Friday, May 5, 2017

A Simple Observation on Healthcare Legislation

To those happy with the new legislation, which you haven’t read.  I am glad.  For those outraged by the new legislation, which you also haven’t read.  I am sad.  For those who “memed up” and pointed out this legislation passed the house by the thinnest of margins along party lines I would remind you the ACA passed the house 220 to 215, again along party lines.  The difference then, and it will be the difference now, will be in the Senate.  Then – the Democrats had the necessary super Majority to pass the bill over Republican objections, now – Republicans don’t, unless of course, they employ the Reid option.

So, for all those celebrating, hold your horns and confetti.  For those who are preparing to march and riot, maybe stop in at a fast food place and enjoy the dollar menu for a while.

While you’re all waiting -- consider this.  Before there was such a thing as widespread or government health insurance the cost of medicine was far less than today (even adjusted for inflation), why was that?  Was it far less government regulation?  Perhaps it was far less profit incentive (i.e. greed)?  Maybe it was national demand?  How about far less technology?  Or, just maybe it was far more of a common understanding of the costs and how to manage them on the part of the entire industry.

Since the 1960s, we have created a regulated capitalistic system designed to get the most dollars possible out of the greatest number of places like the government or insurance companies.  The government tells everyone what they will pay, the insurance industry falls in line, and the hospitals charge twice that so they can chalk up a loss on every treatment.  We as consumers NEVER EVER argue over what a treatment or operation should cost.  We don’t question the bills that roll in and hold those responsible to actually account for them line item by line item, as if it were our dollars being used.

If this legislation does become law, for all the claims of the Republican politicians it will be no better than the law it replaces.  It will make some people happy, it will make some mad, but it will not fundamentally change the way we view and treat the healthcare industry, and their accountants will continue to find ways to exploit the regulatory framework to make the most profit, (this includes the non-profits who just find ways to label the excess as not profit).

Why?  Because long ago we surrendered our responsibility to question.

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