Bad Engagement on Health Care Reform

November 9, 2009

I’m laying around the house with a fever today listening to two self described “moderate conservatives” on the Shanin and Parks radio program.  One topic of discussion is government health care.   Conservatives, these two included, are really, really bad at engaging in this discussion.  Really bad.  Not once did I hear them say something that made an opposing caller reconsider their position.

Here are a couple examples:

Caller 1 said insurance companies have messed up health care, paid 100s of millions of dollars of bonuses to their executives and denied people needed care which is the same as murder.

Their response – the government isn’t going to do any better.  And then it spiraled into discussion of whether they support murder or not.

A better response:

I’d ask if he thought there would be treatments denied under a government insurance program or if the government process for deciding on which treatments are effective and covered and who gets coverage would be subject to some politics.  For example, do certain treatments from companies that are “in” with the politicians and bureaucrats get preferential treatment?  What about the politics of who gets treatment?  No favors there, right?  All the decision makers involved will be altruistic and apply standards consistently.

Then I might fact check the person has done their homework.  Ask which executives, how much were their bonuses and how many claims were denied?  I might also ask how that comp compares with executives of companies of similar size and performance and how the denial rate would compare under government medicine.

Example 2:  Caller #2 told the story of a white collar, 51 year old friend who came down with bronchhitus and shortness of breath and went to the emergency room for treatment and racked up $3,900 in services and tests.  He can’t afford this.  He got scared.  Can’t we do better?

Their response – “Didn’t the guy have COBRA?”

My response:  A 51 year old white collar worker doesn’t have a regular doctor he could call for advice in an emergency?  I’ll assume he does and that his doctor recommended a trip to emergency or urgent care facility.

Next, does a 51 year old, white collar worker not have $3,900 in savings for a rainy day and emergencies?  Why not?

Has he not shopped a high deductible policy on the open market?  I have, they run about $200 per month for a family and they give you access to the insurance company’s discount on the expenses that you cover on the deductible.  My guess is that his $3,900 bill would have been reduce to about $1,800 – $2,300 based on the size of the discounts I receive on my insurance company’s discount.

 

 

An $1,800 emergency room visit this past summer cost me $900 after my high deductible insurance company applied their discount.

Next, has this guy tried talking to the finance department at the hospital to see if he can get a cash discount.  Often those are in line with the same discounts they give to insurance companies.

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