LASIK

Several years ago I went and got my eyes fried with lasers. I hated glasses and had worn contacts since the 7th grade. I spent some time in college with glasses but the moment I could ditch them I could, and the moment I had the cash in hand to get my eyes fried, I did.

Overall, it was a pleasant experience. I sifted through several different offices offering the procedure. I called the one that had a good reputation and was offering a promotional price. I made an appointment to get my eyes checked. The office was neat, clean and offered a state of the art pod coffee machine. Once I qualified for the procedure, I went and had it done. My eyes didn’t heal right the first time so the office gave me a second round of zaps at no charge. I have had 20/20 vision ever since. I am extremely pleased. I paid largely in cash and financed the rest.

LASIK is the great anomaly of the American Health Care system.

* The procedure, once extremely expensive, is now relatively reasonable because the price of the procedure has amortized over time.
* Prices are well-known and customers can shop based on reputation and price.
* LASIK treatment is subject to open, competitive market pressures.
* No insurers were called or consulted. No one was billed except the doctor to me.
* No insurers dictated which LASIK center I could go to, nor did they have to pre-approve the procedure.
* I paid in cash.

Like electronics, the price of LASIK has fallen and normalized. You can walk into the office, give them money, and get the procedure. It is subject to open market pressures. The pricing on LASIK works and the quality has skyrockted.

Let’s look at my current CT Scan. I have had real problems with my chest (left side) recently. The doctor ordered a CT scan because he was worried about what he saw on the X-Rays. Still is, in fact. However:

* I have no idea how much the CT scan cost but I’m sure I will be billed some random and obscene amount of money.
* The insurer would not allow me to get it at the time the doctor ordered the test.
* The doctor had to get on the phone and give justification to the insurer for ordering the test, causing me to wait 5 days.
* I was not allowed to go to the radiologist my doctor recommended and had a working relationship with.
* Instead I was sent to an office across town that was, to put it mildly, “hinky” and “filthy.” But it was either that or no test because the insurer demanded I see this other doctor.

Reality is this — save the interesting outliers like LASIK, US health care is not subject to market pressures, no one knows how much they actually pay for any of it, the prices for procedures are just made up fictions, and because people (hospitals, doctors, specialists, etc) can make up whatever price they want, the prices for procedures are ridiculously expensive. Hey, if I could charge “a million billion bazillion dollars” for a 15 minute procedure, I would, too!

Anyone who claims that the system is a free market system is selling you something.

Take a look at this post on the WaPo about prices in the US health system. We flat-out spend too much money on health care because consumers are completely divorced from pricing systems. I wonder how much something as simple and straight forward as price discovery on procedures and making those prices public by region and state would change the game.

But of course all we’re talking about is health insurance when we should be talking about health care.

Basic Human Rights

This morning before work I clicked on a link that took me to some commentary on NBC that went along with polling on the health care debate. I was not expecting it to be a video, but it was. (This was found on Chuck Todd’s twitter stream this morning.)

I largely ignored it until it came to the last guy who was white male skinny WASP type listed as a “Financial Analyst.” And what he said struck me. He’s not in favor of Health Care Reform because:

A. He doesn’t believe that health care is a basic human right.
B. It’s a “hand out” to “poor people” instead of a “hand up.”
C. Poor people can “go other places like to the Red Cross.”

Other than being incorrect on all three points, I was just floored by the comment that “basic health care is not a human right.” Where does this view come from? It’s not Christian (or Jewish or Muslim or Buddhist or…) It’s not liberal. It’s not even conservative. It’s just… selfishness for selfishness sake. From a purely conservative viewpoint, making health care a basic human right helps:

– People who are less afraid for their health work harder, create new business and generate more wealth;
– Families because healthy people stay together as a coherent unit and those with less financial strain hold together better;
– Communities because healthy people contribute more locally and are less of a strain on the local community’s economy including the local religious community;
– Local economies because fewer sick people move less sick around, more people go to work, productivity increases;
– Macro-economy because sick uninsured people are a drain on economic resources, spread disease, go to hospital emergency rooms anyway, push up prices all over the place, and reduce work.

We won’t even talk about the liberal viewpoint (everyone should have a right to see a doctor regardless of financial means) or religious viewpoint (Man should give up a little to help fellow Man to reduce suffering). From a purely conservative viewpoint of keeping up the status quo and generating wealth, calling basic health care as a “hand out” is bewildering. It seems to me that the “monied” class would want healthy people to generate them money!

Then I thought about that guy, the guy who played a pure classism card, who clearly believes that financial analysts who can afford $20K a year at a private University should be the only people allowed to see a doctor in the United States. Let’s say he’s — A. White, B. Male, and C. In the banking sector. Reading the statistics from the recession, the people getting laid off most are: A. White, B. Male, and C. In the banking sector. Should he lose his job, and should he not be able to find another one, should his COBRA (given to him by that socialist Teddy Kennedy) run out and he get sick, should we tell Mr. Douchebag that he shouldn’t get hand out and he should go to the Red Cross? My answer: Yes. And him. In particular.

I don’t know where to start with people like this except label them as douchebags. It’s okay to… what, if they can’t afford $100K or $200K in tuition then they should all die in the street? Die of tuberculosis? What precisely do they want?

The problem with the health care debate is that we’re letting these people a place at the table. I know it’s a democracy and everyone gets to have their voices heard but if we can’t even start at the point of basic human decency and agree that all human beings have a right to have a basic alleviation of suffering through simple modern medicine, then where do we go?

I’m not exactly thrilled with the sausage making in Congress and I don’t have huge amounts of hope for whatever legislation will end up being passed, but for God’s sake people. Look at yourself in a mirror.