Why is costly health care such a kettle of fish and difficult to reel in? Cross-subsidies, let’s explain. Politicians want to subsidize health care for the poor, chronically sick and those who have the means but opt not to pay. These are laudable governmental goals. Congressional planning causes health insurance and cash payers to egregiously pay the tab.
These goals can be better achieved in a free-market system by raising general taxes. However, lawgivers dislike being regarded as a tax and spend type, so they conceal transfers in cross-subsidies. Medicaid/Medicare patients have no idea what the actual costs are. The system lacks cost consistency/containment. This arrangement makes it difficult for patients to determine costs, seek competitive providers and gain access.
Politicos require emergency rooms to treat everyone regardless of the ability to pay. Many pay nothing. Hospitals then overcharge the payers. Medicare/Medicaid does not pay the full amount. Who pays for these underpayments? Private insurance and cash payers. This mechanism creates cost inflation, lacks transparency, stifles choice and immensely vexes access. Cost-cutting innovation is stifled. Confusion reigns.
Services ought to be paid evenhandedly across the spectrum with honest, definable congressional budgets. The system is nonsensical, yet fixable.
Gerald E. Weitz, D.D.S., Viola
Mathiasen letter: Fatal trench break
“Fatal trench break” — I have worked from coast to coast on large projects involving a power plant and various substations, and every project involved trenches. Field employees like myself, a procurement manager, were given a course on trench safety as well as other safety issues and given the power to stop a work safety issue, whether trenches or some other safety issue. Safety managers were alerted and until their arrival the work stopped. It amazes me how many saw potential safety issues but lacked the authority to stop the digging. In this case the trench should have had the shields or been tapered out on each side. It appears that cost factors and potential fines overshadowed the safety of the employees involved. Where is the justice in all this? Is this an issue of the lack of construction standards and practices to favor employers over employees in the state of Idaho? The lack of standards and in this case the lack of proper trench safety practices led to the death of a worker who had no protection, thus leaving a widow and three children. Each entity in this case should be held responsible for the failure to protect.
Robert J. Mathiasen, Middleton