Friday, September 11, 2009



This morning, “progressive” talk show host Ed Schultz, like just about every talk show host, right or left, was discussing “health care,” a subject that is surely trying the already limited patience and attention spans of most Americans. I don’t know what Mr. Schultz’s major point was; I jumped in in the middle of his conversation he was having with a caller, who was presumably an MD, as I was looking for an alternative to the commercials on CNBC, Bloomberg, Dave Ramsey, and WBBM-AM on my car radio. I presume that “Big Eddie,” a likeable, and occasionally quite sensible, self-described leftie, was promoting the public option or something like it, but I could be wrong and, for purposes of this post, it doesn’t matter. What struck me was a statement Mr. Schultz made regarding “high deductible” plans. I was in the car and, since, unlike most drivers, I pay attention when I drive, I did not take notes and hence cannot quote Mr. Schultz, so I’ll paraphrase while remaining true to his point:

A $2,000 deductible is pretty heavy for a working family with a couple of kids.

I am sure that I will get plenty of flak for the following observations, and not only from the self-styled champions of “the poor” or “the working poor” (Describing people as “the poor” or “the working poor” have been rendered largely meaningless in our profligate, just gotta have it so I can show it society. People would be surprised how many people who are considered “rich” by those who are unable to see past appearances are, in reality, poor in the sense that they, even if not technically bankrupt, have no net worth because they owe more than they “own.” These people may technically “own” large, “upscale” homes, wide screen TVs, the very latest electronic stress inducers, and several “luxury CUVs,” but they are, for all intents and purposes, like Uncle Roman in the classic “The Great Outdoors,” “broke, busted, bankrupt.” A far better description of those we generally regard as “poor” would be “low income.” But I digress.), but also from those who, while “possessing” plenty of largely useless and frivolous gimcracks, have yet to acquire all the trappings of faux wealth they “deserve,” but have driven themselves to financial ruin in their ongoing, yet ultimately doomed, attempts to fill that mysterious hole in their lives with the latest geegaw that their similarly gormless neighbors have recently “acquired.”

Despite the flak I will get for being cold, cruel, heartless, or “out of touch,” I have to ask how a $2,000 deductible can be “heavy”? For whom? Even if one doesn’t make much money at all, one should have AT LEAST $2,000 put aside for emergencies. Anyone, no matter how little he makes, should be able to set aside AT LEAST 10% (but 20%, 30%, or more is far preferable and, believe it or not, doable) of his income. At that rate, accumulating $2,000 should take very little time. Put another way, if one isn’t saving 10% of one’s income, one is spending money on things that are far less important than accumulating savings. Even if one is classified correctly as “low income,” one would be amazed at how much one can save by, say, carrying one’s lunch to work, not buying snacks or pop at the convenience store by the individual serving, dropping some cable channels, eschewing sporting events, movies, or other forms of outside the home entertainment, etc. Put very simply, anyone with an income can put aside at least 10% of that income and thus rather quickly have $2,000 available for emergencies, like a deductible for one’s, or one’s children’s, medical deductibles. One only has to learn to prioritize and save.

Some might argue that they have $2,000 (or, in the cases of the faux rich the Wall Street types once assured us were “immune” to recession because of their “high incomes and net worths,” $2,000 in line availability on their credit cards), but they don’t want to spend it on medical deductibles. That should be someone else’s (the government’s, their employer’s, etc.) responsibility. But what could possibly be important than the health of one’s children? If you child really needs to see a doctor, or worse, a relatively small deductible should be completely inconsequential. If one has more important things on which to spend his money than the treatment the legitimate medical needs of one’s family (Do see, however, my 5/27/09 post “Gimme a bromo;” we would all do well to be a little more discriminating in our usage of “health care.”), why should the taxpayers, or your employer, place a higher priority on the health of your children, or you, than you do?

Besides the larger point I am trying to make about saving and spending priorities, a more specific point arises from this issue: any health care plan that doesn’t involve deductibles, and more than token deductibles, is doomed because such a plan would exacerbate the core problem with our system of health insurance; i.e., the one who uses the service is not the one who pays for the service. One does not have to be an economic genius, or even mildly interested in the subject, to understand why such a separation of user from payer has dug us into the hole in which we find ourselves. Without deductibles, without the user of the service having to ask himself if he really needs the procedure or doctor visit he is contemplating, there will be no effective cost controls. And, no, not every sniffle, twinge of discomfort, or inane commercial for the latest wonder drug to treat maladies viewers didn’t even realize they had, requires us to “ask (our) doctor,” unless, of course, someone else pays. Then that inquiry, doctor visit, or procedure, no matter how expensive, becomes essential to the continuance of our stay in this mortal coil. See, again, my seminal 5/57/09 post “Gimme a bromo.”

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