(Host) As editor of Vermont Business Magazine, commentator Tim McQuiston has been thinking that when it comes to deciding how much to charge consumers – at the pump so to speak – gasoline and health care may have more in common than you’d think.
(McQuiston) There’s been a lot of hullabaloo over gasoline prices lately. Like, how come gas is 20 cents cheaper in Lyndonville than it is in Burlington? Never mind that it’s 60 cents cheaper in Orlando. Bernie Sanders even wants a Senate investigation.
And within that context, I’ve been thinking about health care.
First, I completely appreciate the cultural and political discourse over the Affordable Care Act, Obamacare or as some call it Obamneycare. Chief Justice Roberts calls it a tax, like Social Security, and therefore constitutional.
Whether it will solve health care funding going forward, I can’t say – and I’m not a single-payer advocate, even though I have to admit the old system was killing small businesses – like mine – that offer their employees health care.
But treating health care as a consumer item – and assuming that we have a choice of whether or not to purchase it – may be fundamentally wrong.
People can choose whether to buy a car (probably) or skinny jeans (maybe), but everyone buys health care. Everyone. Whether they want to or not. And, as with the price of gas, people pay different amounts for the exact same product, depending on their circumstances – though not in any logical or equitable way. It’s not based on geography or ability to pay or how much one uses.
And while some may think they’re off the health-care grid by never getting sick or by paying cash for doctor visits or medications, every bit of health care is either subsidized or cost-shifted. This includes not only treatment we’ve had or are getting, but what we might use in our old age – or even – and get this – what we might never use, but which the health care system must plan for on the chance that we might use it.
All those ambulances, nurses, doctors, technology, hospitals are just standing by, waiting for us.
Funding all this, of course, is complicated. A lot of it is paid for by businesses who offer health insurance – and their employees. Some is paid by taxes. Some is paid for by those who do pay out-of-pocket, or through deductibles – even high deductibles – and by co-pays.
Now look at the health care debate through the gas price lens. Some people have been filling up with gas that costs 31 cents a gallon while others have been paying 3 dollars and 60 cents – or more than one thousand percent more.
Whether we have health insurance or not, it’s reasonable to assume that we’ll all consume roughly the same amount of health care in a lifetime. But, incredibly, some of us are paying 31 cents a gallon at the health care pump while others are paying three-sixty. And those of us paying three-sixty don’t have much sympathy for the 31-cent guys. They may be understandably unhappy that they’re going to have to pay considerably more now, but at the end of the day, they’re getting high test – just like the rest of us.