posted on August 11, 2009 12:27
By Joe Pangburn, Inside Tucson Business
Published on Monday, August 10, 2009
If it’s not broke, don’t fix it.
In terms of the national health care system, there is a debate on whether is it broke or not. Most can agree it does have problems that could stand to be fixed, but the best fix is the focus of the current national debate resulting from a push for a government option in health care.
“All agree there are some problems with the health care delivery system,” said John Munger, an attorney with Munger Chadwick. “But it is the delivery system that has the problems; our health care service is the best in the world.”
Munger said there is plenty of competition in the marketplace and we don’t need the government to come in and compete as well as be the regulator.
“They will regulate to win if they enter the game,” he said. “They will run other companies out of business and there won’t be any level ground for those companies to compete on.”
According to a Time magazine poll of 1,000 Americans published in the Aug. 10 issue, 89 percent of the respondents said they are currently covered by a health care plan and 86 percent of respondents said they are happy with their current coverage.
“This isn’t about making sure everyone has health insurance,” said Harry Lodge of Harry S. Lodge and Associates. “If it was just about covering everyone, we could do that. They want to fundamentally change our health care system. It is a back-door approach to a single-payer, government-run system that we know doesn’t work from all the other countries around the world who have tried to do it.”
Munger agrees with the pro reform group that costs are out of proportion and need to be corralled.
“This isn’t the way to go about that however,” he said. “They’re using Medicare as an example, but that program is bankrupt. They are actually paying pharmacies and doctors below costs and everyone who isn’t on it pays above cost to subsidize it. If there becomes a single-payer, government system, there will be no private sector to subsidize it, so how could it stand on its own?”
Rosanne Wolf with the Southern Arizona Chapter of the National Association of Health Underwriters said the average person pays about 1.55 times the cost of health care.
“The consumers don’t understand that what they pay is inflated because of government programs,” she said.
Munger said the numbers proponents of the government plan are throwing out there are completely deceptive and misleading. This is causing the discussions people have to not address the real problems.
“They say there are 47 million uninsured people out there,” Munger said. “I’ll take their number, but that count is including around 12 million illegal aliens, 16 million people who are between jobs but will get insurance in 30 to 60 days and nine million young people who don’t want to pay for insurance. So really we are looking at 10 million people who really can’t afford insurance. For 10 million people, let’s fix the problems that exist and not change the system entirely when so many people are happy with it.”
He also takes issue with the saying that the United States has a higher mortality rate than other countries.
“Many factors go into that, one is simply that we count a life at birth, where other countries don’t count it that way until two weeks after birth,” he said. “What they should look at is the survival rate of cancer patients. Our recovery rate from every type of cancer is higher than any other country in the world.”
Munger offers several solutions to fix the problems the system has rather than change it completely.
One of the first problems, he said, is that many who qualify for the Arizona Health Care Cost Containment System (or medicare nationally) simply don’t sign up for it.
“We need to get the forms to sign up for this in the doctors’ offices and hospitals so that when they come in for something they can sign up right there,” he said. “We have a safety net for those who are uninsured and they need to take advantage of that.”
One argument for this change in the system is the fact that there are so many people out there with pre-existing conditions that can’t get coverage.
“If someone signs up for an HMO, there are no pre-existing condition clauses,” said Lodge. “With a PPO there are but it only takes effect if you have been more than 60 days without insurance.”
Munger suggests to even then let all pre-existing conditions be covered but take note of the pre-existing condition.
“For something like cancer, absolutely you have to take it and you can’t charge someone more,” he said. “But if it is a condition that is due to a lifestyle habit, the companies should be required to take it but be able to charge more for it.”
The next fix comes in the form of tort reform.
According to Lodge, we are the only country in the world that allows people to sue doctors and hospitals. Because of this doctors have to purchase large amounts of malpractice insurance.
“Which in itself is 50 percent of the cost of the health care industry,” Lodge said. “If we set up an arbitration system and could work it out that way that would dramatically bring costs down. But no one on Capitol Hill wants to talk about that because they are all attorneys.”
Munger suggests an even simpler fix to tort reform.
“Let’s make the change so that in those cases the loser pays the attorneys fees,” he said. “Right now plaintiffs don’t have any skin in the game and can take a free shot at a doctor. But doctors are winning about 85 percent of these cases and nearly 50 percent of them are frivolous. If the person had the risk of possibly being on the hook for $100,000 in attorney’s fees if they lost, that would eliminate many of these suits.”
The final fix would be to turn the system into a free-enterprise system where the consumer has the information to make informed decisions.
“People wonder why health care costs are rising so rapidly,” Munger said. “Well shoot, if no one asked me what I charged either I would raise my rates as well.”
He suggests all doctors, hospitals and pharmacies be required to publish their rates on a website so the consumer can see what each charges.
“If we suddenly knew the costs of everything, we would make decisions to find the lower cost, most qualified doctor,” Munger said.
He said the best example of this is Lasik eye surgery, a procedure that isn’t covered under most medical insurance plans.
“When it came out it would cost around $4,000 per eye,” he said. “But because they had to publish their rates and it created competition, that procedure in just a few short years now runs around $900 per eye. We need consumer decision making in the process.”
With all these fixes it is estimated it could potentially save 50 percent to 75 percent of the current costs of health care.
“Then we would make the best health care system in the world much more affordable and that much more efficient,” Munger said. “You can’t tell me the government would be able to run this cheaper and more efficient than the private sector.”
Contact reporter Joe Pangburn at jpangburn@azbiz.com or (520) 295-4259.
America’s Affordable Health Choices Act
There are more than 1,000 pages to the proposed bill, here are some of the things contained in the first 500 pages:
• Page 59: The government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 72: All private health care plans must conform to government rules to participate in the Healthcare Exchange program.
• Page 84: All private health care plans must participate in the Healthcare Exchange.
• Page 124: No company can sue the government for price-fixing.
• Page 145: An employer must auto-enroll employees into the public plan, if they do not currently offer a group plan.
• Page 149: Any employer with a payroll of $400,000 or more, who does not offer the public option pays an 8 percent tax on payroll.
• Page 150: Any employer with a payroll between $250,000 and $400,000 or more, who does not offer the public option pays a 2 percent to 6 percent tax on payroll.
• Page 253: The government sets the value of doctors’ time.
• Page 318: Prohibition of hospital expansion without government approval.