Thursday, March 11, 2010


I took my car in for an oil change. I didn’t make it for the early bird special and thus with tax and everything it cost $42 and some spare change. It took about 15 minutes, the guy came in, tried to up-sell me on some window wipers which I declined and then off I went.

Juxtapose that with my visit to my new, most favorite doctor, Dr. Eelkema.

I don’t like him because he’s personable.

I don’t like him because he’s professional.

I don’t like him because he’s on time.

I like him because he’s cheap.

So cheap in fact that it cost me LESS TO VISIT HIM THAN TO GET MY OIL CHANGED.

I showed up, and with a militant level of adherence to time he was ready for our appointment. Checked a couple things, took my blood pressure, diagnosed my problems and BOOM, I was out the door. And the price for this standard doctor’s visit?

$38 and spare change. AND less time than it took to get my oil changed.

It was one of those times where you were happy to pay because the deal you got provided more utility than the price you even paid.

The question is how does Dr. Eelkema do it?

Simple, he got rid of the insurance companies, thereby eliminating a huge amount of overhead, time and paper work, only takes cash payment and makes you sign a waiver essentially saying you won’t sue.


You eliminate three things – insurance companies, collection problems and lawsuits/lawyers – and the cost of a doctor’s visit drops to $38.

Now it could be because Dr. Eelkema is an older gentleman and maybe he has earned his fortunes and can afford to run his practice that cheaply. Perhaps he is just getting older and as one ages time becomes more valuable than money. But it still couldn’t prevent my economic spidey senses from thinking about what would happen if instead of the 2,000 page health care reform monstrosity Obama/Pelosi/Reid are trying to ram down America’s throat we did a Dr. Eelkema Health Care style reform. That instead treating health insurance like a right, we treat it more like car insurance. You pay OUT OF POCKET expenses for regular maintenance of your car such as oil changes, tire replacement, batteries, etc, just like you would regular maintenance on your body (check ups, visits, tests, etc). However, you only have insurance should a catastrophe occur. You crash your car, the insurance company pays for its repair or an entire new one. You crash your body, the health insurance the insurance company kicks in to repair you. And what amazes me is that if you’re in reasonably decent shape your health insurance and general health expenditures on YOU will cost the same, if not LESS THAN YOUR CAR, BUT THAT'S IF YOU'RE USING A DOCTOR LIKE DR.EELKEMA.

In otherwords, Dr. Eelkema is the empirical proof of "what could be" or what the REAL costs of health care are if you get rid of insurance companies, lawyers, lawsuits, and government. That $38 is what you really have to pay. Not the $200, the majority of which goes to other entities that have NOTHING to do with your health care except to make it more expensive.

But, I know, I know. We’ve all been told health care is a right (forget the fact rights don’t cost anything while health care is a commodity no matter what anybody tells you). And it’s a tragedy if a single mom of 6 children from 6 different fathers has to pay a $15 copay for each of them. And it’s a travesty if a union member has to pay a copay at all. Matter of fact it’s dictatorial totalitarianism if you have to spend a single penny on your own health care. And besides, we have to make sure all those lawyers have plenty of money coming their way, not to mention government bureaucrats need jobs too and taking over 1/6th of the economy will certainly help with that.

But the simple problem is health care reform is just like tax reform. The American people are just too damn brainwashed or perhaps too damn stupid to think that it can be that simple. You can have a flat sales tax or the 13,000 page tax code, just like you can have Obamacare or EelkemaCare.

Enjoy fighting for Obamacare.


Anonymous said...

Did he try to upgrade you into a foot amputation? And of course your doctor will charge less--he's not working for Big Oil. Duh.

Anonymous said...

Sounds good, so long as the insurance company doesn't say, like they do with your car "Sorry, it ain't worth fixing. All we'll give you is a $500 payout. And be glad for that much".

Unknown said...

Nice. People forget here in Canada that Tommy Douglas wanted just such a system, whereby people "wouldn't lose the farm" because of an illness. The separation of patient pay for normal wear and tear vs some unexpected malignancy is not always simple, but entirely do-able

S. Harvey said...

I'll pass this your way captian to fend off the tales of "my uncle was the victum of the insruance companies and is not bankrupt" arguments.

The bankruptcy rate is higher in Canada then it is in the US, quite a shocker if you listen to the far left who will claim numbers from 50-70% of bankruptcies are caused by health-care costs.

CBMTTek said...

One question I ask people over and over again is "exactly how much should a doctor visit cost?"

Here's how the conversation typically goes:
"Health care is too expensive!"

Well, how much should it cost?

"Well per person costs in (fill in the socialist country) are (this much less) then in the US."

Great! How much should it cost in the US?

"There are no out of pocket costs to the patient in _________"

Fabulous! And in the US? What should a medical appt. cost?


Here is what Dr. Eelkema figured out. Get rid of the BS, and focus on the core service, and you can provide medical care for a price people will find reasonable. Sure, he will probably not provide extensive lab tests, or an MRI at that price, but how often is that required?

But, talk to the Obamanauts, and they will tell you that the service he provides is not what America needs. What America needs is free access to every possible test, device, drug, and diagnosis, when they want it, how they want it, and did I mention free?

The problem with health care costs in the US today can be summed up in this one sentence from your post:
"That $38 is what you really have to pay. Not the $200, the majority of which goes to other entities that have NOTHING to do with your health care except to make it more expensive."

Remember the old advertising slogan:
"We cut out the middle man and pass the savings on to you"
Dr. Eelkema is really doing that, and I bet he has a full schedule.

CBMTTek said...

"The bankruptcy rate is higher in Canada then it is in the US, quite a shocker if you listen to the far left who will claim numbers from 50-70% of bankruptcies are caused by health-care costs."

What I really like is how they immediately follow that statement with something along the lines of "the average US family is only three paychecks away from bankruptcy!"

As if that tidbit of poor financial management proves that medical bills are the reason for the bankruptcy.

loki said...

Nice to know your doctor is making that much money; what I get for an office visit in BC is $28.50 (Canadian). Under the Canadian socialized medical system all doctors get paid the same amount so the "efficient" walkin clinic doc who cranks through 10 patients/hour gets paid more for doing bad medicine than a doctor seeing 5 patients/hour who actually takes a bit of a history and examines the patient rather than just prescribing reflexively. One of the things I dread most during my walkin shifts is the "simple" prescription renewal patient who is often an undiagnosed bipolar in for their SSRI prescription; wrong drug for the condition but so easy to just re-prescribe it and let the next doctor deal with the inevitable future mess.

The only thing I worry about is that US doctors fedup with Obamacare are going to move north should the US get socialized medicine. It would solve the doctor shortage up here but take away the power of our threat to leave a particular city if we don't like the way things are.

Anonymous said...

I think it's very important to remind people-as CC is-that America's healthcare system does NOT operate as a free market. Both liberals and many conservatives make that mistake.

Anonymous said...

Ironically, $38 is about what an Alberta family physician gets paid for a normal patient visit.

And it is possible to earn a very reasonable living... not crazy rich but comfortable.

It can be achieved by working in larger groups of physicians, keeping wages reasonable (but not at hospital union rates), having modest infrastructure and applying solid business principles.

Oh yeah, and provide good, friendly and consistent care to your customers (ie. patients) so they tell their family and friends how well they are being treated.

Applying some of these principles to hospitals would revolutionize care in Canada and the United States.

Liberista said...

in private healthcare the patient is the boss and the doctor is the employee. in public healthcare the government is the boss and the doctor is the employee. and the patient? only a nuisance.

Anonymous said...

You're letting the liberals have one point that I think should be contested. You said that rights are free...they are not. Every right at some point has some cost to someone. Our freedom from Great Britain was bought with American lives. Our freedom from Nazi Germany and Imperial Japan was bought with American lives. Under the 10th Amendment, we have the right to drink coffee or tea, which we have to buy. We have the right to earn an income, which we have to work for.

If someone tells you that healthcare should be free/government run because it is a right, ask them if drinking coffee or tea is a right. Then, suggest that it is absurd to have the government run all the tea an coffee companies.

The real debate here is private care versus rationed health care. Private health care makes people pay based on their means. Rationed health care goes to those who are more politically powerful.

Anonymous said...

You're conceding one thing which you should not...the idea that a right should be free. Our political and economic freedom were guaranteed to us because people died in the Revolutionary War and War of 1812. The nation was saved from being conquered by fighting Nazi Germany and Imperial Japan in WW2. We have the right to choose our own occupation, but that costs something as we have to provide a product or service to other people in exchange for money, products, or services to live. Even smaller rights like the right to drink coffee and tea, protected by the 10th Amendment cost money to exercise, namely, we have to buy the coffee and tea.

Don't let them frame the debate as being between free healthcare and corporate healthcare, this is an illusion. Frame it as a debate between private/charity healthcare and rationed healthcare. Because that's what it really looks like to the consumers. In the private/charity system, people pay more based on what they can afford to pay. Hospitals do this all the time. This is opposed to government run, rationed healthcare which doles out healthcare based on who has more political power. You see this with Armed Forces hospitals treating high ranking officers (and their wives/children) better than that of ordinary soldiers.