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Don't knock U.S. medical care 

Take some responsibility for choices

Many letters have been published extolling the virtues of socialized medicine. My family's recent experience should illustrate such a system well. A year ago, my brother, a Canadian citizen, visited Houston, Texas. While there, he had a heart attack and was taken to the hospital. His travel insurance company wanted to air ambulance him back to Toronto for care. The jet was ready to take him, but he had to wait for a hospital bed to open up in Toronto, a major Canadian city. After three days, while my brother was still waiting for bed space, he had a second heart attack. At that point, he received good care in Houston. Waiting for care is common in socialized medicine countries.

What about the cost of governmental versus private insurance care? Earlier this year, I was in Germany and discussed the issue with a small business owner. He had a choice between private insurance and government care for his wife's coverage. The premiums for private insurance were comparable to those in California. This businessman chose private insurance because the premiums were less than those for the governmental plan. Taxes are much higher in Germany.

A couple of years ago, while visiting Finland also a highly socialist country I discussed medical care. My friend, a lawyer, made $160,000 per year and had to pay 67 percent of that or $100,000 in income taxes! On top of that, there was a national sales tax of 23 percent and home mortgage interest was not tax deductible. Also, depending on the age and condition of the patient, many procedures were limited. Care was rationed in spite of high taxes. Interestingly, a lot of residents in socialized medicine countries are purchasing private insurance in order to augment their coverage to make sure they have other options for care, should they need it.

The concept of insurance means that you pool your resources with other people and pay premiums for those risks which no one person could afford to cover individually. In essence, you shift the risk of large claims to an insurance company. Insurance should not be purchased or used for small co-pays or bills. Don't pay for the insurance company's overhead and profit to shuffle paperwork for small payments. You should only buy a high deductible major medical policy to cover the unexpected high expenses and save the rest of the premiums in a tax-deductible health saving account. Insurance is merely a safety net. That is why it does not make sense to buy dental insurance or vision care insurance. How many people have gone broke because of dental expenses? We need to stop depending on insurance companies to act as our aspirin nannies.

Michael Moore, producer of the film Sicko, believes that Cuba and other communist countries provide better medical care than can be received in the United States. He tries to persuade viewers that we should change our medical care system to a single-payer system, also known as socialized medicine. He would rather go to Cuba for medical treatment than receive the benefits of our medical research, equipment, and doctors. Let's see if he actually in fact goes there when and if he needs medical care. Also, I bet Mr. Moore himself has medical insurance.

The issue of medical care has evolved into the bashing of insurance companies. So, if you do not like medical insurance, don't buy it. You don't have to have it. In America, we have a choice of being insured or not, while in socialist countries everyone is forced to be covered through high taxes. Here we can choose the level of insurance care we want instead of being forced into one government plan that supposedly suits everybody.

If you believe insurance companies are gouging you, let's turn the tables. Would you insure your neighbor and reimburse him for all of his medical expenses if he paid you $300 per month as premium? He might have an accident and break a leg. He might get cancer, need surgery, and require chemotherapy for several years. Or he may have a child born with a congenital heart problem. How about being on an allergy medication or cholesterol-lowering medicine, which by itself might cost $200 per month? What if he is a smoker or is overweight and a diabetic who needs insulin? What if he is a reckless motorcycle rider? How about choosing to binge drink or live a high-risk life style? He might have a heart attack and need angioplasty. What if you suggest ways for him to reduce his risks and he refuses to change his habits? Would you charge more if he were older? If $300 per month is not enough, how much would you charge to cover him?

Would you be willing to agree to cover his expenses if he told you up front when you made the reimbursement agreement that his doctor had told him just five months ago that he had a heart problem and faced surgery in a couple of months? Would you still reimburse him for that operation now that you know he lied to you about his health history when you made the agreement? Once you uncovered the lie, should you have the right to rescind the agreement?

Many people who have chosen not to have insurance and have spent their money on other items they deemed more important are clamoring for socialized medicine because they now want somebody else, namely the impersonal government, to bail them out. Of course this would be a good deal as long as someone else pays for it.

Government benefits have created an attitude of entitlement with the recipients. In fact, they believe the government owes them these rights. The availability of free benefits through socialized medicine is a magnet that draws people here. Tens of thousands of pregnant women have crossed the border illegally in order to deliver their babies in the United States for free.

Government already controls a lot of medical care in the United States. You can get a good idea of how government currently handles medical care by looking at the Veterans' Administration Hospitals. In California, hospitals are required to give treatment to all who require it. Because of the costs, in large part due to the illegal and uninsured aliens who have flocked to California for its benefits, many hospitals have been forced to close their emergency rooms. My daughter, an emergency medicine doctor, has told me of the repeat "customers" who keep returning in taxpayer-paid taxi rides for free treatments. Society keeps paying for these benefits in spite of the individuals' lack of changing their lifestyle.

The state of California also offers no cost Medi-Cal coverage, as well as the "Healthy Families" program at varying rates ranging from $4 and up per month depending on family income. In San Luis Obispo County, children can be covered for premiums ranging from nothing to $15 per month through a joint venture between government funding and public donations. Since the actual cost of this socialized medicine plan is $105 per month, the balance is covered by society. The plan covers medical care, dental care, and vision care. Interestingly, an individual policy for children from, for example Blue Cross, costs $45 per month.

Paradoxically, prisoners receive comprehensive and free medical care often far exceeding the level of coverage available to the general public. All of this is paid for by taxes, instead of user fees.

An examination of other countries with socialized medicine shows their shortcomings and high cost through taxes. Our government does not possess a magic wand that would reduce the cost of medical care. In fact, history proves that costs will increase, quality will deteriorate, and we will have fewer choices. We need to reassume personal responsibility of our lifestyle, choices, care, and costs. At the same time, our society has taken care of, has the resources to care for, and will continue to take care of those who are in need indeed.

Matt Kokkonen is a financial planner who has designed medical insurance plans and employee benefits for 36 years on the Central Coast.

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