You\u2019re a doctor. You need to bring in $3,000 apiece for your most common procedure. But Medicare and Medicaid — which pay for about half your patients — have just told you they\u2019re only going to pay you one-third of what they\u2019re billed. What do you do? You don\u2019t need to be a CPA to know the answer is to start billing everyone $4,500 for your procedure. The half of your patients who pay full price thus pay $1,500 extra, covering the $1,500 shortfall for each Medicare\/Medicaid-covered procedure. <\/p>\n
Now the tricky question: If someone who\u2019s NOT on Medicaid or Medicare visits your medical office to have this procedure done, and promptly pays his or her $4,500 in full, how much has he or she paid you, this year? <\/p>\n
And the answer is: $6,000. Those who are not on Medicare or Medicaid are known as \u201ctaxpayers.\u201d Where do you think Medicare\/Medicaid got the $1,500 to pay for the welfare patient? The taxpayer pays $4,500 for his or her own procedure, and then an extra $1,500 in taxes to fund someone else\u2019s. <\/p>\n
For all those who have written in insisting that we need government to pay our medical bills because they\u2019re so high, let\u2019s keep this simple: <\/p>\n
Medical bills are really high because the government promises to pay most of them, the same way government-backed \u201ccollege loans\u201d have driven up the cost of college, by allowing colleges to charge you whatever you can afford plus whatever the government will loan. <\/p>\n
Perhaps it\u2019s still technically a minority of Americans who are currently \u201ccovered\u201d by Medicare and Medicaid. But since the old and the poor (the latter often skimping on health maintenance and prevention) use the most medicine and medical care, the majority of medical COSTS are covered and \u201cpaid for\u201d by these two socialist programs. <\/p>\n
Some say as much as two thirds. <\/p>\n
If we switched over to \u201ccash only\u201d medicine tomorrow — no government or even private insurance payments allowed — what do you suppose would happen to medical costs? <\/p>\n
Remember, the doctor who\u2019s been accustomed to billing $4,500 for a procedure really only gets $1,500 from Medicare\/Medicaid, a scheme that\u2019s already jacked up YOUR cost by 50 percent. <\/p>\n
Of that $1,500, another $500 (and that may be understated) goes to pay doctors\u2019 non-medical office staff who negotiate bills and payments with the private and government \u201cinsurance\u201d firms. <\/p>\n
So the doc who \u201cbilled\u201d $4,500 expected to get about half that. The rest is only \u201cin there\u201d to buy off this unholy private-public \u201cinsurance\u201d bureaucracy. <\/p>\n
If he could fire all those non-medical \u201cbilling\u201d people in his office, and if the doctor could again assume that most patients might pay the full amount billed on a timely basis, in cash, he or she could drop many posted charges from $4,500 to $2,000 overnight. <\/p>\n
And what if that still didn\u2019t produce enough business? Could our M.D. somehow manage to drop that price again, to $1,500, advertising \u201cLowest rates in town\u201d? In a true free market, he\u2019d have to. Streamline his costs of \u201cregulatory compliance,\u201d and he could probably do even better. <\/p>\n
Not only that, in a \u201ccash\u201d environment, conversations might be heard in the examining room which are virtually unknown today. Conversations starting with: <\/p>\n
\u201cThere are three ways we can handle this problem. The middle course will cost $500 and probably not do much good, which means you\u2019ll just have to come back for the $5,000 \u2018third-choice\u2019 procedure, anyway. But first we may want to try something real simple that\u2019ll take a few weeks but will only cost you fifty bucks …\u201d <\/p>\n
Or: \u201cThere are three medicines I can give you for this. The first two were recently patented and would cost you $500 a month and the salesgal who comes by to promote them has great knockers and wears short skirts and gives me all kinds of free notepads and ballpoint pens. On the other hand, there\u2019s an old generic drug that\u2019ll probably do just as well or better for five bucks a month. Want to try that first?\u201d <\/p>\n
Doctors long ago fell out of the habit of discussing things this way. It sounds \u201cunprofessional.\u201d But it\u2019s no more \u201cunprofessional\u201d than a roofer telling you about something he can try to repair your chimney flashing before you go to the expense of replacing your entire roof. The difference is that roofers know you\u2019re likely to contact someone else — someone who won\u2019t make them wait a month for \u201can appointment\u201d because the number of practitioners in that profession aren\u2019t as artificially limited by the state licensing agencies — if they get too arrogant and don\u2019t tell you all your options. <\/p>\n
As medicine has gotten better, some treatments have been introduced which are just plain more expensive. But a true free market always works to reduce such costs. Compare the inflation-adjusted price of a color TV today to one in 1963. <\/p>\n
Government, on the other hand, pays on a \u201ccost-plus\u201d basis. Far from creating pressure to make things cheaper, this creates an incentive to jack prices up, which is why taxpayers pay 20 bucks when a candy-striper brings a Medicare patient two aspirin in the hospital. <\/p>\n
If government had undertaken to start buying us \u201cfree\u201d color TVs in 1963, from only \u201clicensed\u201d suppliers, they\u2019d still be clunky 300-pound \u201cconsole\u201d models and they\u2019d now cost $12,000 apiece. <\/p>\n
No, from regulation designed to limit entry into the field (reducing price competition), to licensing, to socialist government \u201cinsurance\u201d schemes, it\u2019s primarily government meddling that has made a nightmare of our medical costs. So now we\u2019re prepared to believe the politicians when they tell us the solution is not a return to the free, unregulated, pre-1916 market in medicine, but rather … more government meddling, by the same people who have been busy \u201cfixing\u201d the banking industry since 1913? <\/p>\n
And to those who say, \u201cThat\u2019s unthinkable! Snake oil and charlatans! We want regulation! It makes us feel safe!\u201d — First, licensing and regulation are protection rackets. They keep supply down and prices up. If regulation guarantees our safety, why can\u2019t we sue the regulators when the doctors they \u201cregulate\u201d screw up? <\/p>\n
But second, answer me this, just once: America was supposed to be made up of 13 — now 50 — sovereign states, little greenhouses free to try all different ways of doing things. I\u2019d gladly move to the one state — one out of 50\u00ca– where medical liberty is restored, providing it also imposed no state income tax, no helmet or seatbelt or anti-smoking or \u201cendangered species\u201d or \u201cglobal warming\u201d or rural \u201cspeed limit\u201d laws, that it \u201callowed\u201d incandescent lightbulbs and full-sized rifle magazines and full-sized toilet tanks and encouraged the private ownership of machine guns. <\/p>\n
(I just described all of America in 1912, a place where our grandparents seemed pretty happy, only without the racism that CREATED the Wars on Guns and Drugs.) <\/p>\n
Which state is that? If there are a couple million of us who want to try it another way, why can\u2019t we have just one state to call our own? We\u2019re even willing to settle in the most inhospitable, God-forsaken desert you\u2019ve got. <\/p>\n
If you liked all the taxes and regulations back in California or Illinois or New York or wherever you came from, why did you come here, determined to try and make this state just like the one you fled? <\/p>\n
Do you know the meaning of the word \u201chubris\u201d? Has it never occurred to you the miners and ranchers who were already living in Nevada might have set things up just right for conditions here, and that you might want to check with them before you blithely insist on changing things in America\u2019s last endangered refuge of freedom to be just like that decaying, jobless hellhole you ran away from? <\/p>\n","protected":false},"excerpt":{"rendered":"
You\u2019re a doctor. You need to bring in $3,000 apiece for your most common procedure. But Medicare and Medicaid — which pay for about half your patients — have just told you they\u2019re only going to pay you one-third of what they\u2019re billed. What do you do? You don\u2019t need to be a CPA to […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[18,20],"tags":[],"class_list":["post-123","post","type-post","status-publish","format-standard","hentry","category-economics","category-medicine"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/pWqFl-1Z","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts\/123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=123"}],"version-history":[{"count":0,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=\/wp\/v2\/posts\/123\/revisions"}],"wp:attachment":[{"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vinsuprynowicz.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}