Thursday, June 11, 2009

How did we get here?

Health care seems to be the major topic of the day so let me throw out a little history to see exactly how we ended up in this sinking boat. Some time ago schools required students to participate in gym class at least three days a week. They also encouraged after school sports. This was at a time when TV was so new that it wasn't on most of the time so kids would grab a football or baseball and head to the streets to play before dinner. In the summer it was out to play some more after dinner. Hide and seek, stoop tag and army were some of the favorites back then. All involved a great deal of running. Meals were different then too. Fast food was something that was relegated to special occasions when you went to the roller rink or ball game which wasn't very often. Soda came in either 8 or 12 oz bottles. If it was 12 you only got to drink half because you had to share it with a brother or sister. Milk or juice was the beverage of the day back then. No fried or high carb foods were served back then unless it was chicken or spaghetti and even then there was a salad or green veggie that went with it. Desert in summer was fruit. Schools had no vending machines and the only beverage they sold at lunch was a half pint of milk.

So now we contrast that with what's happened. Kids hunker down to watch their favorite cable movie or hit the web to IM their friends. And let's not forget the snacks. Grab a twenty four oz. cola and a bag of chips so you can eat with one hand and type with the other. That's three times the cola and about six times the chips (bags used to be 1 oz.) than were eaten in the past with no offsetting exersize to burn it off.

How did the health care system get where it is now. I may have mentioned this before but I'll repeat it. Our system back in the fifties was mostly non profit as were the insurance companies. And stop to consider this was at a time when we had a baby boom so hospitals were in the process of expanding. It wasn't until the coming of HMOs started by Nixon that there was any strain on the system. There were entire charity support groups who volunteered their time and raised money to help offset some of the costs. Doctors back then did something unheard of in today's market. They charged their wealthy patients a bit more to cover the costs for those who couldn't pay. There was also grants and special loans and payment terms. All you had to do was stop by the billing department and they would set you up with a payment plan (with no interest charges by the way). And that was true up through the 70s.
The cost of going to an ER wouldn't scare you to death like today. Even private hospitals back then would accomodate most people even if you weren't J. Gotrocks Jr.

So where do we go from here. At present this country spends $2 trillion dollars on health care each year. If we can get that figure down to $1.2 trillion then it would amount to about 10% of our GDP which is a managable figure. To do that we'll need to eliminate the many layers of administrators and bean counters who do nothing more than add to the cost. Patient info could be kept safely on a portable flash drive or card with biometric security. That would save a ton of money right there. A copay by working people of $50 for a doctors vist or $100 for emergency room visit would help pay a bit of the costs.
At present we pay well over $6000 per year per person for health care. It's Obama's hope to get that down to $4500. Here's an idea. Have the employer pay 1/3 of that which would cut his costs by 2/3. All workers would be charged 1/3 as a payroll deduction much like medicare and social security and that would cover him when he out of work as well as covering the uninsured. The final 1/3 could be covered by a small federal sales tax. That would fill in any gaps. It works out to $30 per week for a worker and I don't know where you could get any type of insurance for that little right now.
There should be a public option and if it works out right unions just might switch to it if the insurers they have now don't become more competetive.

Well it's a thought.


Tom Harper said...

Good description of how we've dug ourselves into this hole by eating junk food, and too much of it, and not exercising. As contemptible as HMOs are, we can't blame them for the millions of obese couch potatoes whose only exercise is walking from the TV to the refrigerator.

There's a book from the 1960s (it might have been written earlier than that) called Back To Eden. The author talks about herbal cures for almost every ailment, but mostly he rants about over-processed and devitalized foods and how they've wrecked Americans' health. And this was before the days of fast food and Big Gulp soft drinks and computers. This author would be turning in his grave if he could see how Americans' diets and health habits have degenerated in the 50 to 60 years since he wrote his book.

Anonymous said...

You can't unscramble an egg or unring a bell, so now what? NO ONE goes outside anymore unless they're (A) on their way to work, or (B) on their way to rob your house while you're at work. Kids have NO reason to go outside when video games are so entertaining. I used to get so sad that mom made me go to bed while the kids were still outside playing.

BBC said...

I'm telling you that this issue isn't going to get fixed so just take care of yourself.

Do like me and eat to live and not live to eat. On some days I have to force myself to eat more to keep from being under weight.

Not that it matters, I'm still going to die, and I'm not going to expect the taxpayers to put out a lot trying to keep me alive.

Here's an idea. Have the employer pay 1/3 of that which would cut his costs by 2/3. All workers would be charged 1/3 as a payroll deduction much like medicare and social security and that would cover him when he out of work as well as covering the uninsured. The final 1/3 could be covered by a small federal sales tax. That would fill in any gaps.

Actually, that wouldn't change a darn thing. It doesn't matter where the money comes from in the bookkeeping because all money comes from the workers and what they produce.

Workers and their consuming pays for everything. Everything!!! So I don't care how you cook it in the books, it's still you that has to pay for it all.

Make the employer pay it all or break it up any other way you like, it's still you that will be paying for it all, either directly or through increased costs for the things you buy because your employer has to pay for it.

Health care is no free lunch, I don't care how you look at it. It would help if the greed could be removed from it though.

And it would help if we wasn't having to keep supporting millions of these monkeys that only worked for 20 years and now want us to support them for another 40 years until they die.

Oh sure, we can afford to do that. Well, maybe you can, but I can't. I worked my way to an honest retirement and helped pay the way for other bottom feeders all the way.

Now I'm pretty much out of the loop so I guess it's up to you to keep working to keep it all going because you not only have to pay for your health care you also have to chip in to keep the bottom feeders alive.

So how do you like those beans?

BBC said...

NO ONE goes outside anymore unless

Excuse me but even though it seems like I'm on the internet a lot I also spend a hell of a lot of time outside.

I do more camping in one month than a lot of monkeys do in a year. I was outside for a good eight hours today but I did find time to do a post.


Demeur said...

Tom I vagely remember that book. I wasn't into much of that but I do pay more attention now. Even a lot of the " natural foods" in the health food section aren't good for you either. Much of it is contaminated because it has no preservatives at least that's what my naturopathic Dr. tells me.

Dana Well we might start with PE in schools and some after school programs to keep them from playing cat burgler. And now aren't you glad your mom made you get your beauty sleep?

Billy you and I grew up when there wasn't anything else to do and that has stuck as a habit. I can't say that I'm much of an outdoors type person because what I do is quite physical but I do keep fairly active outside work.

S.W. anderson said...

You're so right about how it used to be and some of the contributing factors to a poorer level of health nowadays. We dined at a popular buffet restaurant today, and the percentage of grossly overweight people there, many of them eating immoderately, to put it mildly, was troubling. When I say grossly obese, I'm not talking about a little overweight or kind of paunchy. I'm talking about people whose knees and ankles, heart and circulatory system are surely taking a beating because they are way, way overweight.

Add to your list people routinely getting too little sleep. A report a couple of years ago showed the average American 25-55 (I think) getting closer to seven hours a night than eight. That's not good.

Your funding idea isn't bad but I think a federal sales tax would go over like a lead balloon. It's also regressive, hitting the poor and those on fixed income too hard at a time when they're already hurting while very well off have benefited so greatly for so long from incredible tax breaks.

BBC said...

WASHINGTON – President Barack Obama is seeking to help pay for his health care plan by sharply reducing the government's medical spending, mainly by trimming payments to prescription drugmakers, hospitals and other care providers.

I don't have a solution, that others would like, but I admire the problem. But his cutting payments wouldn't help a bit, it would just mean that we would get less health care.

Actually, older American's should be getting 'end of life care' not 'trying to help them get to 120 care'.

Or maybe it should be based on their contribution to society over the years? This country is sure keeping a lot of bottom feeders alive, and supporting them to boot.