Saturday, February 18, 2012

Feelin' A Little Dodgy Today--Lessons In Universal Healthcare

We lived in the UK for almost five years and we used the National Health System (NHS) while there. It was easy, convenient, and, for the basics, it was good quality health care. When I went to the local clinic I never had a copay, nor did I pay for kid's prescriptions, eye care...anything. For the most part this was how British citizens handle their health. In fact, one of Jim's UK coworkers was fond of saying things like...
(NOTE: to get the full effect, read this quote with an English accent) 
"I'm feeling a little dodgy today. Think I'll go to the local surgery (healthcare clinic) and see the doctor." 
This was usually followed by a day off of work. That is the way the system works. It's free, it's easy, people use it that way.

One way our friends Mitt Romney and Barrack Obama have sold their health mandates is that it will cut healthcare costs. If you can find someone willing to show you the numbers, you'll see that RomneyCare has proven that to be false. Not only is federal tax money used to fund this plan in the first place, but it has cost the taxpayer far more than expected. The CATO institute has an interesting article on the fate of RomneyCare in Massachusetts. It explains that the two goals of this universal healthcare plan...all residents covered and costs of healthcare reduced... were in fact NOT achieved. After going through the numbers of those uninsured before the mandate, and then those insured as a result of the mandate, the author says this:
...between half and two-thirds of those uninsured before the plan was implemented remain so. That’s a far cry from universal coverage...The much ballyhooed mandate itself appears to have had almost no impact.
Apparently whatever progress that was made toward reducing the number of uninsured was almost completely due to subsidies. Most of the uninsured who became insured were those who qualified for some sort of subsidized healthcare (paid by the tax payer). And the result was...
...the plan was projected to cost $1.8 billion ... Now it is expected to exceed those estimates by $150 million.  
But, in my opinion, the most telling line of the whole article was almost an aside. While talking about the number of uninsured who signed up for subsidized programs, the author says in passing:
The bigger the subsidy, the faster people are signing up.
THAT'S IT! There is one simple reason that universal healthcare will not result in lower healthcare costs.

We like free things. 

If you never have to open your pocketbook at the doctor's office, then you are much more likely to use that doctor unnecessarily.

If it feels free (I say feels because we pay for it in taxes) then we take advantage of it. It is part of our fallen human can hardly blame us. But we are just as UNLIKELY to take the doctor's advice to lose weight, quit smoking, eat better, and relax a little. You could also say that we are just as likely to avoid the doctor when we suspect something serious because we fear what we might hear.

Being able to go to the doctor freely does not translate into healthier lifestyles. Where are all the uber-healthy Cubans? Are UK residents living longer these days? The only way to ensure that happens is to outlaw unhealthy behavior. And we all know where that is leading us...Michelle Obama, A.K.A. The Sugar Sheriff or The Cholesterol Constable.

These days we have the cheapest healthcare plan we can get through Jim's work, with the highest deductibles. We pay when we go to the doctor. I recently paid well over $100 for a small bottle of ear drops. Outrageous. But, I stood there and quickly assessed---do we need this right now? My answer was yes, so I paid.

There are two interesting points about those ear drops: even with that incredible price tag, it is cheaper for us to pay the low monthly premium and pay out of pocket until something is covered AND if health care was part of the free market, those ear drops would not be $100.

What if you budgeted for healthcare like you did nutrition care (groceries, etc). And you bought an insurance policy (much like your car insurance) that was meant to cover you in case something horrible happens (major accident or illness)?

How would you react to a doctor's advice to change your diet to avoid heart disease? You might take it more to heart (pun intended). You also might asses your own reaction to minor illness (i.e.: "I worry too much and would rather have a doctor's input"; or "I think we rely too much on medical advice and most things can be handled at home") and then budget accordingly.

One of the greatest things that we have found to help us budget health expenses is our Flexible Spending Account (sometimes called Health Savings Accounts) which is a set amount of pretax dollars used for uncovered expenses. We have used ours to cover eye care, dental care, private speech therapy, among other things. By the way, Rick Santorum was a major sponsor of the bill that made these more available, and it was an alternative to Hillarycare, the Evil Stepmother of Romneycare and Obamacare.

The way healthcare in this country works, pre-Obamacare, is that we have come to depend on our employers, or the government, to provide us with a "healthcare plan". This means that we are part of a plan that covers a huge group of people with a wide variety of needs and wants and we pay for both those needs, and the wants. Premiums continue to go through the roof because they are no longer dictated by the market, but are determined more by federal regulations and the size and diversity of the pool of participants. American's are used to, even addicted to HMO style healthcare (Thank you Ted Kennedy!).

Obamacare is HMO's on steroids. While we all "pitch in" via taxes so that everyone has "free" healthcare, those costs go through the roof. The government then has more incentive to legislate healthy behavior and to decide whose health is the best investment.

And we give up more and more freedom.

Ironic isn't it. Our love of free things comes at a cost: our freedom.


  1. Amen and Amen!
    Just out of curiosity, how did taxes in the UK compare to here? I realize that's more complicated to answer than it sounds, but I think it's important for people to know they'll be paying about X% more in taxes for all this "free" health care.

    1. Hi Amy,
      Yes, taxes there were higher. I really don't know how much since my husband's employer handled the tax situation.

  2. I love how you stated it: Obamacare is healthcare on steroids!