The Car Dealership Solution to Health Insurance Costs

Bloomberg reports Obamacare premiums are scheduled to skyrocket up to 59 percent in Maryland, 38 percent in Virginia and 34 percent in Connecticut. A Baltimore 40–year–old would pay $715.00 a month for a plan with a $2,500 deductible.

Health insurance is costly for three reasons: Government interference, lack of price transparency and consumer overuse.

Here’s what would happen if we used car insurance like health insurance.

We’d expect oil changes to be covered after our $20.00 co–pay. There’d also be a long list of routine checks and diagnostics run each time your ride was in the shop, because the Dept. of Transportation requires mechanics to treat every vehicle like it was a 1961 DeSoto that had never had the oil changed.

Your $250.00 invoice would have itemized charges for GoJo, shop rags, coveralls, disposable ratchets, oil, opening the oil, oil filter and about a hundred other entries.

But that doesn’t matter, since after the co–pay, everything is free! Besides you feel sorry for DeSoto owners.

Later the car breaks down on the highway. You tell the CarFlight pilot to drop it off at the Mercedes dealer. Cost doesn’t matter once the deductible is paid, but you do demand a nice loaner while your car is in surgery.

Before leaving, you tell the mechanic to check the tires and see if they need replacing, because after all that’s what insurance is for, isn’t it?

Car insurance usage at that level would end our obesity crisis, because we’d soon be a nation of pedestrians. Obamacare would be joined by Obamacar.

Real Obamacare reform would require the health market to operate like the auto market.

I don’t mean the patient goes in the doctor’s office, negotiates for six hours and agrees on a price have his appendix removed. Then, in his weakened state, the finance manager pressures him into breast implants for the wife.

What I do mean is allowing consumer choice and provider accountability.

Smart consumers get an estimate before their car is serviced. If it’s too high, they talk to another shop. If it’s too much money to sink into an old car, you start shopping for new.

That’s price transparency. In health care we have price opacity. If you ask the hospital what it costs to have your appendix removed you get one of three replies: Uproarious, table–pounding laughter. Dead silence. Or thinly veiled contempt at such an ignorant question.

Price uncertainty might make sense if it was a brain transplant. Plenty of variables there, but that’s not the case with appendectomies.

The Annals of Surgery estimates 280,000 are performed each year. Producing a reliable cost estimate should be routine — give or take a sponge left inside.

Yet you can’t get an estimate because consumer knowledge is consumer power.

One way to begin imposing market discipline would be to require any hospital taking federal money to post turnkey prices for the 25 most common hospitalized surgical procedures; the 25 most common out–patient procedures and the 25 most common tests. All charges must match the best price offered insurance companies.

The howls this would generate from the medical–industrial complex prove how useful the information is. (More details on this in an earlier column here.)

And speaking of sponges, if you take your car in to the shop for an engine overhaul and a mechanic leaves a wrench in the crankcase, that car is going back to the shop. The subsequent repair–to–fix–the–repair is free.

That’s not the way it works with hospitals. Hospitals make money on their mistakes and get away with it because consumers send the bill to the insurance company.

That means higher premiums in the long run and it encourages incompetence. If the guy who works on your car has to fix his mistakes for free, the guy who works on your heart should, too.

People should pay for routine doctor’s visits out of their own pocket and save insurance for major expenses. When my family was between insurance policies I negotiated the cost of doctor’s appointments and lab tests by offering to pay in full right before I left. I saved 30 to 40 percent by taking the insurance company out of the equation.

Putting a middleman between the provider and the patient adds another layer of cost and bureaucracy. Hiding the cost of medical services encourages overuse.

Consumers can choose health insurance coverage options just like they can choose auto insurance coverage. Government “experts” requiring coverage simply guarantees a lifetime income to lobbyists and treats citizens like serfs.

My car market analogy isn’t perfect. Legislators protect in–state auto dealers from out of state completion, just like health insurance companies are protected now. It is certainly a start, though, and a vast improvement over what we have now.

Ryan’s Obamacare Lite Is Another Travesty & Betrayal

Freshman Rep. Moira Walsh had an unusual explanation for some of the bad lawmaking in her state capital during an interview on Rhode Island’s WPRO, “It’s the drinking that blows my mind. You cannot operate a motor vehicle when you’ve had two beers but you can make laws that effect people’s lives forever when you’re half in the bag?

Too bad Moira isn’t in Congress. Booze would be a more acceptable explanation for Paul Ryan’s Obamacare replacement bill than the truth, which is this bill is a betrayal of conservatives seven years in the making.

As the Heritage Foundation points out this slap in the face protects the Democrat base that got free or heavily subsidized coverage at the expense of the GOP base that earns the money to pay for Democrat’s discount insurance.

As I’ve pointed out to friends in the past the price of an Obamacare policy isn’t bad if you remember your premium is buying for two policies: One for your family and another for the moochers.

Ryan evidently believes Republican meddling in the health insurance market is such a big improvement over Democrat meddling that he’ll rule for decades. The truth is the base didn’t vote to swap incompetent meddlers we don’t know for incompetents we do know.

Our mistake was believing the lie that once Republicans controlled all three branches of government they would repeal Obamacare.

My doubts began when “repeal” was amended to “repeal and replace.” Why replace Obamacare’s socialized medicine with the Republican’s Obamacare Lite?

A simple return to the situation that existed before the passage of Obamacare could mean a reduction of up to 30 percent in the cost of insurance premiums and the return of the missing doctors. That alone should be enough win re–election.

The insurance market circa 2008 will cause problems in the dependency class that doesn’t like their handouts interrupted. But I have news for Ryan and his RINO gang — they don’t vote for you anyway. Your voters are the people this bill continues to burden.

Ryan and the rest of his brain trust would rather betray the voters who supported them than risk headlines from the Opposition Media about taking free insurance away.

Ryan’s bill fails in three major areas.

First it does nothing to increase competition in the insurance market. Insurance companies still can’t sell nationwide, the “lines around states” Trump mentioned in the debate. This change alone would lower prices because companies would compete against each other. That’s why you can afford homeowner’s insurance and you can’t afford health insurance.

Second it does nothing to lower prices because the onerous and expensive coverage requirements for every policy are still included. If the consumer wants to buy a policy that covers him from Q-tip to transplant, fine he can pay for it. But if all he wants is major medical, he should be able to make that choice.

Finally it penalizes Republican states that didn’t expand Medicaid and rewards Democrat states that ran up a tab on Uncle Sam. The bill promises this will be phased out in the future, but we’re supposed to believe a Republican Congress that won’t boot 25–year–olds off daddy’s policy today will find the backbone to cut Medicaid tomorrow?

This debate isn’t really about health insurance and discussing it in those terms lets leftists set the parameters. This debate is about personal liberty. The liberty, as an adult, to make your own decisions regarding the future.

Government isn’t the national airbag saving the impudent and foolish from the consequences of their own stupidity. This only encourages more irresponsibility among the demographic whose only long–term commitment is a tattoo.

Healthcare isn’t a right. You don’t have the right to make someone go to medical school, graduate and then treat you for a price you think is reasonable, any more than you have a right to make the barber cut your hair.

I hope there are enough conservatives in the House to defeat Ryan’s disingenuous travesty. Because if they don’t it, means Obama won.

It’s obvious only difference between Nancy Pelosi as Speaker of the House and Paul Ryan is velocity. The train just moves slower and the conductor’s assurances are less believable under Ryan, but the final destination is still Greece.

Passage of this bill will raise a very pertinent question for conservatives: Why do you have a stronger belief in conservative principles and the power of the free market than the politicians who get your vote?

Why should we pretend anymore?

My suggestion next November is vote for the politician who promises to give away the most; at least he’s not a hypocrite. Maximize benefits now and hope the money doesn’t run out until after you’re dead.