Medical Care Misconceptions

Discussions on medical care are filled with misconceptions. First, what we call health insurance is not a true risk management product like car insurance. Instead, we need to start calling it what it really is, prepaid medical care. That is how it is viewed and treated by everyone in the system. The only true health insurance is the catastrophic plans that are part of health savings accounts (HSA).

Second, the term single-payer system is inaccurate. It is already a government run system. There are 7,800 CPT (Current Procedural Terminology) codes used in every aspect of medical care. It’s an 800 page book. Medicare has reimbursement rates (prices) on every code. Insurance company  rates are a multiple of Medicare rates for the same codes. Imagine a group of bureaucrats in Washington setting the price for every item in every grocery store. The inefficiencies and inequities would be enormous, but we tolerate this when it comes to medical care.

Third, we are almost halfway to a government paid system. The National Health Expenditure projections for 2017 estimate 55.5% of all expenditures will be paid by the government.

Fourth, Medicare is not insurance. This is how Medicare works. Medicare sets the rules for reimbursement for services. Any recognized provider who submits a bill to Medicare gets paid. Medicare is a bill paying machine, not insurance. There is virtually no abuse oversight. Why do you think you see so many commercials selling diabetic supplies for Medicare patients? Because they get paid whether it is needed or not. The majority of patient self testing is irrelevant.

This is just scratching the surface. The problem is too much regulation not too little regulation.  Whether it’s the Affordable Care Act or the American Health Care Act both are filled with mandates whether you want them or not. All elected officials talk about all of the choices you have. If the government was out of the medical marketplace, you would have hundreds if not thousands of choices of insurance products that would be much cheaper. It would be like going through the line at any cafeteria. You pick only what you want and need with no extra mandated services that you will never use. But elected officials believe a government bureaucrat can make decisions about your medical care better than you.

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