Comments on: Painful Choices 2: Rural Care Pits Profits Against Access

By: LHKMAN

LHKMAN — Thu, 20 Dec 2007 16:08:22 +0000

The rubber meets the road, so to speak, when it comes to medical care. The same people who argue strenuously against “socialized” medical care, line up to get it when it’s their own hides that are at stake. If our society ever had a legitimate debate - instead of political sound bites - perhaps the discussion would start with the issue of making a profit. Can health care be provided by practictioners, institutions and insurers who have a profit drive? Should it? This isn’t quite the issue in the urban areas because those without insurance are a minority of the population. In the rural areas, they are the large majority of the population and that seems to make all the difference in their attitudes toward “socialized” medicine. I do not begrudge those who live in rural areas their health care; I just happen to think all Americans should have access to health care, regardless of where they happent to reside.

By: noidea

noidea — Fri, 21 Dec 2007 05:25:09 +0000

If you live in the middle of nowhere, access to many things will be harder to come by. Are we comingling access and ability to pay? Or is the combination of inability to pay and the lack of population making medical care even more scarce? So we make health care totally free and subsidize the best facilities in the country in every rural area, what should the acceptable cost per capita be? If you are the only person living in a 50 mile radius, should we put a team of doctors in your living room waiting for you to get sick? Obviously tongue in cheek but I’m just asking the question. It’s not that I want people to go without health coverage. But people choose a lifestyle for a reason and there is a give and take.

By: Wildflower

Wildflower — Fri, 21 Dec 2007 05:52:47 +0000

Well said Lhkman, I couldn’t agree with you more. I imagine 90% of people in isolated rural areas vote Republican. Kind of like cutting their own throats isn’t it.

By: Mandell

Mandell — Fri, 21 Dec 2007 14:08:17 +0000

I don’t understand why people keep lumping insurance companies as part of the “profit” problem. Insurance is a tool, a method of sharing risk. When insurance paid only for the medical expenses related to illness and injury the cost was relatively lower. Today, “insurance” is no longer insurance. It is pre-paid medical care. The public demanded that health care plans cover expected expenses. Based on the concept of insurance, expected expenses are not insurable. To have them covered requires collecting 100% of the expected expenses plus enough to cover the cost of administering the plan. It is insurance that allows people to pay a few hundred dollars a month so that if they develop a serious medical problem, they don’t have to come up with tens or hundreds of thousands of dollars to pay for the treatment. Anyone with a brain insures their home. For a few hundred dollars a year they are assured that if there is serious damage to their home it can be repaired or rebuilt. (Flood insurance is a different topic which deserves its own book.) If you want homeowners insurance to cover the cost of repainting, fixing the toilet, replacing washers in sinks, replacing worn out carpet, etc., the cost will go up substantially, and it will look like the product the public had demanded for health care. Is there profit in selling health insurance? Yes, otherwise it wouldn’t be sold. And, if you have an HMO, you don’t have insurance, and they still want a profit.

By: LHKMAN

LHKMAN — Fri, 21 Dec 2007 16:08:01 +0000

Mandell: When you can predict precisely when an individual will become ill and precisely what treatment will make that person well again, your screed might have some validity. Until then, it reads like the usual conservative/populist pablum we always get here in Colorado.

By: LHKMAN

LHKMAN — Fri, 21 Dec 2007 19:51:20 +0000

noidea and Wildflower: Your comments both are interesting. Let’s make distinction, though, between availability of health care and the cost of that health care. Rural areas always will have issues of availability, just as they do with much of modern society’s trappings. It goes with being rural and not having sufficient population density to support many things we in urban America consider our right. As for the cost issues, let’s face it, insurance companies are in business to make a profit. I’m an unreconstructed capitalist, so I think that’s just fine. One way they can make that profit, though, is by cutting back on what they will pay for for policyholders. Like it or not, that’s about the only way an insurance company can make money — unless people suddenly were to stop dying or getting sick and houses did not burn or get blown three states away. I pose the following question as just that a question: Should health care (to say nothing about its availability) be subject to the decisions of a bureaucrat at an insurance company who can read the fine print of a policy and determine that the company will not pay? If the answer is yes, and I’m sure some, like Mandell, will say it is, then we’re back in the days of the Old West and the frontier; it’s every man and woman for him or herself.