Health Care Fantasyland

Tamara Dietrich, a local columnist for the Newport News Daily Press is among the latest uninformed and uninforming media types to consider the current proposals in Congress to reform health care. In a column appearing Monday, Ms. Dietrich manages to display a stunning degree of ignorance. Where shall we begin?

Ms. Dietrich begins by citing the concerns of a local resident Teresa Crowson described as being "married to a city firefighter with good private insurance." When Ms. Dietrich describes this as private insurance one should not read this to mean individual insurance obtained directly by Ms. Crowson, but a plan purchased by the city that the firefighter works for and for which she and her firefighter spouse are subscribed. This is important because the insurance coverage purchaser, the city, determined the terms of the policy, and shortcomings of the plan if any are the result of the city's negotiation with the insurer or the result of a competitive public procurement based on specifications provided by the city government.

Ms. Dietrich tells us that Crowson's insurance (that is the city's health insurance) would not kick in right away because her diagnosis was only probable. It is likely that the plan the city negotiated only covered services for an actual diagnosis, not a probable one. After the initial denial it is not clear that Ms. Crowson and her physician communicated about the denial to permit the physician to confirm a diagnosis for the insurer to permit payment.

Ms. Dietrich then goes on to opine:

Insurers who drag their feet when you need them most, who drop you if you get sick, who fight you over procedures or won't take you on to begin with because you might be a drag on their profit margin — all excellent reasons for a government-run health-care plan.

There is no evidence of any foot dragging in this case, except for the doctor's unfortunate uncertain diagnosis. Group health insurance as described here does not drop anyone due to getting sick, it is open to all eligible employees defined by the employer. Being open to all employees who meet the employer's requirement, it covers employees who maintained credible insurance coverage from the previous employer regardless of prior conditions, and picks up new employees.

There is also no evidence from Ms. Dietrich that Ms. Crowson's coverage was paid on an insured basis. Many city governments have self insured plans administered by health insurance companies. In these plans the total cost of the paid claims is an expense to the city and any profits for the administrator come from the administration fees alone. The profit motive does not enter into decisions about the claims payments.

Ms. Dietrich's comment about "all excellent reasons for a government-run health-care plan" is entirely wrong given that the insurance Ms. Crowson had, the basis of their complaint, was a government-run health-care plan.

Ms. Dietrich's diatribe continues with a quote from the current Secretary for Health and Human Services, and prior late-term abortion promoter Kathleen Sebelius: "We spend twice as much on health care as any other country on earth, and we live sicker and die younger than any developed nation," Kathleen Sebelius, secretary of Health and Human Services, said this week. "So we are not getting our money's worth out of our health-care system."

Ms. Sebelius statement may have elements of truth in it, but in total it is a lie. We spend tice as much on health care as any other country on earth. If would be nice if Ms. Sebelius told us who was the "we" in we spend and who was the "we" in we are not getting our money's worth. Health care is purchased by many different entities in the United States. Individuals, employers, associations, and governments. Health care spending includes laser eye surgery paid for entirely by individuals, botox and viagra purchases by individuals, health supplements and vitamins purchased by individuals together with health care purchases through insurers and governments. All of that un-reimbursed spending by individuals including those late term abortions Ms. Sebelius had been promoting is entirely their choice. Unless Ms. Dietrich wants to decide if she approves or not, it should remain an individual choice. Perhaps Ms. Sebelius is correct that the federal agency she runs does not get its money's worth for the health care it purchases and has been purchasing for more than 30 years. If that is the case it is no argument for more and greater ineffective and incompetent government health care purchases.

Ms. Dietrich next brings out the trope about 46 million uninsured Americans. That is the 12 million illegal aliens who cannot now enroll in a health care plan. One would suppose they could participate in the wonderful health plans their home country governments sponsor and would provide them if they went home. Another 9 million are already eligible for Medicaid or S-Chips but choose not to enroll. Perhaps they don't value those government health care plans quite as much as Ms. Dietrich. Another quarter of those 46 million live in household with incomes over $75,000 per year that could purchase health insurance but choose not too. If they are healthy they may find their expenses are less than the cost of the insurance and pay for it at a lower cost out of their own pocket. As an extreme but telling example here, Bill Gates and Warren Buffet don't need health insurance. If they are sick they can buy a hospital.

Finally Ms. Dietrich quotes Rep. Bobby Scott (D VA3rd):

"The public health-care option will not have multi-million-dollar CEO salaries. It will not have dividends paid to stockholders. It will not have sales commissions in advertising that would come before anybody gets any health care."

If Rep. Scott does not believe there are the same administrative costs for the 'public option' or for current government medical plans he is delusional. The agency Ms. Sebelius runs is budgeted to spend in FY2010 over $17 billion administering the Medicare program ( an increase of $646 million over 2009) not counting an agency overhead of over $7 billion. HHS will also incur $12.3 billion in expenses for the states to manage the Medicaid program.

I don't have a firm diagnosis for the cause of Ms. Dietrich's article. Willful ignorance comes to mind, perhaps recto-cranial inversion. Whatever the diagnosis, the prognosis for people believing her arguments is terminal stupidity.

(Fantasyland photo copyright Walt Disney World)