KDA Today

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For Immediate Release
Date: Nov 6th, 2009
Contact: Dr. John Thompson
Phone: 800-292-1855

Break your right arm and suddenly you have time to study economics.  If you can’t practice dentistry and you go to the beach to recover…  you can’t sail, go boating, play golf, write or type you might as well try to figure out how we got into the Great Recession that will mark most of our lives. What I have learned is that a financial prophet is someone that wrote a book before a crash happens. Generally the book is read by only a few people (with good reason) and no one apparently gives it much credence.  I was either given or directed to two such books by friends that wanted to punish me because they could not take money from me on the golf course for the next four months.

The first book, “Empire of Debt: The rise of an Epic Financial Crisis”, by William Bonner and Addison Wiggins, was written in 2006 and was read by my friend, Nana Mensa who had nothing better to do at the time and chose to believe the prophet.  I now enjoy drinking wine from his vast cellar selection because he can afford it and I no longer can. I will tell you without question this might be the most historically accurate and totally negative text that I have ever endured. Bonner has the satisfaction of being the pessimist that gets to say I told you so on September 15^th of 2008 when Lehman Brothers failed. He drives home the fact that President Andrew Jackson had it right when he opposed the National Banks in the 1840’s. In a convoluted way he points the blame for today’s economic crisis back to the presidency of Woodrow Wilson and just about every president of each party since that time. I do have to give this book credit as it paralleled the course of the Roman Empire with the rise of the United States as it became the sole imperial world power following the breakup of the Soviet Union in 1991. The fact that we began to act like an imperial power has not set well with the rest of the world and may well account for the negative image we have acquired over the previous two administrations.

I have to admit that I did find the second book by Fareed Zakaria, “The Post-American World “,  fascinating.  Zakaria used the same accuracy of economic history, but paralleled the United States to the rise and ultimate breakup of the British Empire. While his forecast of our banking collapse was published in early 2008 his conclusions about what was going to happen and why were the same, his treatise was not without a substantially positive context as to our national potential.  We retain a tremendous GNP in relation to the emerging giants of China, India and Brazil that will be the economic engines of the future. We have acquired the ethic and the blueprint of failed empires. We have become the consumer and not the producer. We have either outsourced everything we no longer choose to produce or we have brought in populations that will do the work we will not do and we are making no effort to integrate these peoples into our established society. We have become the borrower instead of the lender. Uniquely, we remain the only empire in history to rebuild our vanquished enemies at our expense rather than to plunder them.

I remain convinced that we have just avoided a depression. I am convinced that we cannot continue to acquire national debt at the pace we are going. I am completely convinced that I do not understand economics and that what I have read and learned is dangerous for my health if I dwell on it. Good health has protected me until recently from having to use my health insurance and accessing the United States health care system. During the last twenty months I have had the opportunity to have accessed emergency rooms and orthopedic surgeries twice. My care has been incredible and I have had the experience of great care throughout the system. My health insurance has done exactly what the contracts called for without any administrative complications. It is my conclusion that my health care system is not broken and I thank God that I live in the USA.  I know I am in the 85% of Americans that have health insurance.  I am told that the other 15% number 46 million people with no health insurance.  I have looked at the billings from hospitals and physicians that have provided my care. I see the tremendous discounts my insurance has negotiated on my behalf. I know that I do not want myself or any member of my family to ever be in that 15%.

As health care professionals and small business owners we do have the ability and some control over our own health care insurance policies. We do not have any real bargaining power over the rates we are charged and we seem to be delighted when our annual premium increase is only 15%. We are ecstatic when we experience a fee increase somewhere south of that percentage. We don’t tend to change jobs and we don’t fire ourselves; therefore we are generally able to sustain health insurance coverage. We are a privileged group that has witnessed job loss, bankruptcy, foreclosures in our extended families, our friends and our patients with the subsequent loss of health and dental insurance. We might say that these people just fell out of the 85% and they were just like us. My health care system is not broken but it is not perfect.

It is mid September and the rancor of the national “debate “on health care has given way to the partisan gridlock we have come to love. It does appear to this observer that there will be a health care reform bill that will make its way through a divisive legislative quagmire. We can only hope that the result will be at least as good as our last twenty years of economic policy. Even now a person that does not have insurance or any ability to pay is not turned away from emergency medical care and at least a degree of follow up care.  The patient that pays cash, the patient that pays his co-pays and the insurance contract payments are based on inflated fees that absorb much of this cost. There is already a disconnect between the posted fee and the actual cost of care and we are already paying for care for uninsured patients in either fees or taxes. If the real cost of care per patient is ever discovered the cost of a universal health care policy might not be as prohibitive.  We are the only industrialized nation that ties health insurance to employment. This seems to have served us well in our previous economy, as we have health care available that is the envy of the rest of the world. It is our access to care that has excited the national conscience because of the massive job losses of the last eighteen months. This country still retains the ability to find a solution.

Let us be positive about what is about to take place. Every solution that has been proposed is going to be fraught with unintended consequences. As a profession and personally let us look for solutions and eliminate roadblocks. Our legislators are no more qualified to make decisions on health care than we are on macro economics and for the future of this profession we must maintain dialog and what was it we used to say? “Dentistry is health care that works!” I hope you are having a good day.