Vive La Diff?rence

Commentary January 13, 2010 at 07:00 PM
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Never in the 54 years that I have been affiliated with the insurance business have I witnessed such a bashing of our industry as that which occurred in 2009. Even the assault by the Federal Trade Commission that we experienced three decades ago paled by comparison. And all this because the current administration and leaders of Congress needed a villain to justify their agenda to change the financing and delivery of health care.

It is bad enough that we have to endure the nightly assault on our business by ads run by personal injury lawyers drumming up business. Ironically, they are part of the problem insofar as the cost of health care, as well as other goods and services, but are not the target of these same lawmakers. No wonder much of what could be produced in this country is outsourced to other countries not similarly burdened.

The sad part of the latest attacks is that they are more often based upon myth than fact. Usually there is just enough fact to gain credibility but never enough to tell the whole story. Benjamin Franklin's admonition, "A half truth can be a great lie," seems altogether appropriate in describing much of the bashing this past year.

By far the biggest single issue with respect to our health care system is the rising costs. No one questions that the costs are rising, but the reasons are not usually cited, nor are the costs placed in context with other services or the benefits derived from the increases. In analyzing health care costs today there are significant factors overlooked or omitted. Like the cars we drive and other services, health care today is not the same as that of yesteryear.

The first new car that I owned was a 1947 Ford and it cost just $1,200. The car had a 90-day or 4,000-mile warranty as compared to my present car's 5-year, 50,000-mile warranty. Tires on the '47 model lasted about 15,000 miles, whereas tires today are good for 50,000 miles plus. There was no air conditioning, power steering and brakes, automatic transmission, non-skid brakes, turn signals, power windows and seats and a hundred other improvements that I enjoy on my present auto. Of course, the price today is many times higher, not just from inflation–it is a totally different car.

Our health care system has gone through much the same evolution. One hundred years ago life expectancy was 47 years. Improved sanitation and medical care are largely responsible for the increase of about 30 years. How do you place a value on an extra 30 years of life expectancy?

In 1909, the three leading causes of death were pneumonia/influenza, tuberculosis and diarrhea. Numbers two and three have been pretty well eliminated as causes of death along with polio and a host of other formerly common diseases. During my lifetime, medical miracles came into existence that we often take for granted but which were not available to my parents when they were growing up. Today we have chemotherapy, organ transplants, robotic surgery, shots for flu, and drugs that control previously life threatening conditions. We have diagnostic tools like MRI, CAT scan and ultra sound that were not even imagined 50 years ago. The list of the new features of our 2010 health care system is almost endless.

But the medical community has had an important traveling companion in this road to progress. In 1934 I had my appendix removed at Saint Vincent's Hospital in New York City. I was hospitalized for three weeks and since there was no insurance it took my parents a year to pay the bill at the hospital and the doctor. In 1948 my wife also had an appendectomy. She was in the hospital four days and back to work in 10 days. My insurance covered the costs and everyone was paid promptly. Progress in treatment and financing.

The ability to finance the delivery of health care has been the driving force behind the development of a more efficient and effective supply of medical care. Absent this mechanism there would have been less demand for the sophistication in medical services that most people now take for granted. Of course, there have been public and private grants to medical research that have been of great help in this journey. But by and large it has been the ability of people to pay the bill for services in a timely manner through their insurance programs that has paved the way for these incredible advances.

Blue Cross and Blue Shield were created as a means for doctors and hospitals to collect bills that previously either went unpaid or were paid over time. A hospital cannot purchase modern equipment if it does not get paid for its services.

Private insurance companies have performed essentially the same function parallel to and in competition with the "Blues." Those who claim there is a lack of competition in the marketplace have obviously never sold insurance. My own experience and that of other insurance people has demonstrated that this is a highly competitive market with employers changing carriers regularly to pursue better rates.

Far from being the villain in this debate, it has been the ability to finance health care through insurance that has been the key to our progress and which is unmatched by countries that do not have this mechanism. We did not create the miracles of medical science, but we did finance them so they would be more readily available.

Just as the car I drive today bears little resemblance to my 1947 Ford–our health care, also more costly, is not the same as what we had in 1947. Vive la difference and thank God for it.

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