"Medicare for all or adoption of a universal single-payer healthcare system. The broken Medicaid program will be eliminated as redundant. Affordable healthcare for all shall be a human right. The Social Security trust fund shall be secured against government borrowing to fund unrelated spending. The earnings loophole shall be abolished by removing the $110,000 cap and lowering the tax rate which will keep Social Security solvent for future generations."This is a gigantic, complex, and emotional issue, so I really can't write about all of the ins and outs here. What I can do is try to touch on a few key points that I think should shape the discussion.
First, though, I need to disclaim myself a bit. I work as lower management at a retail drugstore. We have a pharmacy, and the company also operates retail clinics (though we don't have one anywhere near where I work). As part of my 401K, I do own a small amount of stock in the company.
I also need to apologize in advance, because in order to discuss this issue, I have to strip away the emotion and just look at practicalities. Some things might seem harsh and unfeeling. Please bear with me through them.
In my view, healthcare is a slice of a larger issue that we as humans are facing. We are living longer, increasing our numbers, and depleting our natural resources. The combination of these three things is not sustainable. At some point, all of humanity is going to have to discuss what it is that we want to do to ensure the viability of future generations. Do we sacrifice our own longevity for our great-grandchildren? Do we limit our reproduction so that the population stays static? Do we find more efficient ways to use renewable resources so that there will be plenty for future generations? Do we start looking for a new home on another planet?
I'm not saying that we're going to go extinct tomorrow, but we need to start the discussion, so that our children can start the work, so that their children can flourish.
Now, to healthcare specifically. I have to wonder what we even mean by healthcare. Are we saying that every citizen can have access to affordable solutions for every potential health problem out there? Are we saying that if I get an infection, I shouldn't have to skip paying my electric bill for a month so that I can get an antibiotic (which requires paying for an office visit, at least one culture test, and then the script itself -- quite a bit of money when you're uninsured)? What exactly is the scope here?
Even if we assume that -- for instance -- cancer treatments should be available and affordable for everyone, I have to wonder why we tend to just look at treating cancer. Why aren't we focusing on preventing it in the first place? I think that preventative care is probably more important than treatment. If we can reduce the amount that people get sick, we can significantly reduce the costs associated with treating them.
I've long been uncomfortable with the idea of insurance companies. Since they are for-profit businesses, it is necessary that the average person pays in more than he'll ever get back out. They also seem to keep prices high, at least for pharmaceuticals. Let's take imaginary drug "Imaginex". Imaginex has a retail price of ten dollars a pill. It makes no difference what pharmacy you go to, they all sell it for right around ten dollars a pill (let's say there's a 50 cent spread). Now, I come in with my prescription for 30 pills.
Scenario 1: I don't have insurance. In this case, I pay $300 for my 30 pills. It doesn't much matter where I go, I'm still paying $300.
Scenario 2: I have insurance. In this case, I'm paying whatever my insurance says my co-pay is. For a 30 day supply of Imaginex, it happens to be ten dollars. I get 30 pills for the cost of one! What a deal! Again, it makes no difference where I go, I'm paying ten dollars. However, my insurance company has used me and all of its other customers as leverage to get a lower price. They pay the pharmacy $200. So the pharmacy collects $210 for a $300 script.
In both of these scenarios, the consumer doesn't care where he gets his script filled as far as price, because he's paying the same amount regardless. Meanwhile, the pharmacy is going to charge as much as it possibly can, because the average customer doesn't care what they're actually charging the insurance company, and the cash customer pretty much has no choice.
I'm really not sure how you fix the problem. I don't know if increased competition could lower prescription prices to a manageable level without insurance companies. I'm sure that there are a lot of facets to this that I'm not seeing, but if I can buy a 30 day supply of Claritin (which used to be by prescription only) on Amazon for $13, it makes me think that there must be something that we can do for the rest of it.
I think that if we focus on getting at least basic healthcare affordable for everyone, increase preventative care, and start looking into the economics of prescription drugs, we can get to something that's manageable and effective for every citizen.
No comments:
Post a Comment