Confusing Health Care and Health Insurance

The cost of healthcare is expensive in America. First we need to understand the difference between health care and health insurance. For some reason, these seem to be linked together as one, and they should not be. You receive health care services from your doctor or pharmacy or hospital. Health Insurance is what helps you pay for these services.

We know health care spending is growing faster than the economy and a Harvard study show that it will continue for 20 years. (http://www.nytimes.com/2014/04/23/business/economy/forecasting-the-scale-of-health-spendings-climb.html?_r=0)

Everyone thought that the Affordable Care Act, Aka “Obamacare” would prevent this. It cannot, all this did was expand health insurance. Obamacare first expanded Medicaid, which in turn will expand trips to the emergency room (http://www.newsmax.com/Newsfront/Harvard-Obamacare-Medicaid-ER/2014/01/03/id/545066/) The emergency room should be for just what it says emergencies, but people go there for a common cold. Even before the Affordable Care Act, I knew people who would have a co-pay on their insurance to see a doctor, but no co-pay for the emergency room, so where would the go for care? To the emergency room because it did not cost them anything, it however did cost the insurance company. Or using a better term, the patient got to use other people’s money to pay for the emergency room. Because of the cost associated with the emergency room, it drives up the cost of health insurance as it is not designed that way.

We were on the right path when Health Savings Accounts (H.S.A) were enacted into Law in 2003 under President Bush. These were created by Senator Bill Archer, (R) Texas. They were originally called Archer M.S.A’s which stood for Medical Savings Accounts.

You see Mr. Archer realized that the most expensive part of the health insurance was the cost of doctor visits and outpatient prescription coverage were driving forces of the cost of health insurance. He believed if you eliminated them, but kept the major medical part in tact it would reduce the cost of health insurance.

To off-set the cost of the co-pays and prescriptions, you were allowed to set up a savings account to go with it for medical expenses, the money went into the account tax-free, it comes out tax-free for medical expenses. This is huge as the patient or consumer decides how they want to spend their medical dollars.

You see if you really think about it. Insurance should be for the things you cannot pay for. If you look at your auto insurance, it does not pay for maintenance on your vehicle, it pays for more expensive damages. If we left everyday type things to the consumer, they would decide if they needed a doctor ( at their expense) or not. They would decide should I go to the expensive emergency room, or should I go to my doctor or a clinic.

If you look at say cosmetic surgery. In most cases, that is not covered by insurance and has little government regulation and it has driven the prices down and the quality of service up.

To reform the healthcare system, you cannot take just one aspect of the system. If people were in charge of their healthcare dollars, they could make their own decisions. Also, have you ever been to the doctor and wondered what things cost? You never know. Why is it when you go to the doctor’s office you don’t know what it costs? When you buy your groceries you know what it costs.

There are some simple solutions, we just need to look for them.

Eric Wilson