Letters to the Editor
Medicare Mugged St. Mark’s
To the Editor:
The idea that health care is, or should be, a right — guaranteed by God and funded by government — is what, in the end, killed St. Mark’s Hospital. While it’s arguable whether God ever signed off on health care, it’s wrong to believe anything government hands out is free. The trick is knowing where to look for the price. Our wise protectors in DC, too often cripple viable free market alternatives with their handouts, and this loss of choice is the hidden price we pay in the coin of unforeseen consequences. Were it not for the consequences, foreseen or not, of Medicare and Medicaid’s price fixing policies on rural communities, Fayette County’s only hospital would be prospering and not on its way to a long postponed bankruptcy.
In effect, Medicare and Medicaid are gigantic insurance operations run more like the Post Office than their private sector brethren. As program costs skyrocket the DC swamp creatures in charge cover the sloth of federal bloat and corruption by paying hospitals and doctors less than their actual costs. As a result, some doctors refuse to take Medicare and Medicaid patients, and those who do try to make up for the difference on privately insured patients whose plans pay more.
In large metropolitan areas, the mix of privately insured to Medicare and Medicaid patients enables profits for hospitals, and a good living for doctors. However, in rural areas like Fayette and surrounding counties, where Medicare and Medicaid insures the preponderance of patients, hospitals and doctors suffer from their inability to earn a reasonable income from the government’s mandated rates.
Mandating is like you going into HEB and telling them, “I’m taking that steak and paying no more than fifty cents a pound.” It’s what governments and monopolies do when they can get away with it. While most rural doctors and hospitals find Medicare and Medicaid mandated payments too low to cover their costs, St. Marks found it challenging as well to hire and keep skilled professional employees and also pay down the $13 million mortgage on its buildings — something that was never going to repay on the government’s mandated revenues.
Local sentiments, and a lopsided “no” vote in a prior election made it also clear there was no appetite for a local hospital district capable of raising taxes to add to St. Marks revenues. Signing a blank check to throw good tax money at a federally mismanaged program that seems likely to continue for many years was, and likely still is, not popular in Fayette County.
In a country, and even more so in a rural community, where problems are solved with common sense and old fashioned ingenuity, taking federal handouts rarely turns out better than what local free enterprise can accomplish on its own. Government freebies — and the overhead, waste and corruption that come with them — rarely turn out to be more than a shadow of what the industry of free people and free markets can provide. For example after the end of the Vietnam War many Vietnamese emigrated to Houston. They chose to avoid U.S. insurance companies in favor of clinics offering walk-in $40 visits that began popping up in areas where they lived — arguably serving them as well or better than insurance plans paying $250 for a doctor visit.
The moral in St. Mark’s mugging is the easy-to-ignore truth that personal freedom and government benefits are often incompatible. Health care as it existed 75 years ago, before Medicare was a gleam in government’s eye, worked. It worked in the cities and everywhere else. Affordable health insurance was readily available, and doctors made house calls. Today two chickens or a side of beef are not acceptable payments under Medicare or Medicaid regulations, and maybe that’s the heart of the problem.