Look: Democrat, Republican, Liberal, Conservative, MAGA, Socialist; nobody likes taxes. But reasonable people understand that there are tasks better handled by the Government than by \u201cpay as you go\u201d private industry. It\u2019s \u201cNo Taxes\u201d until your house is on fire. Then it\u2019s how quick can the fire department get there to put it out. <\/p>\n\n\n\n
So when the Republicans in the Congress look to \u201ccut taxes\u201d by cutting Medicare and Medicaid, like they are doing in Trump\u2019s \u201cBig, Beautiful Bill\u201d; on the \u201csurface\u201d it might sound OK. If you\u2019re not sixty-five (or you still have employee insurance), or your family of four makes more than $78000; those cuts are \u201cno skin off your nose\u201d. Or are they?<\/p>\n\n\n\n
It would be easy, at this point, to give you my \u201cstandard\u201d, Democratic\/Liberal rationale for why health care ought to be a right, not a privilege. I would tell you that any modern nation that fails to take care of the health of their citizens is failing as a society. I would point out that every \u201cfirst world\u201d country on Earth, from Canada to Germany to Japan, sees healthcare as a basic human right. And you might respond that in those countries healthcare is \u201crationed\u201d by waiting: waiting in line for an appointment or an elective surgery. <\/p>\n\n\n\n
I would respond that here in the United States we also \u201cration\u201d our healthcare. We do it by the capacity to pay for it. So, instead of \u201call people are created equal\u201d for healthcare, it\u2019s a \u201ccash on the barrelhead\u201d system. Don\u2019t have the cash, well, as Iowa Senator Joni Ernst said, \u201cWe\u2019re all going to die\u201d. You go first. <\/p>\n\n\n\n
We know that. Go to the doctor\u2019s office, or for a test, or for a procedure in the hospital. The very first thing you do, is make sure the bill will be paid. I remember when I was coaching middle school wrestling by teaching kids on the mat, and a young heavyweight countered my move with an elbow to my mouth. My tooth went through my lip, and I needed stitches. As I stood before the counter at the emergency department, the attendant took my through all of my insurance coverages, making sure I could pay. When she couldn\u2019t understand my answers (after all, I had gauze compressed against my mouth), I finally had to just bleed all over the desk, and give her the \u201ccorrect\u201d responses. It was my proverbial \u201ccash on the barrelhead\u201d, my admittance to get care.<\/p>\n\n\n\n
But, your response should be that \u201cno one dies\u201d. If someone shows up at an Emergency Department with a life-threatening condition, they are treated no matter what. And I\u2019ll drop my head, and agree. But that stills leave the question \u2013 in our \u201ccash on the barrelhead\u201d system, who pays for them?<\/p>\n\n\n\n
Well, Medicaid does right now, for those under a certain income level. And Medicare pays for most of those over the age of sixty-five. But for those who don\u2019t qualify now, or for all of those millions (10.9 million according to the Congressional Budget Office) who won\u2019t have insurance after the \u201cBig, Beautiful Bill\u201d passes; where\u2019s their \u201ccash on the barrelhead\u201d coming from?<\/p>\n\n\n\n
The answer, just like taxes, is from you and me.\u00a0\u00a0While most of our hospitals are considered \u201cnon-profit\u201d organizations by the IRS, they are in fact, more business than fire department.\u00a0\u00a0They need to cover their costs.\u00a0\u00a0And when a patient doesn\u2019t have the capacity to pay their bill, then the rest of us \u201cchip in\u201d.\u00a0\u00a0Of course, no one passes the hat at the hospital to pay for them.\u00a0<\/p>\n\n\n\n
The \u201cbusiness\u201d of the hospital simply raise all of the prices for procedures, medications, \u201croom and board\u201d, and service. So each of our medical bills (paid by our insurance), increases to cover the cost of \u201cindigent care\u201d. Those costs go up, and as everyone with health insurance knows, so does the cost of that insurance.<\/p>\n\n\n\n
So cut Medicare, cut Medicaid, and what happens. Well, those folks without insurance will go to the \u201cback of the line\u201d for most healthcare. They won\u2019t be able to get preventative care, or \u201celective\u201d procedures. Their lack of \u201ccash\u201d to put on the proverbial \u201cbarrelhead\u201d puts them last. And when those medical conditions that could have been prevented become life-threatening, then they end up with the most expensive care our medical establishment offers: emergency care. <\/p>\n\n\n\n
And we all pay for it.<\/p>\n\n\n\n
If you look at what\u2019s gone up more in the past decade, taxes or health insurance, my bet is you\u2019ll find that insurance is the \u201cwinner\u201d. And when we take millions out of the \u201calready paid for\u201d column, and make the hospitals ante up for their costs, whose really eating that?<\/p>\n\n\n\n
We are.<\/p>\n\n\n\n
For many, the cost of insurance is in the \u201ctop five\u201d annual expenses, along with housing (mortgage), food, and taxes. What good is a $1600 a year tax savings by the \u201cBig, Beautiful Bill\u201d (per the CBO), if health insurance will eat that and more? <\/p>\n\n\n\n
\u00a0It\u2019s bad medical care and health policy.\u00a0\u00a0And, it\u2019s just more of our money out of our pocket and on the medical \u201cbarrelhead\u201d.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"