Accountability (financial accountability on behalf of providers and personal accountability on behalf of patients) replaces skyrocketing costs and personal irresponsibility
Stop the financial madness. Stop the fitness madness.
The health insurance industry, medical profession, pharmaceutical industry and hospitals need to live within the Cost Of Living world that the rest of us must comply with. Why can’t the normal rate of inflation apply to them?
This blog was written before the Covid-19 pandemic struck, so I’m adding these notations:
There will be hell to pay if the above listed conspirators try to list Covid-19 as “pre existing conditions”. What do you want to bet that they don’t try? Just like the health insurance industry tried to put a sunset provision on the 911 responders (cops/firemen/EMT’s) and the construction workers who have cancer and other illnesses that are killing them. The “powers that be” will try to wiggle out of long term costs affiliated with this pandemic’s patients just like they tried to short change the 911 patients.
This tragic pandemic is a prime example of how we could have been so much better prepared had there been a national health insurance system in place. Everybody would have been covered by health insurance rather than this ridiculous scrambling with a patchwork of private unaffordable insurance plans, millions who are still without coverage and a patchwork of states offering different medicare/medicaid options. We could have had in place a nationwide mobilization for everything from supplies to preventive procedures to quarantine measures to affordable health care for victims. Maybe we will learn our lesson from this pandemic and have it in place for the next one.
Back to my “big ideas” concerning health & fitness:
If it costs too much. Don’t do it. This may sound harsh but it’s the reality. We all need to come to terms with our own mortality. Until we do so, the cost of doing whatever is necessary at whatever cost will spiral out of control. For chronic incurable situations, palliative care to mitigate symptoms might be the advisable course of action.
Why can’t good health habits be rewarded, comparable to auto insurance providing good driver discounts. Likewise, bad drivers pay higher insurance rates because of their bad driving. Why should we all pay higher health insurance rates because of your unhealthy lifestyle.
Accountability needs to replace personal irresponsibility. Here is where the tough-love theme kicks into overdrive.
After years of people watching, these are my observations and recommendations:
People need to stop spending money they do not have. Credit card debt is astronomical. I cringe when I hear economists refer to consumer spending as a barometer of a healthy economy or as a means of spending ourselves out of an economic slump. Deficit spending as a nation and as a consumer can only lead to collapse. It’s like buying chairs for the deck of the Titanic and rearranging them. End goal should be debt freedom not commercial consumption.
People need to eat healthier, exercise more and sleep more. Stop feeding the diet/fitness industry buying their books, programs and panaceas. Too many of America’s exercise equipment and gadgets are gathering dust and filling the landfills. As the Nike slogan says, “Just Do It”.
Most absurd are the cars that circle around in the parking lot trying to get a space close to the gym before the driver gets on the treadmill inside.
Stop buying junk food, eating junk food, get moving and take better care of yourself. This is not rocket science.
If both of the above described proposals are adapted (buy less stuff, eat better stuff and exercise more) the carbon footprint will shrink. Less stuff bought, stored, tossed. More people walking and biking improves both their health and the environment.
Healthier population will reduce medical costs and in the long run this is a cost effective solution. The first step starts with us, the patients taking more responsibility for their own health.
Now the second important step is to stop the blame game that occurs among the following players: doctor, specialist, hospital, clinic, health insurance companies, pharmaceutical industry and an assortment of medical related suppliers. This complex of characters today is comparable to what was termed the military-industrial complex being in cahoots with each other since the 1950’s.
These players need to stop hiding behind each other when assigning costs and following procedures.
Case in point: Let’s look at the controversy over coding a procedure as “preventative vs. diagnostic”. Everybody in the profession talks a good line when advocating for “preventative” medicine and touts prevention as a long term method of lowering costs.
However, when preventative measures are taken, they often get coded as “diagnostic” with many health insurers refusing to pay for diagnostic procedures.
We need to establish a clear line distinguishing diagnostic vs. preventative.
Anything done after a situation/condition is found because of taking preventative measures should be classified as diagnostic. Checking to see if there is a problem (whether this is a lab test or a reconnaissance type procedure such as a colonoscopy) should be coded as preventative. Coding more procedures as affordable (low cost or no cost) preventative will encourage patients to take these preventative measures thereby avoiding costly subsequent medical costs and saving everybody in the long run. Makes sense for everyone except the “powers that be” in the medical/insurance complex who benefit from the blame game of coding and billing.
How did I come up with this tough-love, cost-benefit perspective on finances (personal and medical)
I’m personally immersed in this “preventative vs. diagnostic” coding tug-of-war.
Everyone I speak with has horror stories concerning health care costs. Assurances are given that procedures will be covered and then the bill is delivered. Thanks’ for nothing but deceit.
Outrageously high annualized insurance deductibles. Ever increasing insurance costs with nothing to show for it.
Everyone I speak with experiences an adversarial relationship with some or all the players in the healthcare industry (doctors, insurers, hospitals, specialists, pharmacy). Name any other industry where so many customers (i.e., patients) are so disgruntled and yet still seek these services. Why? Because it’s medical and we really don’t have another choice.
What if every other transaction in the marketplace (the purchase of gas, bread, etc.) was so convoluted, irritating and inflationary? Our system would grind to a halt as it has been doing in the current medical/pharma/insurance marketplace. Why can’t prices be set and why are set artificially high in anticipation of negotiations with health insurers? Why do you feel like you are dealing with a sleazy used car dealer?
Why is it that the older you get and the sicker you get, the financial and medical/insurance system is structured to make things more complicated? Why is it that when you are feeling sick or are too tired to think straight, this is when they force you to make important decisions? The older and sicker we get, the more we prefer a slow, steady, predictable, affordable lifestyle.
I have been told that you cannot be denied treatment for pre-existing conditions. This is great. However, this does you no good if the cost for that treatment exceeds your ability to pay.
I have been told that the reason smaller companies cannot get an affordable health insurance rate is because they’re small. Whenever it’s suggested that small companies could be aggregated into a larger pool and thereby mitigating the risk to insurers, everyone says “that’s a great idea”.
However, for some reason everyone also says “that’s not possible”.
Likewise, the USA has a big, diverse population (sick people and healthy people). Even after the Covid-19 pandemic subsides, we overall have a pool of healthy people. It seems like if we all got into the same insurance pool, the risk would be sufficiently spread and the costs would go down. It also seems to me that some people want to keep the insurance/medical/pharma Ponzi scheme intact.
As for a return to personal financial sanity, the insanity all starts with the American Dream and the notion that bigger is better with each generation expected to do better than the next with money buying happiness. The commercialization of Christmas is the ultimate example of buy now, pay later. Gifts purchased on credit cards in winter are not paid off until summer (if then). Wedding and vacation costs can rival a year’s worth of salary.
Everyone needs to ask themselves the following questions:
Do I have enough food, clothing and shelter to survive (nothing fancy just the basics)?
If I get sick are there funds to patch me up?
If I can’t be patched up is there money to let me coast out relatively peacefully.
I acknowledge that this is harsh and the bar is set low but it might just return us to financial and medical sanity. This new way of thinking might also reduce the carbon footprint thereby increasing the longevity of both us and the planet.