Nationalized Health Care - How Consumers Act

The abrupt and direct response to US Nationalized Health Care is that it will become a floundering mess of inefficiency and waste. One can argue, will nationalized health care in the US become more inefficient than what we have today and will it consume 20% or more of our nation's resources like what we experience today? My opinion is that if it doesn't consume 20% or more of our nation's resources, it soon will be designed to do so!

Two main problems exist with nationalized health care in the US: The supply side and the demand side. More clearly, in an environment where everyone is allowed and encouraged to seek medical attention as often as they want, the demand goes skyward. And since everyone is supposed to have equal access to health care considerations and resources, there certainly will never be enough to go around.

We get back to the major premise of socialism and why it distorts the reality of the free hand of an open market. With everyone wanting a service and theoretically enabled to have that resource, demand will always outstrip supply. (Insert image here of an old Soviet-ere Babuska slugging it out with another, similar woman over a package of toilet paper in a bare-shelved Moscow store).

One can argue all day about how successful Britain's or Canada's semi-socialist medical system is and they would be absolutely correct! Let's see if we could transfer that model to the US. Hmmm! I don't think so!

Why? Because US citizens are used to having the access of total availability of health care resources but at the already subsidized rate. If one thinks the present market has placed any restrictions upon consumer demand for health care resources, then please let's look at the reality of the marketplace.

There is no real "open-market" considerations where the actual payer makes decisions based upon price, availability and local resources. Most consumers are insulated from knowing the "true" cost of a procedure because insurance programs almost always pay the bill. The consumer only has to find a medical provider and the cost be damned! He or she really doesn't pay the bill anyway, so there is no understanding of the overall economic cost of specific services, resources or facilities.

So, what exists now is a "seemingly subsidized" consumer health care system in the US. Consumers buy the insurance program options when their employer's benefits renewal program presents repriced options, but nowhere does the consumer take direct responsibility of their own health care dollars as if no insurance existed.

As a nation, we are seeing more and more people without insurance for health care. The US Census Bureau has calculated that amount to be near 45 million up to 50 million people per year. The realities of a true consumer market for US health care actually only exists for a little less than one sixth the present population. These 45 to 50 million people have to make decisions as to how to spend their limited monetary resources on health care without the benefit of an insurance policy to smooth the way. WOULD A CONSUMER WITHOUT INSURANCE MAKE DIFFERENT DECISIONS ABOUT HEALTH CARE THAN ONE WITH?

The answer would have to be a resounding YES! Certain tests would have to be weighed with extreme scrutiny for cost-effectiveness. "Iffy" procedures and operations with low response and success rates would be immediately removed from the decision-tree. Greater importance would be placed upon how an individual makes choices for him or herself.

Specifically, individuals would have to take greater responsibility for diet, physical exercise, alcohol and tobacco consumption in order to preemptively remove the excessive and extremely high cost of obesity, diabetes, heart failure, arterial sclerosis, emphysema, various and sundry cancers and other life-style diseases.

Why is it then, when spending time with most Western Europeans or Canadians, they continue to exhibit such consumerism in health care even when there is socialized medicine in some form or another in their native countries? While US citizens are bellying up to the buffet table/trough on cruise ships, our German, Icelandic, Italian, French and Danish counterparts have modest portions. Why is smoking so unpopular in Europe, but still nearly 40% of Southern US adults still smoke? What is different where in countries health care is readily available the citizens show individual responsibility for its use? My premise is that such responsibility would not be exhibited by US citizens who would fight and claw for each very last piece of good or service to claim as their own, regardless if they needed it or not. Possibly, after years and years of being told they have to take on their own health care concerns, especially regarding life-style issues, Europeans have been conditioned to do so. And since post-WWII was the beginning time for such education, the remaining population really had to believe the government's statements of limited resources!

Yet, if we were to try that very same thing today to instantly limit the access medical resources, with the current level of over-abundance of medical resources just waiting to be called upon at our slightest whim, consumers would revolt.

And that is what we are going to see. As resources tighten-up further and further and people who had previously had access to too much in terms of medical resources suddenly have little or no options, there will be problems. What needs to happen is more "medical consumerism" where the vast population understands and realizes the true value of each and every medical procedure. From there, individuals can decide on how and on what to spend their 20% per annum charge. Additionally, everyone will have to acknowledge the fact that those with more income and wealth have more options.

At least, that is, until US citizens understand how to responsibly use nationalized health care.

Skewing the Medical Supply/Demand Curve

As of yet, I have not addressed the issue of US Universal Health Care. I can only assume readers will be asking themselves as to my position of such a national offering.

Universal, or more accurately, nationalized health care will not work in the US. If you are a fairly cognizant person, emergency rooms now are overrun with people who have no need being there. For the most part, visitors of ER's are there because they have no regular physician for themselves or more likely their children. ER visits happen when the parent is not at work, which often is after 6 pm and before 7 am. As a result, ER's become overwhelmed with sore throats, minor viral infections and little boo-boos.

Now, consider the scenario of health care where the individual feels it their right to take as much of the resources as possible in order to get their 'fair share'. Consumers will see health care with the same concern as cheap gasoline which spawned the overly huge SUV's that get terrible gas mileage. At today's gas prices of $3.++ a gallon, SUV's are dying horrible dinosaur deaths.

The 'cheapening' of valuation of US Health Care would only drive the hypochondriacs out of the woodwork and choke the limited resources we have now. In a way, cheap health care insurance up until now, has cheapened US Health Care too. The process of cheapening a resource also drives up demand (refer to Econ. 101 for supply/demand curves). Artificially cheapening a good or service really screws up the demand curve!

The reality is that US Health Care is to be more expensive in order to allow the market to keep it scarce. But, why is the thought to raise the cost to the middle class and the working poor? And is making such an important service like health care scarce what this country really wants or needs? What makes it very hard to accept as an institution, is to see the very poor who are taking a disproportionate amount of the total resources because THERE IS VERY LITTLE OR NO COST TO THEM!

Really! Oh, some states have a small co-payment for their programs for children's health care, like $15 - $25 per child for total care coverage. California, I believe has a very generous plan which has people opt for a state run program that is totally inclusive rather than use a commercially available plan with co-payments of 10 - 15%. What happens? People will find ways to cheat the system by excluding specific information in order to qualify for cheaper, but more inclusive state programs and by-pass the higher costing, but more legally accurate market available health care insurance program.

US Census data can tell us that there is a huge number of uninsured individuals and it even may tell us of how many citizens qualify for extremely low cost or no cost health care coverage. And with that data, one will begin to see the amount of waste directly attributed to undeserving individuals. Indirect waste is the viewpoint that the service is worth less than it really is in the market, and the demand for service for boo-boos and runny noses is totally unnecessary, artificially taxing our US Health Care resources. (Thanks to intelligent triage nurses, most of the people who don't need to be in an ER have to have a very long wait).

No, we need to bring the concept of higher value (best administered by cost) to the ones paying the least illegally and artificially. We must attack the hit to US GDP at 16 - 18% for US Health Care by attacking waste in all areas. The waste Southwest Medical Bill Review & Recovery challenges is the $51 Billion in fraud conducted at the medical provider level and the over $220 Billion at the error and clerical aspect of hospitalizations. Hitting the problem from several ways will increase the efficiency of US Health Care to make it more market realistic.