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Paul R. Hollrah, O.E.

The Real Problem with Healthcare
August 19, 2009

The real problem with healthcare in our country is not quality or availability; the problem with healthcare is the inexplicably high cost, and the fact that no one seems interested in finding out exactly why healthcare is so expensive and who gets all the money.

 

The current resident of the White House and his friends in Congress are now attempting to ram through a national healthcare system that will extend healthcare coverage to 10 million or 40 million (take your pick) uninsured residents, legal and illegal; a plan that they claim will not interfere with existing patient-doctor-insurer relationships and that will reduce the overall amount that Americans now spend on healthcare.

 

It is a fool’s errand and it is bound to fail. Yet, Democrats are attempting to write a prescription without first determining the nature of the ailment. As I have written in a previous column, it is as if Obama and congressional Democrats asked the American people to join them on a long hot drive across the barren wastes of Kazakhstan, where the distance between service stations is 500 or 600 miles, without first checking the gas gauge. In other words, no one appears to be asking the operative question: who gets all that money?

 

For example, in a recent radio broadcast, conservative talk show host Neal Boortz discussed the rationing of healthcare that is almost certain to occur if Obama and congressional Democrats are successful in winning passage of their healthcare reform proposal.

 

Boortz described how, for many years, a seriously dysfunctional knee made it almost impossible for him to walk after playing a round of golf. He went on to say that knee replacement surgery completely changed his life. In fact, the knee replacement was so successful that he didn’t mind paying the $45,000 cost of the operation.

 

Boortz’s enthusiasm for his new knee is understandable, but the question arises: what was the true cost of Boortz’s knee replacement? It couldn’t possibly approach $45,000.

 

Let’s assume that the total amount of time the orthopedic surgeon spent with Boortz was two hours...a total of thirty minutes pre-op and post-op and ninety minutes in the operating room...at $500 per hour (that’s more than even lawyers make). And let’s assume that the surgeon is supported by two full time nurses at $30 per hour and two full time clerical employees at $25 per hour, that his employees receive a 25 percent markup in fringe benefits, that his office rent and utilities run to $3,000 per month, and that his medical malpractice insurance premiums come to approximately $200,000 per year.

 

And finally, let’s assume that the cost of Boortz’s prosthesis was $3,000, that charges for the use of the operating room were $1,000, that he spent two days in a post-op semi-private room at $300 per day, and that the anesthesiologist charged $1,000 for ninety minutes of his/her time. Adding up all these costs, the actual cost of Boortz’s knee replacement should have come to just under $7,000.

 

So who got the other $38,000 from Boortz’s knee replacement? How did the medical profession manage to mark up his knee replacement by a whopping 540 percent, over and above the actual cost? Is it because, as doctors and hospitals like to tell us, it is the only way they can recoup the cost of medical services provided to the poor and the uninsured who use hospital emergency rooms for their primary care?

 

Although we Americans have the best healthcare available anywhere on Earth, our system is burdened with real problems, most related to cost. We have a Cadillac healthcare system with a used pickup truck population. Barack Obama has said that, as a people, we spend more and get less than is provided by other (healthcare) systems. Well, he’s half right. We do spend more on healthcare than any other nation, but we get an awful lot for it. So the problem becomes one of making it affordable for all, rich and poor alike.

 

As a way of getting at the true cost of healthcare for all those who are either insured, or who pay for their care out of their own pocket, we should begin by separating out the healthcare costs of all those who cannot or will not pay. If 270 million Americans have some means of paying for their healthcare, and 30 million do not, let’s concentrate on getting healthcare costs for the 270 million out of the stratosphere and down to Earth.

 

If Obama and the Democrats feel the need to buy the political allegiance of 30 million uninsured people, including illegal immigrants, then so be it. We know that’s what Democrats do and there’s probably nothing we can ever do about that; it’s the nature of the beast. So, if we must, let’s provide the funds necessary to develop a system of low cost, not-for-profit community clinics...clinics that do not compete with private for-profit clinics and hospitals...for all those who now use hospital emergency rooms for their primary care.

 

Similar to the Veterans Administration clinics, which provide excellent service to veterans, the non-profit community clinics would be government operated, staffed by doctors and nurses who want to work with the poor, the homeless, and those who’ve made poor life choices, and who would be happy with a modest income. For those doctors and nurses burdened with student loans, service in a clinic for a period of years would provide an opportunity to retire their debt. Most importantly, without the poor and the uninsured to hide behind, hospitals and medical professionals would be forced to adopt reasonable and supportable fees for their services.

 

The community clinics would also serve as magnets for retired doctors and nurses who wish to contribute their time and talents to the community. They would also provide an opportunity for wealthy liberals with an unquenchable concern for the poor and the less fortunate to write a generous check from time to time.

 

Hospitals emergency rooms could once again return to the business of providing emergency medical services. And gone would be the days when patients could experience the sort of "sticker shock” suffered by a friend in South St. Louis. After a two day hospital stay by his wife, the itemized invoice contained a $40 charge for toilet tissue. Good manners prevent me from repeating exactly what my friend said to the good Sisters of St. Mary after reviewing his invoice.

 

Although most everyone agrees that something must be done about the high cost of medical care, the American people are becoming more and more convinced that the Democrat proposal now under consideration in the House of Representatives is not what is needed. And lest members of the Democrat majority doubt the truth of that, their constituents are giving them an earful during the August recess.

 

None of this is surprising. As one young Pennsylvania woman shouted at the turncoat senator, Republican-turned-Democrat Arlen Specter, "You have awakened a sleeping giant.”

 

What is hard to understand is why normally astute Democrats fail to understand the intensity and the sincerity of the grassroots opposition. A union-backed organization called Health Care for America Now (HCAN), which supports the current House bill, has recently published a four-page memorandum telling Obama supporters how to "bully” town hall protesters. The document tells union members, "it’s important that you take away right-wingers' opportunities to talk with reporters." It tells its enforcers to physically "confiscate signs or leaflets” of those opposing ObamaCare.

 

Deputy White House Chief of Staff, Jim Messina, has advised Obama supporters at town hall meetings to "push back twice as hard,” a clear incitement to violence by union thugs against protesters who are mostly senior citizens.

 

House Speaker Nancy Pelosi has accused town hall protesters of being Nazis and the Democrat leaders of the United States Senate, Harry Reid (D-NV), has referred to opponents of the House healthcare bill as "evil-mongers.”

 

When is the last time that the principal leaders of a major political party, in Congress and in the White House, have attacked law-abiding American citizens in this manner? It has never happened before in our nation’s history.

 

But one thing is certain: when the members of Congress return to Washington in September, there will be a great many more who will have experienced a "come to Jesus” moment while spending a few weeks with the folks back home.


About Paul R. Hollrah, O.E.
Paul R. Hollrah is a freelance writer. He is a member of the Civil Engineering Academy of Distinguished Alumni at the University of Missouri - Columbia and a Senior Fellow at the Lincoln Heritage Institute. He currently resides in Tulsa, Oklahoma.