Cost shifting is a big part of the problem in health care

The single greatest cause for the unaffordability of health care is cost shifting by the federal government.

Cost shifting is when a doctor pays one dollar for a bandage to put on your wound and Medicare/Medicaid reimburses only 70 cents. Now, the doctor must recover this loss by charging paying patients/insurance enough more to cover the loss. This method of financing medical services is very inefficient and costly to those who actually pay for services.

President Barack Obama tells us that health care costs are going to increase 100 percent next year. He is absolutely correct because our government tells us that Medicare/Medicaid reimbursements are going to be reduced by another 21 percent. How does 21 percent equal 100 percent?

Medicare/Medicaid patients: • Use medical services more frequently. • Medical services, on the average, are more expensive. • Medical services are used for longer periods of time.

Generally, over 40 percent of a person’s total lifetime medical expenses will be incurred during their last year of life usually when they are on Medicare/Medicaid. Not many people or employers will be able to afford such a horrendous increase on top of already unreasonable health insurance costs.

The most efficient and least costly way to make health care affordable again is for Congress to put the hard question to the public: Do you want large cuts made in Medicare/ Medicaid services or do you want a tax increase sufficient to eliminate cost shifting in Medicare/Medicaid?

The first option is of course out of the question. None of us want increased taxes, but it will be far less costly than the 2,000+ page medical plan that is being pushed today. This one action would reduce health care costs by 40 percent to 50 percent. This would make health care affordable again for many people and would have a multiplier effect in cost reduction for Medicare/Medicaid. The real question is: Does Congress have the guts to do the right thing, or are they too embarrassed to admit they are the cause of medical care unaffordability in the first place?

Washington and several other states have addressed many of the ills of the national health care system. Our access to health care act guarantees insurance to all Washington citizens, but unfortunately our Legislature watered down and diluted some of its best provisions which should be restored.

This state also has a Basic Health Plan for those who can’t afford regular health care. Washington does not allow discrimination for pre-existing conditions. Oregon has tried and needs to re-implement its health care allocation provisions act. Other states have health care provisions that if also incorporated into one comprehensive plan would more than solve all our health care issues for affordability and universal care.

There are many other ways of making health care more affordable:

We need to overcome all the attorneys in Congress who oppose tort reform.

Restitution by all who steal or commit fraud by up to three times the damages incurred whether individuals, companies or insurers. This includes patients, doctors, hospitals, pharmaceutical companies.

Eliminate medical care abuses by requiring all insurers to expose all areas of abuse as in palliative care vs. curative care, excessive care and unnecessary care.

Correct the ills and inefficiencies of the Hill-Burton Act such as having a nurse triage all who come to a hospital and limit to appropriate care.

Find a way to deal with the illegal aliens issues.

I’m sure we can find many more ways to make life better for the honest people of this great nation.

Frank Byles, retired deputy insurance commissioner, can be reached at 360-352-4725.