HealthCare: how do we fix it?

Not that it is any surprise to anyone but the recent news that Blue Shield is going to raise their rates by something like 40% due to Obamacare is disconcerting at best. Of course, the entire situation is just badly messed up. On the one hand you have the progressives who seem to believe that anything that goes wrong with someone which is not a direct, conscious decision on the part of that person should be mediated and fixed by the government. On the other hand, you have the conservatives who seem to think that the government should not be involved in the business of business, no matter what the impact to the consumer.

Over the past 20 or so years, these two groups instead of finding commonality and trying coming closer together have moved to the opposite ends of the spectrum. Interestingly, 20 years ago, it was common to hear that we have a one party system with two sub-groups; it being hard to tell the difference.

But if my recent experience with Blue Shield is any indication, we are all seriously in trouble.

Due to the unprecedented rise in healthcare rates, corporations have been struggling to find the lowest price provider. Let's forget for a minute how inefficient it is to change, yearly, from one insurance to another, not to mention the overhead in having to constantly take a copy of the insurance card and change doctors due to changes in insurance.

Ok, I screwed up. I should have ordered 90 days of prescriptions at the end of last year while everything was still working. But, I got busy and didn't. So, of course, no one can order anything in January because no one has the information needed. That, it seems takes several months to figure out what your group number is and what your ID is.

We did get that information a week ago (end of Jan). After an hour wrestling with the various websites, finally, I figured out that I can't order my meds on my wife's user ID and there is a trick to how you create your own ID. Got that. Thought, I'd try transferring my meds from my prior on-line pharmacy. I diligently entered all the information in, which took at least another hour. (boy, these computers sure have made life better huh?)

Then I waited.

A week later, I checked the status on my "orders". Yikes! There ARE NO ORDERS! Huh? Sure enough, there are no orders under my account anymore. Nothing, nada thing.

Ok, well a week ago, I was OK, since I thought I could wait another week to receive my meds.

Now I have to go to the doctors, get the prescription for a 30 day supply, go the pharmacy, get the meds. then have them fax in the req, fight with the new insurance company and perhaps, in a month or so, I'll get my new meds.

Don't get me wrong, I'm not upset that I should get my meds for free or that I should get my healthcare for free. I shouldn't. I believe (unlike so many today) that I actually get a lot for my money.

What I'm trying to point out is that if this is the type of inefficiency that exists today, then where will we be later after the government has their own version of the insurance plan (think of the DMV).

I wonder what it would really cost if I could just order my meds directly online from the drug company - no middle people. Isn't it surprising when the pharmacy shows me my bill as it would be if I didn't have insurance and the cost is gigantic! We're talking hundreds of dollars a month.

So, I'm told that others, who don't have any health costs, are covering my costs with their monthly payment to "insurance" (which by the way, is the biggest mis-nomer on the planet. Why don't we get real and just call it a union? We combine all our money together and give it to an agent who then negotiates a lower cost on our behalf.)

But the extreme overhead in processing the medications has got to put a huge burden on the system. You have banks of call centers and insurance brokers and adjusters. People spending all day, every day, denying claims; arguing with physicians telling my doctor, who knows me and has known me for 20 years, that his prescription is not right. So, my doctor has to charge more for my office visit so that he can cover his costs while he waits on the line to have some clerk somewhere with no medical training argue with him about what is best for me - the patient. Oh by the way, the clerk has never seen or heard of me and the next time you call in, you won't talk to that person either.

Doctors offices have had to consolidate into groups so that they can afford to pay someone to fight with the insurance companies to get paid. So, there are people who spend all day, every day, as an advocate for the doctors offices, negotiating with the insurance companies and trying to cut through all the red tape. After all, insurance companies lose money when they pay claims.

Wow, what a business. I want to go into business where you pay me to NOT pay for services that you need. What kind of idiot would subscribe to such a business? Oh, wait, that's most of us and soon to be all of us! This business wouldn't work if it wasn't mandated by government (which is the core tenant of Obamacare).

I don't know, I am no expert but it seems to me that the system could be more efficient. Yet, there may be few (if any) government services that are as efficient as private sector services. So, I worry that the situation will get much worse.

I worry that America has lost its spirit of independence and replaced it with dependence on government.

There are some loud voices on both sides of the health care debate, but the common person doesn't understand the issues and can be easily swayed with harsh rhetoric. I perceive that the health care debate can not be resolved in isolation which is why it has been so difficult to deal with. The same sickness that cripples healthcare, infects social security, has caused the bank bailouts which were precipitated by stupid lending practices and stupid people buying property they should have known better not to buy; this sickness infects the entire nation from the ground to the top.

We are getting fat and lazy. We don't hold each other accountable nor do we expect anyone to hold us accountable. Everywhere there's the idea that someone will step in and fix this. Grab me another beer and turn on the tube so I don't have to be bothered with it. Then when we do feel guilty for not doing our part, we think "where do I start?" How do you go about changing the world? It's just so big and hard and complicated. What can one person do?

I'll tell you. Stop expecting anyone to take care of you. Work your ass off. Keep your affairs honest and right. Do what you believe to be the right thing and don't apologize for it. Set your mind to do things and don't let anyone deter you. Cheerfully embrace competition and stay away from bad people. Turn off the tube. Spend some time working up a plan and then do it.

Ok, now go to it. Turn off that computer.

It's Ok if you never comment on this blog. I'll understand - you're out changing the world.