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Sunday, June 14, 2009

Health Care is a Zero Sum Game

President Obama made a startling announcement this week that his opponents ought to hammer him with in the health care debate. Here's how he proposed paying for some of his health care plan.

President Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are resisting.The high-stakes struggle over medical care is heating up as Obama declares the status quo unacceptable.

The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying greater efficiencies and broader insurance coverage will justify the change. Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly.

So, here's what the president wants to do. In order to mandate universal coverage for everyone, the president wants to cut government spending for medical coverage for older folks and the poor. It sounds to me like he's taking one equation 2 + 7=9 and turning it into a new equation 3 + 3 +3=9. He can rearrange the numbers all he wants but in the end the final number remains the same. To make another metaphor, he's taking the exact same pie only cutting it up into different pieces.

If in order to create universal health care coverage, the government cuts back on services it already provides, what kind of reform is that exactly? I am no fan of either Medicare or Medicaid but there's an inherent lack of logic here. How does creating one new government medical program by cutting two others make any sense whatsoever.

The problem is very simple and President Obama can't seem to square. We have limited resources of health care in America. He's done nothing to increase those resources. There aren't more doctors, nurses, health equipment, etc. Instead, there will just merely be more people to take advantage of those resources. It's the same pie with much smalller pieces. That's why he proposes to cut Medicare and Medicaid. Those folks will now get too much service so there's will be cut back in order to make sure that those that have no insurance at all get some service.

What everyone will soon find out is that unless there is a fundamental shift in the manner in which health care reform is approached, that's all any of this will be. They will simply rearrange the pie. Unless the plan focuses on competition and productivity, all we'll be doing is rearranging the pie.


Anonymous said...

Surely there must be something gained from people no longer having to use the ER as primary care because they couldn't afford treatment earlier.

mike volpe said...

for the people getting this treatment of course there's a benefit. If they aren't paying for it and someone else does, that is a negative for everyone else.

Anonymous said...

And of course as long as YOU have your top-notch private insurance then everything is OK in your protected little world isn't it?!

Let the great unwashed fend for themselves eh Mike.

mike volpe said...

If you don't or can't afford it, someone else should pay for it. Is that how it works in your world? Our country will go bankrupt doing that.

Anonymous said...

But you're forgetting the most significant point, Mike. When you say "for the people getting this treatment of course there's a benefit. If they aren't paying for it and someone else does" you neglect to mention that when the uninsured use the ER as primary care someone else is paying for it anyway!

mike volpe said...

Maybe, however, one trip to the emergency room doesn't cost nearly as much as constant check ups getting treatment on a regular basis.

Certainly, someone that can't afford insurance, but still gets it, would be a lot healthier. I won't argue with that. It will also cost society a lot more to treat that person. It also means that our health care system gets stretched that much more.

Here is a dirty little secret of medicine. It's much more expensive to keep someone healthy their entire life than it is to treat them only when they absolutely have to have care.

You may call me heartless and it may seem that way but in reality, you just can't have a health care system in which someone gets treatment regularly without paying for it. That would break the system. There are only so many times that doctors can work for free. So, someone has to pay for it when someone without insurance gets treatment.

You are suggesting that someone with no insurance gets regular care. So, someone else pays for that. So, everyone else's taxes go to make sure that someone who doesn't afford it gets regular and quality health care. How does that work?

Anonymous said...

You don't understand zero sum. You sound stupid.

mike volpe said...

What are we in third grade? I sound stupid. I don't understand zero sum. Maybe, you ought to elaborate. If not, you just sound like a third grader saying I'm stupid.