This commentary is by Jeffrey Reel, a resident of Hartland.
The debate continues over controlling health care costs in Vermont. Of course, this problem is not unique to our state. Every municipality in the country struggles with this seemingly intractable problem. Institutes, governing bodies, think tanks keep trying on one “fix” after another to see what fits.
Keeping to the subject of Vermont’s health care challenges, over the past few years, representatives of just the Ethan Allen Institute alone have tried on one idea after another.
Back in 2018, the institute heralded direct primary care and, before that, a draconian approach it coined “income tax-based recapture,” a concept that fell just short of hiring bounty hunters to track down citizens who can’t afford to pay the hundreds of thousands of dollars in catastrophic medical costs. When that didn’t fit, it tried on the “health care retail sector,” citing a book that recommended cost-effective medical tourism (including the Narayana Hrudayalaya medical complex in Bengaluru, India) — cutting medical costs by sending Americans overseas for cost-effective treatment — and only for those Americans who can obviously afford the time and expense, given that these treatments will not be covered by American insurers.
Its latest iteration is recommending Singapore’s model of health care. I believe there will come a point in time when the institute, and others, will need to question the very assumptions they hold concerning health care and market forces. This is not meant to single out the Ethan Allen Institute but to illustrate that even the best minds are at a loss for a way out of this health care thicket.
Over the years, there has been a lot of criticism leveled at those attempting to socialize the American medical and insurance systems with initiatives like ObamaCare. What critics don’t understand is that our health insurance systems were already socialized.
I am required to pay very high premiums for health insurance. This money is not being set aside for my exclusive use in the event I have to draw from it in the future. It is used to pay for the present health care costs of others, all of whom are already insured. After all, where does the money come from for an insured who is billed up to $300,000 annually to aggressively treat their cancer? From other insureds.
This is not news, but here’s the kicker: Most of every insurance premium dollar is spent on treating illnesses that are within people’s ability to control and even prevent.
Annual expenditures on treating heart disease are on track to reach $800 billion by 2030, which does not take into account over $275 billion annually on the indirect costs of heart disease such as lost productivity, which puts us over $1 trillion annually for that one lifestyle choice alone. Add to that projections for treating Type II diabetes ($500 billion as of 2020 and increasing), and throw in for good measure the $2.3 trillion spent annually by our health care system.
It is now common knowledge that many of today’s leading, and expensive, health problems can be slowed, halted, and even reversed through dietary and lifestyle changes. These illnesses include obesity, Type II diabetes, heart disease, hypertension and many forms of cancer. Smoking and the excess consumption of alcohol, refined sugar and dietary fats are behind millions of chronic and acute illnesses in the United States each year.
And the cost of treating these illnesses is crippling — physically, emotionally and financially. Most people know enough now to make significant changes in their diets and lifestyles but choose not to. And so, the financial burden of caring for them shifts to the rest of the insured population, who must then pay, out of pocket, through costly monthly premiums. This is the nature of socialized medicine.
Critics of universal health care do believe in socialized medicine — but their own particular version of it, and one they personally benefit from. No, they don’t want their hard-earned dollars to be taxed to pay for those who lack any medical coverage at all; but, yes, they seem fine having my hard-earned dollars siphoned off through health insurance premiums to defray the costs of those already insured but who are often neglectful of their health, including those very critics.
This is what socialized medicine and insurance look like. Don’t be misled: It is not only the uninsured who cannot pay for today’s medical costs. No one can afford to pay for the cost of medical care today — not even the insured, alone.
The notion of a “free market” system of health care is myth, as is the myth that it can regulate itself. Market forces reward maximum profit combined with minimum expenditures (thus overprescribing, overtesting, etc.). Health outcomes be damned.
My health needs will never square with the needs of my insurance company. Our interests are at odds with each other. Someday, as we embrace preventive health practices and lifestyle choices, we will provide the only lasting solution to lessening the cost of health care: by lessening the need for it.
Until then? Socialized medicine is here to stay, in one form or another, and the cost of care will only increase along with declining health outcomes.
