Dr. Craig Reese, DC, PC

Unfortunately, school is back in session and the days are getting shorter. The good thing about fall is that it is a great time to do a cleanse. The Standard Process Purification program is a great 3 week program that cleanses your bowels and your liver. Just ask one of the staff and they will gladly give you the information on the program.

Health (Sick) Care

August has been a month of debate both pro and con about the possible government take-over of our medical treatments system. I won't pretend to have read the entire 1000 page House bill or the 700 page Senate bill but I have seen excerpts. I hesitate to call it our "health" care system because it has nothing to do with health and everything to do with sick care. Our current system looks at "preventive care" to mean early testing and early detection of the cancer or disease you are eventually going to get. The system would rather pay $30,000-$60,000 for a disc surgery than to pay $3000-$6000 for months of non-surgical spinal decompression. Mammograms that use radiation that can eventually cause cancer are paid for but mammotherms (breast thermograms), which use no radiation and can find dangerous changes to breast tissue long before mammograms, seldom are paid for by insurance. Our system is already controlled by the insurance companies and the government and is based on having lots of sick people to keep it afloat.

Medicare

The government programs like Medicare and Medicaid are under- funded and quickly failing. Every year Medicare pays for less care and the need for people to buy supplemental insurance increases. Most doctors don't accept Medicaid payments because the amount of red tape and forms you need to fill out to get a fraction of your normal fee makes it an expensive proposition for the clinics that treat these patients. Even with the Medicare tax, the program is still going broke because of skyrocketing medical costs to treat an aging population. Medicare covers less in my office today than it did 10-15 years ago. The Medicare viewpoint is that you are old and you are going to hurt so unless you had an accident or injury, it is maintenance care and they aren't going to pay for it. I would hate to see those same government officials monitoring all medical services in this country. Watch this John Stossel report on medical care: http://www.youtube.com/watch?v=q9GMKK_fWKg

Insurance

Decades ago, when the Chiropractic profession was trying to get insurance coverage for our patients, one of our negotiators was told by an insurance company executive that chiropractic care was too cheap to sell insurance policies. He explained that since chiropractic care was only responsible for ½ of 1 percent of all health care expenses, no one was driven to buy insurance for their chiropractic needs. But a $30,000 cancer case or a $5,000 surgery (1970's prices) struck fear into the buying public and made it easier to sell them large health insurance policies. Interesting viewpoint isn't it?

I find it interesting that the only solution for our sick care system is some form of insurance. Whether it is government run single payer or the current system with multiple health insurance carriers, everyone agrees that we need everyone to be covered by insurance. In reality, what we need is affordable health care. Medical costs rose about 10- 20% a year for the past 30 years because of insurance coverage. When the person receiving the benefits doesn't have to directly pay for them, they really don't care how much it costs. Anyone who has kids has experienced that phenomenon! (But it only costs $$$$$ dad)

Do you know which medical specialty has only increased its prices about 3-5% a year over the past 30 years? It is plastic surgery because most of their services are not covered by insurance since it is an elective procedure. More insurance coverage raises the cost of medical treatments because the patient doesn't care what is charged and the doctors have to charge more to put up with waiting months to get paid and they know the insurance company will cut the bill somewhere plus they have to hire extra staff just to hound the insurance companies for the payment.

When I opened my first clinic in 1985, I charged $25 for an adjustment. Nearly 25 years later I charge $50 for an adjustment. That is a 100% increase in 25 years or 4% a year average because I don't accept insurance and have to price my services for cash paying patients.

True Nature of Insurance

Insurance was developed to help spread the risk in case something unforeseen happens. It is for catastrophic losses and not for everyday expenses. How much do you think your car insurance would be if it covered the cost of your gasoline, too? How about your house insurance that also paid your utilities? We have been spoiled in this country for the past 40-50 years with a low deductible insurance program that got us used to having health insurance cover everything. In the 1930's there were wage controls that limited how much an employer could pay a top employee. As an incentive to get that prized worker to come to work for your company, executives had to come up with incentives and benefits beyond the salary or wage they could pay. That's when job related health insurance started and the initial deductible was about the equivalent of a month's salary or $100. That deductible stayed for most union and corporate insurance programs right up into the 1980's and 1990's when that same $100 was a day's pay or less. That created a virtually free medical system for these policy holders and they used it to the max! The same has happened in every country that has socialized medicine. If you want more of something subsidize it and if you want less of something then tax it. Government run medical services will subsidize patient use and will be a tax to the doctor's in that system. That will give us more patients and fewer doctors in the long run.

HSA's

The Health Savings Accounts and Cafeteria Plans were actually starting to bring down the costs of health care by putting the provider and the user of medical services back into contact. You created a savings account with pre-tax dollars that you could use for anything from aspirin and acupuncture to vitamins and witch doctors. Witch doctors like me that is! This account was combined with a high deductible health insurance policy to cover catastrophic losses. Most years you would only be using the money in the HSA for general doctor visits, supplements, adjustments, etc. If you had a serious illness or injury, your medical bills are covered at 100% after the $2000-$10,000 deductible was met. This arrangement got doctors to lower prices for cash payments because they didn't have to wait for months and spend lots of staff hours trying to get paid. The HSA would also pay for the kind of care you wanted to get and not that dictated by an insurance company adjuster. You could negotiate cash fees (sorry but that is the only type of fees I charge) and pick the doctor you wanted to have treat you.

Solution

I don't have a magic solution to this complex problem. I believe going back to more of a market driven solution will lower prices and keep the supply close to where it is currently, than going to a subsidized government run system. Just like Lasik surgery, which started out at $3000-$5000 an eye, saw its prices drop to a few hundred dollar's an eye now because there is no insurance reimbursement and competition drove down the price. If insurance didn't cover many of today's common procedures, I believe their prices would be ½ to ¼ of what they are now. Having more insurance coverage, regardless of who runs it, will just raise prices and create even more demand for services. The place where government can really do their best is for the poor who can't afford any care. They are currently being treated by government run hospitals or charitable organizations and those programs alone are very costly but necessary. Health insurance companies need to be reformed but with fewer restrictions imposed by government and more ability to actually compete for business. Yes, their prime directive will still be to collect premiums and to not pay claims but more competitors in the market will force them to be competitive. Term life insurance experienced that same change once the internet made it possible for people to compare prices on line.

Community Rating

Lastly, I would like to see community ratings dropped from health insurance just like car insurance. If you are a bad driver and have lots of accidents then your insurance goes up. If you take care of yourself and don't have health claims, your insurance should go down like it does for your car. My catastrophic health insurance plan has gone up every year that I have owned it but have never submitted a claim. My price goes up due to community rating and not because I over use my policy. Those that are high risk health-wise would pay higher insurance premiums but that would motivate people to take better care of themselves or to only use their insurance when a major illness or accident occurs. The healthy would pay less because they use the system less.

Office News

As I told you in last month's newsletter, I am leaving for vacation this weekend and will be back in the office on the 14th. Deirdre and Stephanie will still be in the office next week to help you with supplements and decompression treatments. Diana will be finishing her Internship this Friday and will be back in school again. We wish her well and have enjoyed having her in the office. We will be taking applications for someone to work at the front desk over the next week or so if you know someone who might do a good job for us.

We are going to see patients on Friday mornings in September still (except on 9/11 when I'm gone). We were in the office every Friday morning in August and many people came in to see us but I don't know if that was just because it was the summer. For now we are still testing to see if that is a popular day and time. If it is, then we would put it back in the schedule permanently so as to better serve you.

Aloha!