Archive for January, 2010
Trillion Dollar Band-Aid
Saturday, January 30th, 2010
Now that we have the most liberal Federal Government in the history of our country, they’re just salivating over all the different ways they can spend our money. And the biggest fiasco of all will be National health care. We already have the best health care system in the world. People come from everywhere to take advantage of the superior and accessible treatments that have been developed in the United States through free enterprise. However, in an effort to gain votes, politicians have used fear and enticement to sell people on “fixing” our system.
Unfortunately, that’s one campaign promise I’m afraid they will try to keep. So before we take our medicine, let’s consider what we could expect, by examining what the existing medical and dental insurance and government programs have done to those professions, and to the costs and quality of care borne by the participants.
Dental insurance became a significant factor in patient finances around 1970 in larger cities. At first, it was a considerable benefit, paying 80% of all charges up to about $2500 per year. If you take into account that costs are about ten times what they were in 1970, today that would be like having $25,000 in benefits every year. You couldn’t use it all if you tried! But even at that, there were complaints that dental insurance companies were making too much profit. They were collecting about twice as much in premiums as they were paying out in benefits. Consequently, the Insurance Commission made a rule that insurance companies could only keep 25% of the premiums for administrative costs. However, the CEO of the now defunct Pacific Union Dental Insurance Group confided in me that there were so many ways around that one, it wasn’t even funny.
So why can they collect many times more in premiums nowadays and be hard pressed to pay a meager average maximum benefit of about $1000 a year? To find the answer, just count the number of fingers in the pie.
The average dental office consists of a dentist, two assistants, and a receptionist. If a patient pays one hundred dollars, eighty of it goes to pay rent, equipment, supplies, labs, taxes, insurance, and payroll, and about twenty to the dentist. If a small insurance company is added into the mix, then part of that hundred dollars is used to pay premiums. The owner and employees of that insurance company are paid out of those premiums, with the remainder going toward actual dental benefits. The premiums from other insured members that don’t utilize their insurance that year can make up the deficit in benefits.
On a small scale, it works nicely, but as the insurance company grows and goes national, those premiums are quickly eaten up by more employees, big buildings, CEOs, VPs, executives, investor dividends, lawyers, consultants, advisors, company cars, company psychiatrists, data base management systems, stationary, postage, vacation pay, retirement pay, day care, office parties, waste, graft, fraud, lobbyists, taxes, and another list twice as long. There’s not enough left to pay decent benefits so they substitute double talk for benefits, and coerce hungry dentists into accepting less, causing service and quality to suffer, and one of the assistants to get fired!
So far we’ve been talking about administration woes associated with the implementation of large plans, but when you move from private dental and health care plans into government programs, there are other factors that make national health care an entirely different animal. With dental and medical insurance, do the employers pay your premiums out of the generosity of their hearts? Of course not. It comes out of your salary, which seems fair. You might think it would be the same with the government, but there’s one fatal flaw. A huge portion of the population isn’t paying their premiums. The working stiffs are footing the bill and the liberals are taking the credit, while villainizing those “rich” people in order to quell any pangs of conscience anyone may have about getting something for nothing. Well, the real joke on everyone is that that ‘something’ IS nothing!
Let’s use the example of the “charity” funds to illustrate. Those organizations solicit money from well-meaning people for this-and-that cause, but the recipients only end up with from 20% all the way down to 3%, depending on the size of the fund; the bigger ones keeping a higher percentage. Even though the government is vastly larger and more inefficient than any private enterprise would ever be, we will give those people who brought us the $4000 hammer and the $6000 toilet seat, the benefit of the doubt and say that 3% of the cost might trickle down to the facilities and personnel that are actually giving the medical care.
At that rate, for every million dollars used, about thirty thousand will actually go towards any kind of treatment; about the cost of a gall bladder and double hernia operation. In order to support even the worst of medical systems, (which is what it will be), economists have estimated a cost to taxpayers of about two trillion dollars a year; about one seventh of the gross national product, which is about 30 times what we currently spend on healthcare! To put that in perspective, in only five years it will have cost as much as every war in the history of this country! It will make every bailout and stimulus package we have ever done seem like a tip for your waitress. It’s like taking out a bigger credit card to pay for your last one, and you know where that leads.
That’s just the tab though. The real cost will be the downfall of our ability to access quality medical care. There will be no money left to provide it, no rapport between patient and doctor, no accountability by the providers, and no ability to find your own private practitioner. If you can get through all the red tape and beaurocracy of a system so complex it will make a dinosaur like Medicare look like a gazelle, and if you live long enough before you’re able to get an appointment, the person you will be assigned to will be some sort of tech rather than a doctor. The few doctors that are left will probably be reserved for the politicians when they realize what an abject failure this system will be, just like social security and the misappropriation charges right on the heels of the latest bailout. Instead of people coming to America for decent medical care, we will have to go somewhere else.
If you think this sounds a little extreme, I assure you I’ve been breaking it to you gently. At this point, we are pretty much at the mercy of this administration. All we can do is just not go quietly into that night.
Dr. Moulton’s article was published in the Desert Valley Times, January 2009
Posted in Dentistry | 1 Comment »