Harry and Louise’s Golden Years
In the early 1990s, they were on TV all the time, a middle-aged, middle-class American couple named Harry and Louise, sitting around the kitchen table, worrying that Hillary Clinton’s health care plan would get between them and their doctor.
Now, that Clinton woman is back again with her radical ideas about insurance for everyone, but will Harry and Louise still be worrying about socialized medicine?
Not Harry. When his company went bankrupt a few years later, he and Louise lost their insurance and couldn’t get new coverage because of Harry’s asthma and coronary history.
They lost the family doctor they loved so much, too. He switched his practice to “concierge care,†but Harry and Louise couldn’t afford the $2000 annual dues to stay on his roster of patients.
Louise can’t be sure but, if Harry had been getting his annual checkups and follow-up visits, he might have avoided or survived the heart attack that killed him at the age of 60.
As a widow, Louise has now reached the age of being eligible for Medicare. She is still free to see any doctor she chooses, but it bothers her that the government is involved in her health care and she is waiting with some annoyance to see what mischief Hillary is up to now.
Cross-posted from my blog.
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20 Responses to “Harry and Louise’s Golden Years”
Can someone tell me how it used to work 30 years ago? Apparently healthcare has gone downhill, and my friend’s father whose been a doctor for 45 years seems to certainly agree. How come it used to work and now it doesn’t?
Can any politician tell us why healthcare costs have gone up 70% in the last few years? And if 40% of people are uninsured shouldn’t we be looking at radical alternatives? Perhaps the 40% of the uninsured that aren’t able to pay are still getting sick and causing costs to rise so? Damn uninsured people.
Well, Sam, since you were gracious enough to not find a way to blame this directly on chimpymcbushcohalliburton as well, I’ll make an effort at a response. (That’s now two threads in a row……. the left must be off their game today.)
First off, I believe medical costs have been rising much faster than average inflation for a long, long time…..like 50 years, maybe. (Nixon, believe or not, briefly flirted with a nationalized healthcare program.)
Why? Because the US has undertaken the R&D to reduce mortality and morbidity significantly. Each one of those 1/2 year’s worth of statistical improvement have come at a huge cost, both in terms of R&D and treatment costs.
Life was pleasant in the 50′s and 60′s, but people got sick and died and there was not the 6-figure cost routines to deliver a 5 month preemie or give a terminal cancer patient another 5 months.
The retiree population going on Medicare back then was not outnumbering the funding population, therefore the fiscal drain for subsidized healthcare was not really headline material when LBJ signed us up for round 1 of government-subsidy-heroin. Nor did the indigent get to bring their children into the emergency rooms for treatment of a cold. Nor did people automatically sue their doctor if someone died.
Admittedly, the delivery system has moved from non-profit Blues to for-profit corps (which is usually all the left needs to hear to find a cause for all the world’s ills), but as a percentage of aggregate cost escalation components, the profit element is certainly not a lion’s share.
So, bottom line, the US has improved the quality and depth of care immensely on the back of immense R&D cost, diagnostic technology and defensive medicine protocols………we have improved morbidity and mortality, but like your friend’s father, I would suggest this has actually not improved life in general.
And then there was Harold and Lisa, who like the majority of working Americans, had insurance obtained through their employer which, for a reasonable premium that was paid partially by them and partially by their employer, covered pretty much all of their medical coverage. Then their premiums and copays were raised and their coverage cut back to offset the costs of providing insurance to all the so-called uninsureds and under insureds whose plight Hillary and her friends were crying over. While Harold and Lisa were lucky to keep their jobs, as their employers cut payrolls as they shifted more and more work offshore (to countries who weren’t so economically illiterate), their taxes went up a whole bunch as the government raced to find ‘revenue’ to pay for guaranteeing everybody health care (which is what guaranteeing health insurance basically does).
As a result, Harold and Lisa had to sell their house of 30+ years and continue working well past the age at which they hoped to retire in order to come up with the after-tax cash to pay these extra medical charges. And even as they had to pay thousands of dollars extra a year for less coverage than they had before, the quality of care they received went down as doctors raced through even more patients in a day trying to offset in volume what they were losing in insurance reimbursements. And even with doctors increasing their patient loads to an unmanageable and unsafe extent, Harold and Lisa found it hard to get an appointment as, with insurance being offered to all comers, doctors were being overwhelmed with people wanting appointments.
So Harold and Lisa went to sleep each night unhealthy but knowing their lives were screwed up just so free and discounted health care could be offered to all comers. And guys like Robert could also sleep soundly, oblivious to and/or not caring that, in their nice but misguided attempt to make things right for all these poor people lacking health insurance, they had made things miserable for millions more people than they had supposedly helped (ah, liberals don’t mind cracking some eggs to make omelets, right?
And Sam, where do you get 40% lack insurance? The worst I have seen is that 40 million or so people lack coverage, which in a country of 300 million or so people is, let’s see, using some basic math, a whole lot less than 40%. sarcasm works so much better when you get your numbers right.
casualobserver: I disagree that the improvements haven’t made life a whole lot better. We’re much better off not having to accept as much ‘we don’t know’ and ‘sorry, there’s nothing we can do’ than we did just twenty years ago. yeah, it’s expensive, but, taking away the relatively insignificant components for profit, litigation and paperwork, the dollars we spend on health care are going to keep us alive longer and healthier. sure, it would be nice to have all of that for fewer dollars, but health care isn’t an industry where there are a whole lot of economies of scale. if we want what medical science and medicine have to offer, we have to be prepared to pay for it… unless you’re like Robert, who seems to think that there are indeed such things as free lunches… and that greedy corrupt republicans are not kicking in their fair share to pay for all of life’s losers…
Yea, 40 million is the figure I was thinking. And I wasn’t being sarcastic. And 13% of the population is still a lot of folks without coverage.
Casual, your observations are indeed casual. Not one thing you pointed out was backed up with any info, just you guessing. Thats not good enough.
The problem with stevesturm’s attempt to make a point is that the horrible, terrible thing he is saying would be caused by trying to help the uninsured is already happening. He has apparently missed it somehow. Copays are already increasing. Premiums are already increasing. One reason given for a lack of salary increases is how much the insurance companies are increasing charges. And has anyone noticed that the rate of increase of insurance premiums far outstrips actual medical cost inflation?
“:if we want what medical science and medicine have to offer, we have to be prepared to pay for it”
Thats the problem, who the hell can afford it? A serious medical issue is going to run you more than 2 years salary for most people. Can run the cost of putting a kid thru college or worse. Its insane, but it’s your health so what choice do any of us have?
sam: as much as readers here try to ignore basic economics, if you want health care, someone has to pay for it. it could be you, or if you’re like the readers here, you can demand that someone else bear the costs of keeping you healthy.
jim: I know very well my scenario is already happening… in large part because of government mandates, community ratings, litigation, defensive medicine, paperwork, insurance company profits and so on. my point was, in case you didn’t get it, the more people like Robert get his way, the worse things will get, at least for most people.
it’s our collective choice and not just in health insurance but in general: how much do we want to hurt the Harolds and Lisas in the hopes that some much smaller number of people will be better off? To Robert, we should just bend over and say thank you…
The hope is to make the costs more affordable by having all members of society “contribute” (their “fair share”) and have medical care function as “insurance” (actually, pre-paid health care) on a community rating basis (adjusted for tax “fairness” rather than on experience rating). Eliminating profit and multiple networks of providers, paperwork, and beaucracies presents an opportunity for cost savings.
That is, at first sight and perhaps so early, but costs will rise in the future. Cost controls (and refusal to provide various benefits eventually) will be imposed sooner or later.
Is that spelled vertically on some punching bag?
So basically you think that prices are skyrocketing, quality and availability of healthcare is diminishing, and there is simply nothing to do about it? I think first thing to do is find out exactly why prices are going up so fast. I do not simply believe its the US bearing the brunt of medical R&D. Taking wild guesses at the problem gets us nowhere. Problem is I don’t see any politicians willing to even try.
That is indeed the general question with government interventionism and in acting as a service agency rather than as a real government, with entitlements.
Some will say the number hurt is far smaller than those who “need” to be made better off. Others will give a more precise, colder, utilitarian answer: It’s acceptable to hurt them so long as much much they are hurt doesn’t exceed how much others are made better off. The truly nutty will simply want Harold and Lisa to be hurt because they are envious, or they want Harold and Lisa merely to be brought to the same level as everyone else, or much closer to it, at least.
In order to provide a benefit to those not now getting insurance, those with insurance are going to have to pay more (in taxes, higher costs, reduced benefits) than they otherwise would… and that makes medical insurance more ‘affordable’ how?
Look, the bottom line is this:
Every business is intended to make a profit. Profit is not a dirty word. That’s how capitalism and America works. If the government operated better and more efficiently than the private sector, we would all be happy living in a communist/socialist state. Dispense with the profit, and see how quickly the incentive to develop new medicine and procedures is gone. Nothing will get better, it will just stay the same or deteriorate. My son has a condition which is not covered under my insurance. It cost twice what most people make in a year, no exaggeration. In stead of getting emotional, I am just happy the Doctors were able to diagnose him and that there is something out there that can help him. I m blessed and can manage the cost, but I know that if it were not profitable for the pharmaceutical company, no one would have ever developed something to help him. The government certainly never would. I do not mind paying my fair share.
I think much of the costs associated with health insurance are for “policing” the policy-holders. Insurance companies pay a lot in salaries for employees whose job it is to make sure that they only pay for covered procedures and keeping track of all the “in network” and “out of network” providers. I have good insurance and rarely see a doctor but a year ago I had to go to the emergency room. My policy pays for emergency room visits and sure enough, my policy did pay for the cost of the emergency room (I suppose supplies) but did not cover all the costs of the doctors. It turns out that while the hospital was network the particular doctors I saw in the ER were not part of the network and I had to pay the non-network rates for the doctors’ work. I still find it unbelievable and no one can tell me that such monitoring and record keeping by insurance companies to make sure that they only pay what is covered is not expensive.
Call me a socialist, but I think the best way to reduce costs is to insure everyone. If everyone were insured then the insurance companies would not need the mammoth bureaucracy to ensure that only “proper” charges were paid.
I really do feel that everyone benefits from a medically healthy society. For instance, it is preferable for someone who has a manageable condition to take care of themselves. If we had universal insurance then that person could get the care needed. However the way it is today, if that same person did not have insurance (and if it were a pre-existing condition it would be next to impossible to get coverage) then that person would not get care and complications would probably develop. Then that person might go on disability of they were unable to work. While on disability that person would collect government benefits. So while we may all pay slightly higher taxes to ensure everyone is covered, there is a cost we all are paying right now by not covering everyone. The cost is not only monetary but for the person with a manageable condition there is a quality of life cost if they do not receive the care they need and become handicapped.
I can’t believe that a country as wealthy and industrialized as we are does not have the compassion to ensure that it’s citizens’ medical needs are met. Particularly when we claim to believe in the sanctity of life. And it does come down to compassion because we have the resources to offer medical covereage to everyone, it’s just that we choose to spend our money on other things, like tax breaks for people who have more money than they know what to do with or for fighting wars (that aren’t accomplishing anything at this point) that are a drain on our treasury or spending a couple hundred million on a bridge to nowhere. How many people could $230 million ensure and wouldn’t that be better than spending it on a bridge to an island in Alaska with 50 inhabitants? They have ferry service and no one forced them to move there in the first place.
At any rate we as a nation can do a lot better with our healthcare.
Those worried about the costs of prividing health insurance for those not currently covered should remember that we already pay the costs of their health care – when they show up the ER with a sore throat, costing lots more than a doctor’s office visit or whem they break a leg pr whem they need to be hospitalized. When, as currently, they are not in the pool of the insured, it skews the costs of both health care and insurance, as well.
I like Hillary’s idea of making health insurance mandatory, like car insurance, for the same reason.
Those reasonably young and helthy often opt out of having insurance, but when they come down with a serious disease, they can’t be turned dowm by hospitals, and we all pay for whatever they can’t pay up front.
As for pointing out how much better off we are, that depends on to what you do the compairng. Comapred to oher modern natioons, we are not doing well, and we’re constantly slipping in rank.
Oh, there’s more, because the most aggressive among the activists want the federal governmen to provide it to everyone free of charge, and they’ll say “free” even though it obviously has to be be paid for somehow.
The idea is to make it “more affordable” to those who cannot afford it either by giving it to them (see above) or by reducing the amounts people have to pay now, when they have pre-existing conditions or simply are older, by spreading the cost among the rest of the population, including the mammoth group among the uninsured that do so out of choice because they’re young and believe they are indestructible. That’s the “mandate” part of Hillary Clinton’s latest “non-governmental” [sic] health care plan.
Additional cost savings (making it “more affordable”) would come from eliminating profits and costs that are associated with a multiplicity of different insurance systems.
By spreading the costs among everyone (making everyone not covered now pay more than they are paying now, incidentally, not only those who already have insurance), the proponents will claim in that reducing average or per capita costs in a number of ways, insurance will be more affordable.
Not to normal people, at least. There are some that loathe it, not merely believe that health care should be a “human right” [sic] or is a “human need” [sic].
Emotion should not be the basis for policy-making, nor for rushing to government interventionism (nor for making the federal, rather than local, then state, government the first government of choice).
“Emotion should not be the basis for policy-making”
I agree, with the addendum that emotionalism should also not be used to reject proposed policies.
That’s why I believe that when we talk about costs, we should include the unitemized costs to everyone when there is no policy that covers eveyone.
For example: Someone mentioned the cost of methods and procedures that extend life.We should factor in the health of those living longer. The elderly would be less of an economic drain if they received good health care and were healthy during their extended life. There are savings to be had as well as costs, and both have to be factored in.
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