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home : insight & opinion : guest columns July 21, 2017

4/4/2017 2:12:00 PM
Health care part of 'marriage' to U.S.
For the Daily News

This will not be popular, but it's the truth and I have a problem with not telling the truth as I see it: You can't have health care for everyone unless we own it all, because we can't afford to do it any other way. 

I'll explain that proposition using sex as an example, because most people understand sex better than health insurance.  You have to marry someone to have sex all the time and be moral about it. There are people who do otherwise, that's true, but they believe differently from those of us who think that love, marriage and sex are not just coincidentally connected but ordained.  It is also expensive, because the commitment required involves dedication, fidelity, and a maintenance bill that would seem exorbitant if you broke it down in business terms. (We married people try not to think about it in those terms.)

Sex is part of the package, and without sounding callous, it has many appealing aspects. Within marriage, it's healthy, fun and free of the fear of rejection.  Sex on the open market is a different story, as partners don't necessarily stay together if not married.  It's a hit-or-miss thing, and involves worries over STDs, rejection and broken hearts.  The costs of that are high, but there are professional providers available, and this is where the insurance analogy comes home to roost.

You have to appreciate their professional status; they are in it for the money.  I have been a licensed health-care insurance agent in Illinois, so I actually know how this works.  You find people willing to bet they can have the coverage they need if and when the time comes for a set amount that you've offered.

There are conditions in the agreement based on statistics.  It's not personal.  There may be a physical involved, because I may want to know if you have high blood pressure or a bad habit like eating too many French fries or not exercising. 

Your health evaluation tells me how likely it is you will need servicing by a health-care provider.  I have a table that tells me what those services should cost.  If you live somewhere your provider charges more than that, then I make you agree to pay the difference.  That's how it works. I can't go broke because I couldn't pay for the services for others that I had agreed to pay.  That means I put a dollar limit on the cost of keeping you alive.  After that, you pay the rest.

I won't insure people who have a disease that can't be cured or that will cost me more than my pool of insured people can afford to pay for, and I have limits on the costs of medication, rehabilitation, and all the other services because as the maker of the deal, I have to be in a position to cover all bets just like the dealer in Las Vegas.  The house can't go broke.

But if my pool of prospective insured people is the entire population of the country, and I must take everyone regardless of their health, then I have a different problem.  I have to have everyone in the pool to make it work out and people who are health-conscious, don't smoke, exercise, and don't eat French fries will not be happy about how much I have to make them pay to be in the pool for all of the unhealthy people who see doing those things as their own business. 

That is the way we are trying to manage our national problem at the moment, and as much as I applaud the effort, I don't believe it can be done that way. That's because if you cannot control the cost of the services you are buying, then you can't make them affordable to the people you are getting them for. 

Doctors, nurses, hospitals and pharmaceutical companies all make money; it's the free-enterprise system.  I'm not judging them, I'm just saying it is likely that the $10,000 a day cost of a hospital visit may seem like a lot if you are only making $10,000 a year.  I have done many bankruptcies caused by cancer or some other uninsured medical expense that simply overwhelms their victims because of where they live.  You should not have to give up your home and all you've worked for your whole life just to die later than sooner. If they lived in Great Britain or somewhere else that health care is publicly supported, then they wouldn't have the problem.  There are other problems, that's true, but the cost is not one of them.

I will stop now because I was only writing to explain the situation, not suggest a solution.  I see both sides. I'll wrap it up by going back to sex. 

If you can afford to fly to Las Vegas and pay for sex any time you want it and can be happy with that, then I am happy for your budget, but will still be worried about your soul.  The service providers in that setting are professionals taking risks that I wouldn't want to take, so I don't begrudge them their fees or complain about how they go about their business.  It's not against the law there, so its not a legal issue. 

With the health care community fundamentally unregulated by the legal community here (tort reform has been the law in Illinois for some time now) they can make whatever profits they need to stay in business and are not subject to the same liabilities as other businesses.

They have costs too, I understand that, and they are ethical as well, so I'm not moralizing about it.  The hinge of this whole argument is freedom of choice.  If I don't want to have health care insurance, if I want to rely upon my good health choices and God's protection, why should I have to pay for services I don't want? That was a question I often heard from my divorcing clients about sex, and it was tough to answer if they hadn't taken their vows seriously to begin with.

When we pay our taxes, we are supporting our marriage to our country. We love her, warts and all, and if she requires me to sacrifice a bit more than I'd like, I just remind myself of what a blessing it is to be allowed to live with her. I will see this through to the end with her. She needs me and I love her.  Now, you say it.

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