Why Bush health care plan won't work

To the Editor: Everyone, including President Bush, acknowledges that the health-care delivery system in this country is in trouble. In his State of the Union message, the president offered one fix — extending the health savings account program. Under this plan, a taxpayer who purchases catastrophic health insurance with a large deductible, will be allowed to put money into a savings account, tax free, and use that money to pay for medical expenses. According to the president, the most important benefit of the program is that Americans will exercise economic discretion, causing health-care providers to compete and, therefore, allow the “market” to lower health costs. This doesn’t effect me directly because I am on Medicare. However, a recent summary notice I received from Medicare causes me to wonder how the president’s hopes can possibly be realized. It also causes me to wonder what is going on with the cost of medical care in general. Recently, my doctor presented a bill for $840 for a procedure. Medicare approved $31.44 and paid $25.15. My “medigap” policy paid $6.29. On another occasion my doctor presented a bill for $2,500. Medicare approved $377.25 and paid $301.80. My “medigap” carrier paid $75.45. What would a health savings account owner have paid for the these procedures? I suspect that the patient would be billed $840 and $2,500, respectively. I had the procedures done because I was sick and a health professional told me that I needed them. Does the president expect the account owner to argue with the professional about the need for the procedure? Should he haggle the price? Health care is not like buying a car or furniture. How do you shop for health services when you are in an emergency room? I have no idea what an operation should cost or how to assign value to health services. There is no way for a market to operate. I think the president and the rest of us have to face the fact that health care is something with which the government needs to be involved. The system in this country doesn’t work. In European countries, national health care costs are a fraction of the costs here. And almost all of them have better results measured by infant mortality and other criteria. Here we have too many fingers in the medical financial pie, with the result that Americans are getting less than they should. Public health programs are almost non existent. Instead of rational health care and preventive medicine, the poorest of us get no treatment until they enter an emergency room. Here they can’t be turned away, so they are treated, but at an expense several times higher than what would otherwise be required. We pay that expense. This makes no sense. Congress would have done well to put the billions of dollars that went into the drug benefit plan into a program to begin rationalizing health care. Improvement is not going to come from cutting the budget for Medicare or from providing tax breaks for the healthy people who will benefit from health savings accounts. Michael G. Busche Sussex