Thursday, August 20, 2009

It's Really Not That Hard to Understand

The problem with the health care reform debate we’re now witnessing is that the vast majority of people don’t understand the problem, let alone have any sensible solutions. So let me offer a simple case history ... and this is a true story.

The case is that of a woman – let’s call her Jane – who slips and falls one afternoon, breaking her wrist. A friend takes Jane to the emergency room of our local hospital where the doctor on duty sets the bones and applies a cast.

She has a before-and-after X-ray of the wrist, an MRI because she whacked her head when she fell, and they send her home with a bottle of pain pills. In all, Jane was in the hospital for not quite four hours. A fair and reasonable charge for those services would have been about $1,800. (I checked.)

But every day our hospital treats people … ordinary folks … who have no health insurance and not very much money. They treat them because they’re sick or hurt and can’t simply be turned away.

But somebody has to pay, so the hospital spreads the cost of that “free” service around by padding the bills of people who do have insurance … people like Jane. And that’s why Jane’s bill came to $5,600 instead of $1,800.

And it’s why Jane’s co-pay was $560 instead of $180. It's also why her insurance company’s share was more than $5000 instead of the $1600 it should have been.

The insurance company knows perfectly well this is what happened, and at renewal time they increased Jane’s monthly premium from $375 to $540.

So because the hospital treated people with no insurance, the cost of Jane’s health insurance went up 44 percent and is now costing her $2000 more this year than it did last year.

In other words, it’s pretty clear that the way our health care system works now, some of us pay nothing and the rest of us are paying way too much.

But if it's so damn clear, what accounts for the video clips on CNN of people screeching “Nazi” and “socialist” at Barney Frank, who is trying to explain some of this to them?

They’re either – as Barney suggested – from some other planet, or they care more about screwing Barack Obama than they do about their friends and neighbors who are being screwed by a broken health care system. That’s why we need to get this health care reform done now ... and done right.

And let the selfish, petty, miserable sons-a-bitches scream.



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