” insurance (those who can afford the coverage or work for companies that can afford the coverage) get better health care than those who don’t have “good” insurance. But, the point is that the US is rationing health care, which is the very reason that the Republicans are afraid of any national health care system at all. The truth is that in order to ration the health in the US in a more fair way, conservatives believe that they will loose out on being able to pay for an expensive doctor to prescribe expensive drugs. But if you look at it in another way, the poor who can’t be treated until they are on deaths door and are rushed to an emergency trama unit could be treated much earlier and not need that expensive care that strips doctors, time, money and other resources out of the entire system.
By Bonnie on Feb 1, 2006 | Reply
This of course speaks to the fact that many if not most hospitals are now “for profit” and this strips them of profits too–when the poor come in and are unable to pay. Once again this impacts the bankruptcy laws so that those who do try to pay are often under such a huge financial burden that they never get out from under it.
Our receptionist is part time and she and her husband don’t make enough to buy the medical insurance from his company. She found out she’s pregnant. It’s going to cost her $4500 to be covered until she delivers (10 months) and I guess her husband has to be covered as well. After delivery, her child will be on state medical assistance but she’ll go back to being uninsured because they can’t afford. it My office mate is a nurse and sat her down and told her why she wanted to spend that extra for all the “just in case” scenarios out there.
These young people work very hard for their money and have a lot of potential. They don’t have a lot–both cars are old, they rent a small house, she shops mostly at resale places and they eat cheap food, she brings her lunch. Up until the pregnancy discovery, she had a treat about once a week of coffee from the coffee stand outside our office. They and their children deserve better from our world than to be shunted aside and making choices about whether to eat or to afford healthcare simply because they are not amongs the fortunate few to be rich enough to purchase a doctor…
By Bonnie on Feb 1, 2006 | Reply
Oh and don’t tempt me on the AMA discussion because that’s another hot button…