The Affordable Care Act: Why Health Care Isn’t Affordable in the First Place

It’s almost impossible to escape the drama surrounding the Affordable Care Act, aka, Obamacare. But have you ever wondered why health care isn’t affordable for many families in the first place?  

In medicine, it is a mistake to focus on the symptom rather than the illness. In our case, the illness is our costly and ineffective health care system, and the symptom is that health insurance is expensive. But why? 

In my opinion, there are three main reasons why our healthcare system is not already affordable.  

1.    To start, rather than focusing on healthy living, our system focuses on preventing natural deaths, resulting in the vast majority of an individual’s healthcare costs incurring during the last 12 months of “life.”

We are all certainly unique, but we have one thing in common – one day we will die. It’s the natural order of things. There can be no life without death.

That being said, trying to keep someone alive, when they’re not really able or willing, creates pain, not health. Check out this article from the Wall Street Journal: Why Doctors Die Differently.

2.    Second, the health insurance industry resembles neither insurance, nor industry. 

Let’s look at your automobile insurance as an example. The odds of your getting into an accident are probably low but, if/when it happens, it could result in a huge expense. Insurance works great for this type of situation – low probability, high cost. But what happens when you need gas? What about an oil change?  You pay for those out of pocket because they are not rare occurrences and they won’t cause you to go broke (hopefully). Because you know that you’ll eventually need to pay for gas and change your oil, you’re less likely to drive around town like you’re Jeff Gordon at Daytona. Events that are common and not super expensive are not meant to be covered by insurance. Unfortunately, our health insurance is set up in such a way that leads to people having no idea what it costs for routine medical care. All they pay attention to is the “co-pay.” 

In addition, there is virtually no competition in the health insurance marketplace! Competition motivates businesses to lower prices and increase quality.  Without it, progress stops and complacency begins (prices drift up and quality suffers).  

Here’s a quote from The New York TimesHealth Care Law Fails to Lower Prices for Rural Areas 

“Of the roughly 2,500 counties served by the federal exchanges, more than half, or 58 percent, have plans offered by just one or two insurance carriers, according to an analysis by The Times of county-level data provided by the Department of Health and Human Services.”

Now we have mostly monopolistic and oligopolistic regions where the giant companies are able to raise prices at a whim.  Has your health insurance premium ever gone down?  Probably not.

3.    Finally, our tort system is outdated and the result is that we have doctors being scared into practicing “defensive medicine.”

Even though your doctor is confident you don’t need this test, or that lab-work done, they’ll order it anyway (which is expensive), for fear of being sued for “Malpractice.” Many attorneys specialize in these suits because the profits are huge and the work required to win big money is minimal in many cases. In other words, big rewards with little risks. No wonder we have so many lawyers! Just kidding… 

Just think about this fact: Less than 5% of the human beings in the world live in the United States. What percentage of the world’s lawyers do you think we have?

We have more lawyers than every other country in the world combined!

Don’t get me wrong, I don’t dislike lawyers – they serve an extremely valuable purpose and we definitely need them.  I’m very thankful for my lawyers, and my little sister is actually a lawyer (the good kind). 

But what does that have to do with expensive health care?

In America, not only can you sue anyone for any reason; you don’t even have to actually “win” the case in order to win a ton of money. In other words, most cases don’t even go to court – they usually end in a settlement (you can hear the cash register noise in the background). In most countries, when you sue someone and you lose, you must pay all the court costs – which makes sense since you’re the one bringing someone to court. If you win, then they pay the costs… Not so in the land of the free – you have to pay for your own attorney regardless of whether you did anything wrong or not. After working closely with many physicians for the last decade, I can tell you that being sued is one of their biggest nightmares. 

Congress has the power and responsibility to fix this harmful situation, but guess who owns them? Answer: Lobbyists & Trial Attorneys. See: Why Medical Malpractice Is Off Limits.

Imagine if the largest portion of lifetime medical costs could be drastically reduced by focusing on prevention and natural deaths… Now imagine what would happen to health insurance premiums over time if we allowed competition in the marketplace while focusing plans on rare events rather than routine visits… Finally, imagine if you knew that any treatment you received was based solely on improving your health, and prescribed by a doctor motivated by passion and not fear…

Now open your eyes because that Utopian dream can NOT become reality until and unless we find and spread the truth. Take ten seconds and send this to your friends, family and coworkers (unless they’re lobbyists or trial attorneys).

I hate to be the bearer of bad news, but at least now you know why healthcare costs are so high, and ultimately, why they’re not likely to come down anytime soon. Unfortunately, some people who were able to afford and liked their healthcare plans are now going to lose them (or already have).

But no worries, it’s all good – the President says he’s sorry…  

Exclusive: Obama personally apologizes for Americans losing health coverage