Hold on, Mr. Virtual President!

The reasons why our health insurance/health care system is in shambles are many and complicated, to say the least. That’s why it is essential to have a firm grasp of the root causes before one can make any suggestions about how to improve the system.

Unfortunately, this is rarely the case. It seems that everyone, from politicians to pundits, comes to this debate armed with misinformation or worse, propaganda, and weighs in with their solutions without really understanding what is going on.

Take www.healthcare.gov for example, which is the portal for buying health insurance through the exchanges set up by the Affordable Care Act. What in the world does that site have to do with health care? Nada. Zip. Zilch.

Even that hallowed bastion of accuracy Wikipedia has it wrong (as of this writing), beginning its healthcare.gov page with the definition that it is “a health care exchange website…”

And so it is with great sadness that I must announce that another media personality whom I really like has, alas, totally missed the mark as well.

On November 22nd I took a break from the inundation of JFK anniversary reporting to watch a new video posted by conservative commentator Bill Whittle, the Virtual President. In his report, he lays out the case for why a 2¢ aspirin “costs” $20 when given in a health care setting, and endorses a plan to fix our fractured health care system.

Hold on, Mr. Virtual President. With all due respect, you’ve got it exactly wrong.

First, Mr. Whittle explains that the costs of health care are mostly driven by two “armies” that total about a million people, and stand between “what we pay for, and what we get.”

Half a million of them make up the army that is the health insurance industry. The other half million work for government agencies, and are responsible for processing all of the paperwork created by themselves, and the other army.

But if you think about it, this argument doesn’t add up. Even though these bloated bureaucracies surely contribute to waste, inefficiency, and even fraud, they cannot begin to account for what has driven the “costs” of health care through the proverbial roof.

Why? Because they are not the ones profiting from $20 aspirin tablets.

Let’s think it through: the various health insurers, employing their half a million-strong army pay for that workforce out of the health insurance premiums they receive from their customers, the insured, and not from fat profits realized off 1,000% markups.

In fact, since they are the ones being billed for the aspirin, in this scenario the health insurance companies are on your side, Mr. Virtual President. And I would imagine that they don’t like being overcharged for aspirin any more than you or I do.

The same goes for the government and its minions. Those folks are paid with tax dollars, not ill-gotten gains from bilking patients (or even health insurance plans). The agencies that regulate and pay for government-sponsored health care have no interest in the price of an aspirin, except to keep it as low as possible.

No, these excuses fall far short of explaining how our health care system got to be so outrageously overpriced. There is one, main, contributing factor, but like everyone else – including the real Mr. President – Bill just doesn’t seem to get it.

But he doesn’t end there; after identifying these two villains in the health care dilemma, the Virtual President goes on to endorse a particular proposal to fix the system. This PeoplePower Plan, devised by Idaho physicians Dr. Loel Fenwick and Dr. Richard Sugden, is, to put it mildly, a disaster.

Dr. Fenwick is an obstetrician who “designed and manufactured the American birth bed (and) created the Single-Room Maternity Care concept.” Really? Wow. Thanks for dreaming those up, doc 😉

Dr. Fenwick also seems to believe that health insurance is bunk. He states (at 29:03 in this video) that neither he nor his family has “never, ever had health care insurance.” Instead, Dr. Fenwick has set aside money throughout his career, and then used his position as a physician to help negotiate medical bills, including those for his father’s cancer treatment.

The good doctors’ Power Plan would replace health insurance with an employer-based contribution system, where all the money that you or your employer put into a so-called Insured Contingency Escrow (or ICE) Account would be yours, to do with as you see fit. Except you can only spend the money for clearly defined contingencies, such as health care, and not on a jet ski.

Now here’s where it really gets tricky. To ensure that the average American spends their health care dollars wisely, Dr. Fenwick’s plan would establish a system of navigators (sound familiar?), or copilots to guide us in doing so.

Virtual President Whittle elaborates on the role of these copilots in his presentation, where he says that they would “do the negotiating, and help you make decisions about what to do with your own money.” He points out that they “don’t work for the hospitals. They don’t work for the insurance companies. They work for you.”

Nowhere is any mention made of who would pay the “copilots,” or how much control they would have over “your money.” In fact, with this part of the plan Dr. Fenwick is contradicting himself because, as he states in his presentation “once you give people your money, you give them your power” (at 7:28) and “…it’s my money. Nobody can tell me what to do with it.” (at 30:04).

I totally agree with Dr. Fenwick when he says that we should have a health care system that operates on free-market principles, just like we use everywhere else. My problem with his idea is that he wants to replace the old system with a new but very similar one – in other words employer-driven, restrictive, and with the need for disinterested third parties to guide medical decisions.

Remember how the health insurance industry sold managed care to the politicians and the public? If you don’t, stay tuned. I’ll explain in a later post, but suffice to say Dr. Fenwick’s plan is eerily familiar.

Virtual President Whittle says the answer is not to make things more complex, but to make them simpler. Hear, hear, Sir. But substituting health insurers for a whole other layer of bureaucracy, and inserting more decision-makers (can you say, gatekeepers?) between the patient and “their money” is not at all the answer.

Why not, as Dr. Fenwick does occasionally say, let the free market reign? I would submit that when it comes to consumerism, no other animal on the planet is as ferocious as the American species. The average shopper in this country will spend four hours visiting three stores within a two-mile radius, just to find the best deal on widgets.

I have little doubt as to their ability to apply that superhuman instinct when it comes to healthcare.

After all, as patients, the ultimate consumers of health care, it is our money to spend, and I believe that we could and would do so wisely, given the chance. It’s gotta be worth a try, right?

Despite its flaws, I still love the introductory paragraph to the PeoplePower Plan, which states:

“Imagine being able to buy medical services the way you book a vacation, where you can search the web for the best destinations, check out features, benefits, ratings and prices, choose the perfect experience, then pay with a mouse-click.”

Well, what’s stopping you?

 

It’s not the COSTS of health care that are outrageous…it’s the CHARGES.

Physician. Health Insurance Agent. Author. Health care humorist. Medical satirist. Disruptor. At your service. My name is Kevin Wacasey, and I’ve been practicing medicine since 1994. When I graduated from medical school, I took an oath to do no harm to my patients. To me, that includes financial harm. But since health insurance took over health care over 40 years ago, health care prices have skyrocketed. And despite what we’re told by the media every day, it isn’t the costs of health care that are outrageous; it’s the charges. So if you’ve ever wondered why we spend so much on health insurance and health care, then come along and join me as I explore the crazy world of Healthcareonomics. Health care doesn’t have to be expensive. Let me show you how. For speaking opportunities and to pass along your questions/comments, please email me at drw@healthcareonomics.com.

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2 Comments

  1. Joe Kessler

    In Mr. Whittle’s example, Kevin, the co-pilot would work for the individual, or perhaps the chapter which the individual would join. There would be a fee for this co-pilot, but that fee would be negotiated and even perhaps made up by the cost savings that the co-pilot would bring the individual or chapter through good negotiation of healthcare prices. The co-pilot has no control over your money but instead presents a number of options where YOU CAN CHOOSE to spend it.

    It’s a very nice model and another reason to vote for Bill as Virtual President.

    • Thanks for commenting, Joe.

      I am going to stick to my guns on this one however by saying that inserting any kind of go between into the provider (as an aside, I really hate that term) –patient equation isn’t at all the answer.

      Because whether we are talking about health insurance companies, or the navigators as proposed under the PeoplePower Plan, why should we tolerate the input of some disinterested third-party into our pursuit of health? I mean, we don’t have to consult anyone for decisions like what kind of new car to get, whether to see a movie or go to a play, or what kind of restaurant we want to try next. And these kinds of choices are trivial when compared to our health.

      And when it comes to your claims of “cost savings,” which could potentially be achieved through the “good negotiation of health-care prices,” I’ll just say that nothing beats an unfettered, competitive marketplace, in which pricing gets negotiated where it ought to be – between patients and, er, um, providers.

      The sad irony is that this system already exists. As I told Glenn Beck a year ago, we already have a free market healthcare system. Americans just don’t know it yet, because they are still focused on co-pays, deductibles, and making sure their health insurance covers – everything. But when you kick health insurance out of the equation altogether, it’s no surprise how prices respond to that cornerstone of American values – freedom.

      Don’t believe me? Well, in my primary care clinic I don’t accept health insurance, nor am I interested in any PeoplePower navigators coming between my patients and I. And yet, the prices for the healthcare that I offer are both transparent and affordable. Take a look at my primary care clinic prices and see for yourself.

      By the way, with how the available options are shaping up for 2016, Bill has my vote for Virtual President, too 🙂

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