Dan

Calabrese

Read Dan's bio and previous columns here

April 13, 2009

You Know, America, You Could Pay For Your Own Health Care

It’s almost shocking sometimes when you realize the extent to which Americans have become programmed to rely on others to meet their needs. Some reactions to my April 9 column on Medicare had that effect.

In summary, I suggested that we get control of exploding entitlement costs by essentially ending the commitment to cover everyone under Medicare after they turn 65, and by informing everyone 43 and under that they had better start saving for their post-retirement health care expenses.

This elicited protests that the idea was too “simplistic,” which of course it was in the sense that you can’t possibly answer every question about how to make such a transition in the space of a single column. The basic idea, though, is that we know we can’t keep this commitment in perpetuity, so the most responsible thing to do is to be honest about it and pick a point at which the commitment will end.

But the most interesting thing about the reactions I got was the theme of how hard it would be under my suggestion for people to qualify for and afford health insurance.

Whoa. Who said anything about health insurance?

American society has reached the point where it is unimaginable that people will pay for doctors’ office visits and prescriptions with their own money. We have become programmed to believe that if you don’t have health insurance that picks up the tab for all this, you don’t have access to health care.

And of course, we have also become programmed to believe that the only way to get this oh-so-indispensible health insurance is to have an employer buy it for you.

This sort of thinking stops us from doing all kinds of things that would improve our own lives and improve American society. It stops us from considering reforms to entitlement programs like those I suggested, or perhaps far better ideas someone else might suggest. No matter what kind of reform you propose, it’s dead in its tracks when you start talking about this or that segment of the population that supposedly would be “without health care,” which really means they wouldn’t be able to find anyone else to pay for it for them. It also stops us from pursuing entrepreneurial opportunities that could improve our economic situations, because we won’t spend a day without full health insurance benefits.

But the truth is that you don’t need such benefits.

For the past three years, I have enjoyed the benefits of having a health savings account, combined with a low-premium, high-deductible policy that covers catastrophic health care needs, but leaves me responsible for paying day-to-day health costs. It leaves our family keenly aware of what we spend and what things cost. If everyone in America paid out of pocket for their doctors’ office visits and drugs, costs would decrease dramatically because a) demand would be tempered by the reality of what things cost; and b) you would cut out the insurance middleman, who doesn’t work for free, you know.

Obviously, people who have retired face challenges generating income to pay for such things, but retired people also need to buy groceries, pay their rent or mortgage and pay their utility bills. Social Security, which is also going broke, doesn’t cover all this, so let’s dispense with the notion that it’s cruel and unusual to expect the elderly to foot the bill for things they need.

One reader protested that he can’t get insurance because of a pre-existing condition, and this, he said, is why the government needs to cover him. No. This is why he needs to be empowered to be responsible for his own health care, because if he pays his own bills, he can make his own choices.

Where would people get the money for this? We already earn it. The amount of money withheld from our paychecks to pay for Medicare and Medicaid would – if properly saved – provide more than enough for just about everyone to fund a health savings account and buy a catastrophic-only insurance policy. A society that believes people are responsible for their own needs would embrace such an idea.

But we don’t think like that anymore. A few days ago, the Associated Press ran a story lamenting the fact that most people without health insurance are not “turning their frustration into political action.”

Good grief. This may shock the AP (most sensible notions do), but there are some people who choose to deal with a need by focusing their efforts on meeting the need – not demanding that someone else meet it for them. In the time it would take you to march on Washington demanding this or that benefit, you could find a way to earn the money required to pay for what you need.

At least you could if you were still part of a society that believed in self-reliance. If my mail is any indication, those days are long gone.

© 2009 North Star Writers Group. May not be republished without permission.

This is Column # DC272. Request permission to publish here.