Scary times a'comin

Scary times are coming.  It's that season when people in all sorts of sizes show up at front doors asking for treats (even though they say, "trick or treat" most don't want to see Tyler do any tricks).  Since our house is essentially the only one on the block and there isn't a lot of light at night, most of these scary folks are too afraid to come to our door.  Rather than sit ignored at the side of the dancefloor we load up our furry friends and head uptown to sit on the front porch of our friends, Joann and Ralph, and watch them shell out thousands of pieces of candy.  Tyler and Tasha think that this is great entertainment as one of their favorite activities is sticking their heads into any bags they can get to in order to look for snacks of their own.  As I contemplated this activity I saw some parallels to some things in our society.

It doesn't seem as though we have any shortage of scary people coming around to raid our pantries.  Unlike Halloween where we can just turn out the lights or go away for the evening,  there isn't much we can do to get away from these monsters.  Health care/insurance is changing, no matter what happens to the current legislation there will be changes.  Some are already kicking in and others are down the road.  There is a distinct difference between issues of "health care" and "health insurance" and yet, discussions tend to refer to both of them as the same thing.

As I see it, how we reform health insurance (as though it was a kid gone bad) will impact and cause changes in health care.  Insurance is a funding method to pay for care.  Insurance, of any kind, in its' simplest form is nothing more than passing the burden of risk (or paying for the unwanted outcome of risk) on to someone else for a fee.  If you don't have insurance then you pay for the unwanted outcome.  There was a time when health insurance did not exist and, as a result, the people with money tended to have better health care.


Now we have insurance companies that will take on the risk of poor health and help pay for the care, thereby, making better health care available to those of lesser means.  Of course, if you happen to be of substantial lesser means then you are right back to less quality health care because you don't have the means to buy the insurance.  When we are in a situation where we are responsible for the outcome of our actions we tend to be a bit more conscientious about how we live.  In a way, you might say that having insurance is akin to having permission to not use good judgement.

I had these thoughts while walking the dogs this morning.  Tyler could not seem to make up his mind which side of the street he wanted to walk on and as a result we kept going back and forth.  In the end, he did a lot of sniffing and checking pee-mails, but never got down to business.  It gave rise to thoughts about all of the debates over what to do about health insurance reform.  We seem to keep going back and forth and nobody wants to talk straight out about the issues.

Insurance companies are businesses.  They exist to make profits the same as the corner bakery.  No imagine what would happen to a package of dinner rolls from that bakery if they were told that from now on each package would have 15 rolls instead of 12?  They would say, "Ok" and then charge you more per package.  That would make perfect sense.  They calculated the price they charge by adding up all of the costs to produce a roll, let's say 10 cents.  They want to make a profit of 20%, so they would sell a roll for 12 cents, covering their cost of 10 cents with 2 cents profit.  They sell their rolls in packages of a dozen for $1.44.

Now, they are told that they must have 15 rolls per package.  Ok, now you can pay $1.80 per package.  But, you say, "Wait a minute, you can't charge me more. I'm only going to pay $1.44 for this package".  This means that the bakery will have to sell their rolls for 9.6 cents each even though it costs them 10 cents.  How long will that bakery be in business at this rate?  An even better question might be how long will the bakery continue to make rolls?

If all of the bakeries realize that to produce rolls will not make any profit for the business, it's just a question of time before they also decide to quit making rolls.  If insurance companies are forced to provide specific benefits then they must find a way to provide those benefits and still make a profit.  Otherwise, there is no point in remaining in business.  One thing they might do is reduce how much they pay the health care providers for the benefits.

 Let's say the providers are required to take what they are paid.  Now. they have a profitability decision to make.  If they are paid less for the services they provide than it costs them to provide them then they have to find a way to reduce costs or stop doing what doesn't make money.

When you take long walks with dogs early in the morning you have plenty of quiet time to think through an issue or situation.  We all should look for some quiet time to open our minds to random thoughts.  You might be surprised what is trying to get in.