Medical Costs & Insurance Systems: Part IV

Reviewing Medical Insurance Insecurity & Increase: Part I, I pointed out that medical costs for a good basic policy in 1972 was about $100 for an individual and $170 for a family, per year. Today, prices for a family are $17,000+, a hundredfold increase.  

In Medical Expense & Insecurity: Part II, I pointed out that every time we spend $20, about four dollars goes to medical costs; directly or indirectly. And, I mentioned my experiences and observations of some of the deficiencies of our system.

In Skin In The Game of Health Care: Part III, I outlined a simple universal plan which I believe would reduce our medical costs by 25%, or more, and whereby the individual has a vested interest in scrutiny of the costs and is encouraged to obtain an annual exam.  

Now in part 4 of the plan, I suggest ideas that could reduce the overall cost by another 25% for some people.

In the world of aviation, as an existing pilot, I am required to have a periodic examination. This requirement saved my life. When I learned of the problem, I chose to make changes. First to save my life and second, to again be granted the privilege of flying.

If our nation is going to provide insurance, shouldn’t we require an initial exam so that the patient and insurer understand the status of one’s health? Employers frequently need the exam as part of the employment agreement; so do insurers.

Another question we need to ask, “Should we have a tiered rate system?”  It’s probably easy to do so in our advanced tech society. Suppose one person is a vegan who doesn’t imbibe while another smokes, drinks, and enjoys heavy meats. Measuring which is which probably will show up in a medical exam. In my situation, I was surprised that the medics knew more than I did while I was in the ambulance for a few minutes. Insurance companies are partly in the betting business or gamblers. So, the odds favor the person on a vegan diet. Why should they subsidize the other person by having the same rate?

And, what about addictions to opioids, drugs, and alcohol? Should our expenditures, as a national provider, have limits? I have regular contact with people in the recovery business, which is booming and very expensive, yet its success rate is quite low. I recently met a person who said he had been through 18 recovery programs! EIGHTEEN. Are we wasting our nation’s funds? The origin of the current era of recovery programs, which I witnessed, may provide a clue.

One of the first quality programs, other than Alcoholics Anonymous, was developed in a military environment at the VA in Long Beach, CA in the early 70s. The early proponents had a tough time getting the military to buy into the concept. The issue was that a person’s personal choice was not the government’s business. If a person didn’t straighten out, they were expelled. Problem solved.

Then, someone put a pencil to the equation. For example, “If it costs us $200,000 to develop an officer and we expel the officer, then we have nothing. If we can assist the officer in the process of recovery and restore him to duty for $50,000, then we just saved $150,000.” Thus, recovery got legs based upon economics.

Today, we often look at the world of healing with little regard to the economic impact that the disease has on society as a whole. I think we need to look at all aspects of health care as if we, as citizens, are indeed the insurance company paying the bill, which we are directly or indirectly.

Rich Meyer, Author & Blogger