Healthcare Math: 2+2=4
How will healthcare reform affect you? Healthcare reform may be confusing and complicated but it does not take a degree in mathematics. At an early age we are all taught certain basic truths, like 2+2=4. Even those who learned “New Math” know that 2+2=4. It may at times be an inconvenient truth, but nevertheless, no one can claim that 2+2=5!
There are three key changes and challenges mentioned in all healthcare reform proposals: Access, Quality, and Cost. In the debate process, look for answers to these simple questions. See if it all adds up for you.
Access: If 47 million currently uninsured lives are added into the system, will you find it easier or harder to get an appointment with your primary care physician? With a specialist? Supporters of current Congressional proposals are saying that that you will have increased access to care. To many, that doesn’t sound logical. Those with the most to lose from less access to care are the Medicare beneficiaries. Many doctors today limit the number of new Medicare patients. Medicare beneficiaries know 2+2=4; they aren’t buying into the political rhetoric that more coverage will mean less waiting. It just doesn’t add up.
Quality: The proposals include $500 billion taken directly out of Medicare. Will you find the quality of medical treatments under Medicare be improved or lessened? If doctors are paid less, will the quality and time spent with your physician increase or decrease? Supporters of current Congressional bills are saying that quality of care will be improved. For many, it makes no sense. Supporters have not explained how a negative (reducing Medicare by $500 billion) will create a positive (improved quality).
Cost: The Congressional Budget Office has estimated the several leading proposals will cost an additional $700 billion to over $1,000 billion (a trillion). Plans proven to lower costs by 12-20% with health savings accounts are likely to be prohibited or greatly inhibited under current proposals. Under proposed bills, cost effective comprehensive catastrophic coverage cannot be priced at less than 30% below a government determined acceptable plan, even if current generation products are 40-50% lower. It doesn’t take a math whiz to figure that advocates of the current proposals are not seeking real cost containment. Citizens can’t understand how increasing expenditure by over $1 trillion will lower healthcare costs.
In a story that may be apocryphal, a king once objected to a mathematical factor called pi that showed up frequently in formulas. Pi is the ratio of the distance around a circle (the circumference) to the distance across its middle (the diameter). The value of Pi is approximately 3.14159…, but its actual value has an unending string of numbers to the right of the decimal point. How inconvenient! The king declared that the “governmental value” of pi would hence forth be equal to 3.0! The result was that citizens could no longer draw perfect circles and round columns could not be built to hold up buildings. The empire eventually collapsed.
American’s are not stupid. Politicians and kings can try to force the public into believing 2+2=5, but “fool me once, shame on you, fool me twice shame on me.” The public trusted the government with bailouts, takeovers, cash for clunkers, and stimulus programs that don’t seem to have worked. This time they are insisting that 2+2=4 and will not accept answers that are more or less.
Ronald E. Bachman FSA, MAAA is an actuary and Senior Fellow at the Center for Health Transformation, an organization founded by former U.S. House Speaker Newt Gingrich. Nothing written here is
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