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By Dave Schallert, Parker

Imagine that you went to your local Grease Monkey or Jiffy Lube for a common oil change and no one there could or would tell you how much it cost.

What if it had no prices posted for any of its services? How much for new wiper blades? How much for a new air filter? Wheel alignment? You certainly wouldn’t be able to figure out if you were getting a good deal. You also wouldn’t be able to compare its prices with anyone else’s in the oil change and car maintenance business.

Now, let’s say you don’t care, because the work has to be done. So, you have the oil changed on your car.

When the work on your car is done, imagine if the shop charged $200 for that oil change. But instead of you having to pay the bill with your own money, the Grease Monkey or Jiffy Lube simply sent the bill to your auto insurance company?

Would you care? Would you know how much was charged only after your auto insurance company paid the bill?

Would The Denver Post, Rocky Mountain News and every other Colorado media outlet be doing stories on how to fix Colorado’s auto insurance industry and demanding that uninsured motorists be provided with cheap or free auto insurance? Would a blue-ribbon commission be formed to look into what could be done about the looming Colorado auto insurance crisis?

Would media stories be going on and on about the rising cost of auto care, as though this was an incontrovertible and inevitable fact of life? Or would the real question be why Grease Monkey and Jiffy Lube were charging people $200 for an oil change?

Now, try to do the following with this story. Substitute health for auto, doctor or hospital for Grease Monkey/Jiffy Lube, and office visit for oil change, and you for your car, then re-read the story.

That’s the main problem with our health care system and health insurance industry.

Dave Schallert is a resident of Parker.

READER COMMENTS

And yet Dave those countries that sent their citizens here PAID the bill. people from America go to other countries to get the same or better treatment AT LOWER COST than here.

westman,
That's a distinction without a difference. Health care being an unavoidable need has nothing to do with the economics of its delivery.

And one way other countries have "figured it out" is by sending their patients to other parts of the world, chiefly the U.S., for health care they cannot get in their own country. Just recently, a Member of Canada's Parliament got treatment for breast cancer, not in Canada, but in California. Last year, the Prime Minister of Italy needed heart surgery. He didn't get it in France or Germany or Britain or Canada or even his own country. He came here for it.

Kelcy of 9:33 points out, correctly that we do already have rationed care by income. However, neither Kelcy nor anyone else ever mentions limits. If there is a 50% probability of survival if an operation is performed on a premature baby without insurance, do we cover the procedure blindly, no matter the cost? Does the answer change if the probability of survival goes down to 10%? What are the limits? Tell me that and I may be more likely to buy off on the whole “gotta fix health care” stuff.

Health care can also be looked at as an avoidable expense. There is nothing that says people have to get treatment for cancer or even chronic conditions and their inevitable repercussions. They will just die sooner. For the working poor without health insurance that is a reality. For many of the poor with Medicaid and even many with health insurance it is a reality because the insurance companies, government or private, put barriers to care up such that care comes too late to be effective. To use the earlier analogy, if you can`t take your car to the Jiffy Lube then you do without and just keep adding oil yourself and changing parts when and where you can until the car stops running.

Reality is that we already rationed care and it is by income and opportunity. Income is obvious and quite frankly has to be pretty high to buy the insurance on the open market for family coverage. It does not have a large pool of people in it so the rates are high. If you take a lower monthly premium then you better stay healthy as the co-pay can be high enough that without a high income you cannot afford it for most procedures. The opportunity pertains to whether your company offers health insurance and whether it will continue to do so. We are rapidly heading in the direction where health insurance will no longer be offered by our place of employment as they want to get out of the business and in a buyers market they don't have to offer it as an inducement to taking a job there. Once it's gone I doubt it will ever return as it once was in its heyday. Corporate America is unlikely to make that same mistake twice. When far less than fifty percent of American`s have insurance through their employment then maybe we will start to look at this as a serious issue for everyone. Currently out of sight is out of mind for most folks.

The question then becomes when this happens whether insurance costs are driven down in order to generate more business. They cannot stay in business without a large pool of people to insure. It will also be interesting to see if prices are driven down as fewer people have insurance to rely on. Will medical business be more likely to negotiate when they do not have the guaranteed income from the insurance providers.

And please, don`t tell me how the medical professionals are losing money because of the uninsured. At this point in time everyone should realize that if that were true you`d see them going out of business and new hospitals and clinics not being built in droves as they are here along the Front Range. If you haven`t had the opportunity to have medical bills and insurance payments sent to you then you cannot fully appreciate the mark up that medicine puts on things. Yes, it is a mark up in order to negotiate down with the insurance companies. If you don`t have insurance you can usually negotiate the bill down to at least what the insurance companies are paying if you happen to know what that amount is. Again, these folks would be out of business if they were really getting paid too little to cover costs. They are not doing this out of the goodness of their hearts but to make money and in the case of individual practioners to live in a lifestyle that exceeds the rest of us.....even with paying off their medical school bills.

The reason people have auto insurance is not the $200 oil change, but the $200,000 liability claim. You can also change auto with health in this case, but add another 0. Further, it is not the people with health insurance paying the $200, but those without. This in turn drives up our own rates. Imagine if auto insurance was only affordable by people who drove new cars or those who had an employer paid plan. Would those others not drive? Now imagine it costing $20,000 to fix your car after an accident, when someone who had insurance would only have a bill of $8,000, of which they were only responsible for $800. And don't forget the $200,000 liability lawsuit that will cause you to lose everything you own.

Health insurance cannot be saved by the free market alone. Universal coverage (by the free market or otherwise) would bring down rates because more healthy people would be covered. A single set of standards, codes and procedures would make the system more efficient. Technology would reduce errors and also increase efficiency. Finally, I have to think our economy would get a huge boost if big companies weren't worrying about how to pay for healthcare while small ones are worrying about how to hire people without it.

OK, then change it to food, clothing, or housing; all are unavoidable needs. Change Grease Monkey to King Soopers. You gotta eat, but there are no prices on the shelves, the bill goes to your food insurance company, and King Soopers charged you $200 for a grocery bag of soup and nuts.

Now that's idiotic. What's also idiotic is pining for a health care system that other countries have. Many of those countries also have cradle-to-grave welfare and 50% nominal tax rates on the middle-income earners to finance it. That's not the United States I want to live in.

Let's make a deal: I won't ask you to pay for my health insurance so long as you don't ask me to pay for my health insurance.

Fair enough?

Health care is an unavoidable need. Owning and driving a car is a choice and a luxury.
Comparing obtaining health care to buying soup, nuts or auto unsurance is idiotic and way off the mark. People in other countires have figured this out and it's time Americans did.

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