In whose good hands?

A couple of months ago, a pickup truck sped south on Interstate 35 through north Iowa.

Starting in Minneapolis, three young hispanic men were on a road trip to...somewhere.

Whether they ever got there, I don't know. If they did, it certainly wasn't when they planned to arrive there, nor was it in the vehicle they started out in.

Encountering a patch of the infamous 'black ice', the man driving the truck lost control and slid into the ditch. As the vehicle rolled over, one of the three men was ejected, presumably not wearing his seatbelt.

All three men were transported to the area's premier medical center, located less than a mile south of my home. The two men who remained in the truck were treated for their injuries, and the man who was ejected was transported to Rochester, via helicopter, to either the Mayo Clinic or St. Mary's hospital, which are presumed to be the best in the region and are held in very high esteem worldwide. In fact, many heads of state and Arab royalty insist upon coming to the Mayo Clinic in Rochester, Minnesota, when they need serious medical attention in other than immediately dire circumstances.

With all the talk about health care lately, some things tend to be overlooked or forgotten by many people.

Is medical attention expensive? Of course it is!

Is health insurance expensive? Absolutely.

What is insurance?

Insurance is a risk management tool where you share the risk of financial loss with a large number of other people. If you assume all the risk, which is essentially what you do by doing nothing - after all, there is risk in just being alive - you're taking an all or nothing gamble. If you never experience a costly mishap or crisis, you pay nothing. However, if something does go wrong, you're completely on the hook. You assumed all risk, so you bear all responsibility. In buying an insurance contract, you assume a small part of everyone's risk. Therefore, you pay, and pay, and pay a little bit at a time, but if and when something big happens, you don't have to shoulder all of the burden alone. You have help from everyone else who also has purchased an insurance contract. When other policy holders experience expensive, unplanned occurences, you're helping to pay their expenses so they're not on the hook alone.

Did these men have health insurance? Hard to know for sure, but I suspect the odds are very good that they either did not or if they had any coverage, it was not likely to be major medical, which is what you would need to have if you were being flown to the Mayo Clinic with critical injuries.

No one at the emergency room here in Mason City asked these men if they had insurance before taking them in. They treated them until they were in stable condition, and transported the most severely injured man to a place where I sure as heck would want to be sent if I was in bad shape, the place where one could expect the very best medical care.

Were these men independently wealthy? I doubt it. Three young hispanic men traveling down the interstate shoulder to shoulder in a pickup truck more likely than not wouldn't be.

Mercy Medical Center here most likely will 'absorb' the cost of providing the care to these men; the cost of the supplies, the share of the physicians' salaries, overhead, et cetera. Most likely, the two men without life threatening injuries were transported to the University of Iowa hospitals in Iowa City by ambulance within a few days.

My baby brother was sent to Rochester on a helicopter over twenty years ago. In 1985, the cost for the hundred mile trip was about $4,000. I have no idea what it is today, but I'm guessing double that amount would be a fair place to start. A 150 mile ambulance ride would tick upwards of a grand with little trouble whatsoever.

So, when the hospital 'absorbs' the cost, who pays? Hmmm....know anyone who's been in the hospital lately? If you do, were they insured? Not too many people can afford to pay for any significant medical treatment out-of-pocket these days. If they were insured, the rate the hospital bills its services at definitely is inflated to recoup the expenses incurred by patients who do not have the means to pay either themselves or though insurance.

Do you have medical insurance? When the insurance companies pay that inflated rate to offset the costs of patients who cannot pay, guess who makes it up to the insurance companies? Yep! All of the policy holders who pay thier own premiums. If their employer covers the premiums, the cost is passed to the customers. Have you spent money anywhere lately? Congratulations, I can about guarantee that you've been helping, in part, to pay for the uninsured indigent souls who've been to the hospital recently.

Now, should the person you may know have been in the hospital without insurance, especially if they got sent to a university hospital, who pays? Know anyone who owns property or pays state income taxes? You do? There you are! You rent? Right. Your landlord pays taxes on the real estate you're occupying...with the money you've paid them last time you wrote out a rent check!

You live in a state that does not tax your income? A few states are like that. I'll bet you a cow and two chickens that your state has a sales tax. Where does your state get the money to cover the expenses run up at the University hospitals, or even sometimes at the local hospitals that are otherwise left 'holding the bag'? Uh-huh.

You just can't escape this. When people don't pay for their own medical expenses, one way or another, you do. We all do.

If you need immediate care, you will not be turned away from any hospital. They'll take you in, patch you back up, and possibly try to pass you off to a 'publicly owned' (as in, run by the state instead of by a private company or organization) facility. Hospitals that are businesses are not in the business of losing money. They tend not to last long that way, and more than a couple have in fact had to close because too many people in the area they were located received treatment but lacked the means to pay for it. Ultimately, everyone else in that area lost out when that hospital was no longer available for them to access in time of need.

Yes, the hospital will try to collect from you whenever you use it. After all, who's responsible for your health and well being? If you're eighteen or older, YOU ARE. That doesn't mean that you have to be your own doctor, but if you need the services of one, it is up to you to pay for it. If you can't afford to pay for healthcare directly, you will continue to pay for it indirectly just like everyone else, although it will get just a little bit worse whenever someone else racks up bills that they don't have the money for.

Most folks don't realize how close we really are to 'socialized medicine', whether we like it or not!

the TiGor