Stossel, 20/20, Bait & Switch, Naivete

Did you watch John Stossel’s take on the future of health care on 20/20 Friday night? If you’re not sure what I’m talking about, you’ll want to link to ABC’s review of the show here.

If you watched it, and you’re curious about my opinions, here they are:

First — can you say “bait and switch?” I’m not sure why the promos for the show all focused on Michael Moore taking people to Cuba (which is all about universal healthcare), but the “fixes” Stossel offered on the show focused on just a portion of our American citizens who have health insurance already? Did I miss something?

OK — as for what WAS in the program:

One point Stossel made was that since we (and our employers) pay insurance companies, and insurance companies then pay doctors, then we patients do not tie the cost of services to the services themselves. He used a metaphor of “grocery insurance.” If we paid insurance companies for our groceries, then when we went to the supermarket, we’d just keep pulling groceries off the shelf and walking out with them, even if we didn’t need them, because we wouldn’t pay for them directly.

(Hmm…. let’s see….. I’ll take a shot of penicillin, an EKG, a few vicodin samples and a blood test, please…. ??)

Actually — I agree with him. Being a step away from actually paying cash for medical services does keep us in the dark, and it does have an effect. It brings to mind the man who told me may moons ago that his health care was free!

Stossel’s next point was that profit and competition make for better health care. Were it not for the possibility of making profits, we would not have the innovation in this country that results in drugs that cure us or improve our symptoms, or devices that do the same, etc.

I agree with that point (in part), too. I’ve said before — I’m a business owner, and have been a business owner for eight years. I “get” the capitalist basis for business, and I embrace it.

But I’m most definitely uncomfortable with Stossel’s conclusion — if that’s what it was. His conclusion seems to be that capitalism provides all the answers, and if we begin using Health Savings Accounts, so that we control our own health spending, then we’ll bring the healthcare system dysfunction under control.

A quick primer on HSAs: you and/or your employer put money into an account that you can draw from when you need healthcare. Your insurance premiums themselves are less, and the difference goes into the HSA. When you need to see the doctor for one of the “basics”, then you draw from the HSA instead of from insurance.

So, John — do you really think using HSAs can “fix” the American Healthcare system?

If he does, then it’s a horribly naive answer. Seriously. It doesn’t take into account any problems beyond the basics, and as we all know, it’s not the basics that are the problem to begin with. Sniffly nose? Maybe I go to the doctor and maybe I don’t. If I have to hand over cash? Then probably I won’t. So for that kind of scenario — yup — I agree. Being responsible for our own spending is a great idea.

But what happens when I find a lump? It doesn’t hurt — do I go to the doctor? I don’t have enough cash left in my HSA. Do I get it checked? Does the stress of worry make me even sicker? There are a million scenarios when an HSA just won’t work.

Or, like in my case. How does that fix the problem of a doctor who recommends a treatment simply so he can make more money? That’s capitalism at it’s best! “Trisha, you need chemo or you’ll be dead in six months.” Bull-pooky.

Further — what about those folks who don’t have insurance to begin with? There’s no employer supplying insurance, and there’s certainly no HSA. In Stossel’s scenario — there’s still no fix for the uninsured.

And what about the catastrophic problems we have? We still need insurance, right? So, does the cost of insurance continue to rise PLUS we need to have an HSA that may or may not have enough money in it when we need to see the doctor?

I still believe the answers lie in the middle. I think that a shift to the system that continues to embrace the good of the private, profitable sides of medical care, but still supplies the basics to those who need it, without a profit basis, is possible.

Social security and medicare both “work”. Granted, at the moment they are underfunded and we need to be more vigilant — but their foundations are fair and good. Neither one subtracts from the idea of separate retirement savings accounts, nor additional private insurance. We have public schools and we have private schools. We have public libraries and retail book stores. We have public parks and private country clubs. We have so many examples of where the public and private have combined to serve our needs — and I believe it can be done for healthcare, too.

One approach — read Dr. Rich Fogoros’ book. It works in theory — why can’t we give it a try?

There are no cut and dried, black and white answers. And there’s no room for naive stabs at an answer. They just fuel the fire and detract from real answer seeking.

So, John Stossel — the next time you want to do a healthcare story on TV? Forget the bait and switch. To suggest to your audience that you’re going to prove Michael Moore wrong about universal care, and then to present only one corner of the debate suggesting it’s an overall solution can only be detrimental. If that’s the only part you understand, then you have a very long way to go.

I hope neither you nor your loved ones are ever faced with the realities of American healthcare dysfunction. Believe me, you’ll be singing a much different tune. Either that, or you’ll sing it in a very different key.

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Trisha Torrey
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