What's Wrong in HealthCare

The Gallup Poll underscores what’s wrong in HealthCare

Americans Borrowed $88 Billion to Pay for Health Care Last Year, Survey Finds           

By Karen Zraick | NY Times | April 2, 2019

Let’s dissect this article in the NYT

Is it irrelevant, fake news, misinformation, misinterpretation or disinformation?

a)    When did borrowing for a service or product become an issue?

About 70 percent of respondents in a new survey said they did not have confidence in their elected officials to lower health care costs. CreditCreditSarah Silbiger/The New York Times (a)

b)    This is not a government function. Price controls are always counterproductive.

 Americans borrowed an estimated $88 billion over the last year to pay for health care, according to a survey released on Tuesday by Gallup and the nonprofit West Health.

c)     Americans should avoid most ER visits since three-fourths are not Emergencies.

There was a partisan divide when respondents were asked whether they believed that the American health care system is among the best in the world: Among Republicans, 67 percent of respondents said they believed so; that number was 38 percent among Democrats.

d)              That’s a liberal fallacy since they feel health care should be free to be the best when, in  fact, when it is free, it becomes the worst.

But Democrats and Republicans had similar responses about putting off medical treatment. Asked if they had deferred treatment because of the cost, 27 percent of Democrats said they had, compared with 21 percent of Republicans and 30 percent of independents.

e)               Have you ever heard of anyone dying from deferring a treatment? In socialized medicine countries treatment is frequently delayed for months or even years. Isn’t it better to voluntarily delay ones own treatment than to have the National Health Service (NHS) or Canadian Medicare to forcefully defer your treatment?

Respondents from across the political spectrum also reported pessimism about their leaders’ abilities to reduce health care costs. About 70 percent of respondents said they had no confidence in their elected officials to bring prices down. And 77 percent said they were concerned that rising health care costs would damage the American economy.

f)      This is one area that leftist and conservatives agree on – government can’t do it.

Governments should not try to do it—price controls damage the Economy.

“Our data shows an American public that’s beaten down from this really serious issue,” said Dan Witters, a senior researcher at Gallup.

g)    That is Gallop’s interpretation. This underscores that Americans need to study the constitution and economics so they won’t be beaten down by logic.

At the same time, 64 percent of respondents said they were mostly satisfied with their experiences in the health care system. When asked if they were satisfied with how well the system was serving Americans generally, only 39 percent said they were.

h)    The leftists are convinced that if one has to pay for healthcare, they are not satisfied and any result would not satisfy.

The survey’s authors noted that Americans’ feelings were complicated and at times conflicted. But one thing was clear: High health care costs had created significant anxiety. Even among households earning $180,000 or more a year, a third of respondents said they were concerned about the specter of personal bankruptcy because of a health crisis. (There has been fierce debate among researchers about the extent to which health care costs can be blamed for bankruptcies.)

i)      Bankruptcies are caused by expensive first dollar coverage of routine out-patient care which is not an insurable expense any more than a car tune-up can be covered by car insurance.  

Many American families earning less than that, of course, feel the effects of high health care costs acutely. They are forced to cut back on other expenses to pay for health care, or skip appointments and prescription refills, creating health risks down the road.

j)      That’s a leftist interpretation because they think there should be no out-of-pocket costs. But in the NHS and Canadian Medicare with prolonged waiting list, patients are dying on the wait list. In America everyone can always get emergency care in any hospital emergency department.

Twelve percent of respondents said they had borrowed money for care, including 11 percent of those with health insurance, who may still face high deductibles and other out-of-pocket expenses.

k)     It’s the high deductible that save you enough money to pay for the deductibles and co-pays.

Most survey respondents said they believed that Americans were paying too much for health care relative to what they receive. Asked to choose between a hypothetical freeze in their health care costs or a 10 percent increase in household income, 61 percent of respondents chose the freeze. Those in low-income households were most likely to choose that option.

l)      This is extremely telling that the poor people don’t believe that you can freeze healthcare expenses to help them escape poverty.

“When we’re talking about health care and the debate right now, it usually bifurcates between the financial impact of health care or the health outcomes themselves,” said Tim Lash, chief strategy officer for West Health, a nonpartisan nonprofit that aims to lower health care prices.

m)   Lower health care costs will come when we all limit our healthcare appetite on our own and lower insurance costs will only happen when we all save by purchasing high deductive plans and pay for our own routine care.

“But those two things intersect at access,” which can have dire health consequences, he said.

n)    Only if you do not save your money by buying HDHPs

The organization believes that Congress should allow Medicare to negotiate directly with drug companies; that there should be more transparency about the prices of medicines and procedures; and that the health care industry should shift toward “value-based care” — in which doctors are paid based on patient outcomes — rather than the current “fee-for-service” model.

o)    Yes, there should be more transparencies about prices of medicines and procedures. This is automatic in HDHP because the patient pays directly for his care, not a third party. Everything he pays is transparent or he won’t pay.

p)    When government negotiates prices, they always increase.

q)    Value-based care happens only when the patient pays directly, never when someone else pays.

r)     One can’t have value-based care without “fee-for-service.” That’s the only way a consumer or patient can evaluate the service he purchases. There is no other way that fees will match services—not only in healthcare, but in everything we purchase.

FINAL NOTE: Steve Jobs was asked why he didn’t poll consumers as to what they want. He said there would never have been any iPhones, iPads, or iPods if he had listened to consumers.

We can also safely assume there will never be any healthcare reform based on any results from Gallop polls or surveys of consumers, physicians, nurses, patients, hospital administrators, insurance administrators, medical group administrators, senators, representatives, lawyers, judges. When I was editor of Sacramento Medicine in the 1990s, I had a number of physicians write me with their ideas of a health plan. When I pointed out the fallacy in their plan, they would have a new one to me the next month.  None understood the intricacies outside of their narrow field or specialty.

The public has as little knowledge of the intricacies of health care as they would have about the intricacies of iPhones, iPads and iPods.

Physicians may be experts in Medicine, Surgery, Pediatrics, OB, Gyn, etc., but they are ill informed about overall healthcare.

Nurses may be experts in nursing, nurse clinical specialists, nurse practitioners, and nursing administration, but are ill informed about overall healthcare.

Great things are done by the professionals in their respective fields with many years of experience combined with an innovative vision. The founder of the Mayo Clinic and the Menninger Clinic are good examples of being innovative in their respective fields after longtime service during which the founders developed an overview and how to improve their specialty but not the entire profession.

So what is this article?

Is it irrelevant, fake news, misinformation, misinterpretation, or disinformation?

It’s not irrelevant. It’s relevant to understand prejudicial thinking.

It’s not news. It’s fake news to serve partisan interest.         

It’s not misinformation but it is information.

It’s not misinterpretation, it’s factual.

It’s disinformation or false information deliberately and often covertly spread (as by the planting of rumors) in order to influence public opinion or obscure the truth.

Comments by Del Meyer, MD, Editor, MedicalTuesday.net