Yep – Changing Health Care Is Really Up to Your ‘Average Joe’

After I wrote my previous blog post about two important principles expressed during the Free Market Medical Association conference, the truth of those principles have continued to be confirmed in my mind throughout the past week, and will, no doubt, continue to be.

I will review those two principles just in case anyone is viewing this blog for the first time (but feel free to read my previous posts, of course). They are:

  • Washington can’t fix health care.
  • We have to fix health care.

Where do I start when it comes to confirmations of these two  principles? A New York Times article written by Marc Santora from November, 2016 entitled, “Many Insured Children Lack Essential Health Care, Study Finds” states the following:

“A new study to be released on Monday by the Children’s Health Fund, a nonprofit based in New York City that expands access to health care for disadvantaged children, found that one in four children in the United States did not have access to essential health care, though a record number of young people now have health insurance.”

In the previous paragraph, the article uses the story of Margo Solomon who has “insurance” for herself and her four children, and yet getting treatment is another matter entirely.  Solomon has trouble finding a doctor that accepts her insurance and she has the challenge of finding a specialist for three of her children who suffer from asthma and other medical conditions.  The article also says, “And once in the door, she cannot afford the costs, including for deductibles and medications.

Clearly, this “coverage” is the result of the Patient Protection and Affordable (?) Care Act. Wasn’t this insurance supposed to be for those struggling with health problems and lack of insurance coverage? But what good is insurance coverage if those who have it are still struggling to obtain and pay for the care they actually need? This is something Washington did, but what good is it? I am willing to bet that Solomon would say “Not much” if she is struggling to pay for the out-of-pocket costs such as deductibles and medications.

Who knows? Maybe those brilliant Obamacare “navigators” didn’t bother to tell her she might qualify for some of the cost-sharing subsidies as well as a premium subsidy for low-income people. But maybe she doesn’t qualify for those anyway. I don’t know the woman’s income situation or the levels of income required for those cost-sharing subsidies to apply. However, as challenging as health care is for her right now with her Obamacare “coverage,” (I assume that’s what it is), I would contend that she is much better off without any more government intervention in her personal business. I don’t see that it has helped her all that much.

I am willing to bet that this woman and her children would be much better served by a low-cost Direct Primary Practice, although I don’t know if there are any in her area. Or perhaps, if she could have a Health Savings Account coupled with a low-cost High Deductible Health Plan (a truly catastrophic plan) that would cover the bigger (and hopefully rarer) expenses. With such an arrangement, she could find the doctors she needed at a price she could afford because she could go into a doctor’s office WITHOUT an insurance card and find out how much they may charge for an cash-paying patient (often less than the insured patient) and pay cash for the service with her HSA. However, as I learned a couple of years ago, such a payment strategy for medical services is close to impossible now under Obamacare because of the essential benefits mandates that force insurance companies to cover services for which a health insurance buyer may have no use. I found that the high deductible insurance was very high even if coupled with an HSA when I was trying very hard to escape Obamacare.

This situation, and many similar ones, has been brought on by Washington’s meddling in the delivery of medical and surgical care. During the failed “effort” for the repeal and replacement of Obamacare, we saw that most of Congress only focused on the issues of how many people would be “covered” by health insurance. Yet, in so many cases like the aforementioned scenario, this “coverage” proves to be more and more worthless every day. Yet Washington and the media babble endlessly about “coverage.” Under Obamacare, my coverage stinks! The deductible for my husband and me is $11,500 this year.

So while Washington continues to babble cluelessly about “coverage,” the point made at the FMMA conference, that “we the people” must fix health care remains very solidly at the center of my thoughts. How do we do it? I contend that we start in little personal ways. I am making it a point to become a more educated consumer in my health care choices. I admit to making a few missteps, but I keep making it a point to learn more.

Once again, the doctors, nurses, and other providers of medical and surgical care cannot change health care by themselves. We, as patients, have to go find high-quality physicians and facilities that offer transparent and better pricing for services and use those services. I believe these actions can encourage a free market in health care.

Sources for further reading:

  1. https://www.nytimes.com/2016/11/21/nyregion/many-insured-children-lack-essential-health-care-study-finds.html?smid=tw-share

*If you would like to join me in my individual journey to fix health care in the United States, I encourage you to sign up for my email list at the top right hand of this post so that I can share my thoughts and strategies for creating and even better system of delivering medical and surgical care.

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