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On Health Care, Money, and Food

The Feds are going after UnitedHealth for overbilling Medicare. The thrust of the claim is that UnitedHealth got more money from the government if UnitedHealth lied to the government, and said people were sicker than they really were:

"The Medicare Advantage program pays insurance companies a yearly fee for each person they enroll. And it pays more for people who are sick, to keep insurers from rejecting them because their care will cost more. The practice, called 'risk adjustment,' gives insurers an incentive to tell the government that people are sicker than they may, in fact, be."

Mary Williams Walsh, UnitedHealth overbilled Medicare by billions, U.S. says in suit. New York Times, May 19, 2017.

It is perfectly good and sensible to be:

1. Angry at politicians for their ineptitude at handling health care.

2. Angry at tall building bankers and lawyers and corporate barons for lying to the government and stealing from taxpayers.

3.  Angry about how expensive health care still is. 

4. Worried if you or someone you love depends on a medication, and may be unable to afford it if health care laws change.

Indeed. But a lot of this anger misses the biggest target.

It isn't "health care" that is big business. Sickness is. I challenge the conventional wisdom that "many" people have some kind of genetic condition that needs to be treated. 

Remember Paula Deen, the celebrity chef famous for her terrible comments and fattening recipes? Recall her disclosure that she developed type-2 diabetes, and of course, appeared in drug company ads?  Refresh your recollection with this Bloomberg article from 2013.

I am more than happy for my tax dollars to pay for someone's insulin, even though the cost is appalling. The amount the drug companies charge people for something that has been around almost as long as a light bulb is like having to pay $15 for the m-f-ing light bulb and having to replace the sucker every day. And type-1 diabetics have no choice in the matter. Read more about that here in Foreign Affairs.

I am happy for my tax dollars to pay to pick someone up off of I-5 and take them to Harborview to save their life, even if that person was a dumbass who caused a five-car pileup because they were trying to load their favorite Train playlist.

Western medicine and American sources of it are the best places to go with a life-threatening issue, God forbid one arises. And the community benefits when we don't just leave people to die and tell them they'd better toughen up.

I am also fine with doctors making a lot of money; that wasn't the kind of grad school I was ever cut out for. 

What I am talking about here is the industry of lifestyle sickness.

The sad irony of the fraud incentive in "risk adjustment" as alleged against UnitedHealth is that our health care system already systemically profits from making people sicker, without having to cook the books. 

Big Food, Big Pharmaceutical, and big everything profits when millions of people are stuck in the consumer goods hamster wheel of eating fake food, getting progressively sicker over many years of doing that, and then needing medical intervention because of it.

Here are the steps:

1. Sell people on the idea of eating themselves sick, in terms of quantity of food.

2. Put crap in the food so that people eat themselves sick in terms of food quality, are more addicted to the food, and thus eat more of it.  Refer to #1.

3. Sell people drugs to keep them alive so that they can buy more food and more drugs.

4. Sell people really special drugs to keep them stoned out of their gourds so that they don't care that they feel like crap from all the food and the drugs.

5. Keep everyone watching TV, eating, pill popping, and pooping as long as possible.

6. Create repositories to house people where they can watch more TV, eat even worse food, pop more pills, and have someone else wipe their bum while someone cuts them open to save their lives so that they can keep up the cycle.

7. Invent radical new treatments to prolong this as much as possible, so we can all keep shopping.

8. Convince you to lease a new car so you can stay cool while you're idling in the drive-thru line at McWhatever.

Aren't there better ways to boost the economy and apply American ingenuity?

"So judgy!" you might say. "Just wait until she gets old too, then she'll see," others might say. "That snobby lawyer bitch, I bet she can afford the fancy local organic yak milk at Whole Foods, and it is too expensive for me, so I'd better get the 12-piece chicken bucket again tonight."

As a consumer lawyer, I've litigated a share of cases involving medical billing snafus, and financial disasters set off by unexpected and totally undeserved injuries, accidents, and illnesses that are very real for people. Every day that I experience good health and physical safety, I am grateful for it and for all of the other people who have had a hand in my good fortune. And if you show me a credit card statement with a lot of fast food visits on it, I might roll it up and bop you on head. My business is about tough love.

There is so much that we cannot predict or control. That said, so much of our good health is in our hands, and with it, an incredible opportunity to minimize risk and maximize the reward in our lives.

Want inspiration? Check out these articles:

"Killing your $1000 grocery bill" with the help of Mr. Money Mustache.

Apparently it takes a team of University of Washington researchers to tell us that cooking at home is healthier and cheaper.

To your health.

 

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