This was originally written in 2013, and re-published in 2015, and then re-published in 2017. And now, IT’S BACK!! Now that the whole debate on “Healthcare as we know it” is back on the front page, and we may actually repeal ObamaDoesn’tCare, I believe we need to make sure we keep this part of the problem in focus-
CO-PAY, THE TWO SYLLABLES THAT ARE KILLING AMERICAN HEALTHCARE
-And how what’s happening with the ACA might just fix it-
As we watch the debacle that is the Patient Protection and Affordable Care Act (ObamaDoesn’tCare) explode before our very eyes, I believe the greatest thing that might ever happen to save the healthcare system in the United States is millions of American Citizens losing their “healthcare”. I know, I know, I’m just a heartless hating Conservative who cares more about politically hurting Obama than the well being of my fellow Citizens. No, quite the opposite, I’m a concerned Citizen who believes more in solutions than saving “healthcare, as we know it”.
Now, why would I say this? Because “healthcare, as we know it” is a Liberty robbing, corrupt system, which I believe is why too many people bought in to the basic concept of ObamaDoesn’tCare. But to start finding solutions, we must first start recognizing the root causes of the problem. I contend that the start of the destruction of healthcare that works and evolved it in to “healthcare, as we know it” lies directly at the feet of the American Health Insurance industry. And it is two little hyphenated syllables, “Co-Pay”. This seemingly harmless, at the time they were introduced, two syllables laid the foundation to destroy the greatest healthcare system in the history of all mankind.
Shall I expound? I believe I will. Once the health insurance companies introduced “Co-Pay”, the first step was in place to start removing the patient from their healthcare decisions and responsibility. Why is this? Because the patient was no longer concerned about what his healthcare actually cost. Ask your neighbor, “What does it cost for you to go to the doctor?” Typical answer, “I have a $20 ‘Co-Pay’ as long as I go to a doctor ‘in network’.” Your reply to your neighbor should be, “So, you have NO IDEA what it actually cost for you to go to the doctor and you don’t mind giving up the Liberty to choose your own doctor?” And just like that, your healthcare is now the wholly owned property of your health insurance carrier, not you. And nobody said a word. Are you following me here?
OK, now we have identified a root cause. How do we start down the path of repairing this situation? I believe we have to return the patient to their position of responsibility for their own wellness. How do we do this? How about first, by millions of our fellow Citizens losing their “healthcare, as we know it” through ObamaDoesn’tCare? What? Am I crazy? Not at all. This is how we start reintroducing market forces in to healthcare and getting the health insurance industry AND the government out of their current position between the doctor and the patient. Unfortunately, in this case it has to be done through panic and force, but sometimes the path to a solution isn’t easy and can even be shocking. Now, how does this become the start of the solution?
First, since the patient who loses their “healthcare, as we know it” is now going to have to pay for their own medical care, they will need to start evaluating their illness before, as they have currently been trained, they just run to the doctor for the sniffles or a hangnail. Can you imagine what this does for the crowded doctor’s offices, not to mention billions of unnecessary dollars spent because people with “healthcare, as we know it” have been trained to run to the doctor because all they have to do is pay the “Co-Pay”. Next, if they decide they do need to go to the doctor, they will have to ask what it ACTUALLY cost for them to see the doctor?
REALLY? What a bizarre concept, actually asking how much something cost before agreeing to buy it? And, since they are no longer “bound to a network doctor”, if they think the price they are quoted is too high, they can go to the next doctor down the street and get a quote, putting real competition back in the healthcare market. WOW, what a concept! Now, this patient is on the way to taking back control of their healthcare. But there are going to be problems to start with that will have to be solved. First problem, too many doctor’s offices today are so locked in to the “healthcare, as we know it” operational model, they might not know how to take payment for services rendered at the time services are provided. But I believe this will be corrected quickly because there are going to be millions of Americans who have lost their “healthcare, as we know it” that are going to be paying for services at the time they are provided. And doctors will be forced to really look at costs because they are no longer protected by being part of a network and will be competing for these patients’ healthcare dollars.
And what the patient is going to find out is that there are BIG savings for medical care if you pay at the time services are provided. Now, why would this be the case? It’s actually a fairly simple business economic model if you remove the stigma of “healthcare” from the equation and replace it with “product” and replace “health care provider” with “small business operator.” What is the baseline necessity of a small business operation to stay in business? CASH FLOW. And the destruction of cash flow to the small business operator, the doctor, by “healthcare, as we know it” is big. The small business operator has to pay his bills every day, week or month. They have to make payroll every week/month. And in “healthcare, as we know it”, the small business operator may get paid in 60 to 90 days for providing services to the patient IF all of the paperwork is perfectly correct. Or much longer if the paperwork isn’t correct.
So, by the patient paying for services at the time they are provided, there are major costs that are immediately removed from the small business operator. There are no longer costs of billing the insurance company. There are no longer costs of the money necessary to bridge the gap of time between services rendered and payments received. There are no longer costs related to actual costs of services rendered and devising a formula to bill insurance to where the reimbursements cover those costs. And there is no longer the aggravation of dealing with insurance companies. This may not seem like much but it can really add up. To the point I know people who are paying less than half in cash than the doctor previously had to bill their insurance company.
But what if they get cancer, or need some kind of surgery, or have a major accident or any of hundreds of other unusually expensive medical needs? How about we now go back to having ACTUAL health insurance, which is what we have come to know as “catastrophic care” insurance, for just these kinds of occurrences. And then to help make this whole thing come together, every Citizen has a “health savings account” where they can put “pre-tax” dollars which are used to pay their out of pocket costs and their deductable.
So what have we learned? ObamaDoesn’tCare may actually end up being the salvation of healthcare system in America by it causing millions of Americans to lose their “healthcare, as we know it”. ObamaDoesn’tCare could force millions of Americans to begin being responsible for their wellness again and escape from the destruction of the “Co-Pay”. ObamaDoesn’tCare will, as promised, bend the healthcare “cost curve” down by not doing what it was designed to do, but by doing exactly what it wasn’t supposed to do, putting market forces back in to healthcare. And the biggest thing we should learn is that it’s time for the Republicans to quit trying to “fix” ObamaDoesn’tCare because it’s going to do what We The People need it to do all on its own, bring an end to “healthcare, as we know it.” For once we could actually benefit from government’s unintended consequences.