Sunday, July 05, 2009

An Examination of Health Insurance

I wonder how many more personal stories have to be related before our health care nighmare is addressed. I wonder how many more experts will have to come out and say it before people believe it. Hell, I don't even need them to believe it, but just start looking at it with an open mind and realize that the current way of doing things is killing us.

In a previous post, I mentioned some of my run-ins with our current "Health Care System," and noted that my benefits a former employer helped me "choose" cost more than my federal or state taxes combined, and that, even then, I was out of pocket for most of my medical expenses because of the high deductible.

But I guess (judging by family and friends' reactions) my own personal experiences are just irrelevant fantasies I have had over the course of my life. I don't say these things because I've actually experienced them, I say these things to score political points on my well-read and policy-driving blog. I don't work in medicine, so I don't know what I'm talking about. I'm not an expert in the Health Care System, or an expert on how "market-based" health insurance is supposed to work.

Luckily, I know Dr. Rigamer, who is, in fact, a highly respected expert on health care. Please take a moment to read what he had to say.

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4 comments:

Dante said...

"But I guess (judging by family and friends' reactions) my own personal experiences are just irrelevant fantasies I have had over the course of my life."

Or statistically insignificant, as is most anecdotal evidence.

A health care solution is not a binary event. Too many people proposing solutions do a great job of pointing out problems with our current system (as does this author) but then propose that their solution must be the right solution to the problem without laying much groundwork. Sorry, but if comparisons to Medicare spending and cost projections pulled out of thin air (or the Congressional Budget Office... same thing) are your argument's pillars, you've failed.

I have no concrete solution but I can tell you that as long as patients are not the clients of the healthcare industry, care will suffer. Right now the healthcare industry answers to the insurance companies and the insurance companies answer to your employer. Note that you are nowhere to be found in that loop. (The few of you who are get lumped into that aforementioned "stastically insignificant" category.) Getting patients into that loop will break the cycle we're in right now. If insurance companies had to answer directly to the patient for its actions, it would be a whole different ball game. But that issue is wholly unadressed in our current healthcare debate because empowering the person who actually needs the care is the last thing anyone in Congress or lobbying Congress wants to happen. And I do mean "anyone," not just one side of the isle.

Cousin Pat from Georgia said...

Happily, enough "statistically insignificant" events have occured to enough people and their families to change the economy and affect the outcomes of elections. It is what will change things now, it is what will change things in the future if whatever we replace the current system with fails to work.

And, luckily, as long as we can discredit all budget projections from every source, we can then all truthfully agree that no one knows how much fixing health care will cost or save in the long run. But each one of us "statistically insignificant" folks know how much it is costing us now.

Though you did hit the homerun with: "as long as patients are not the clients of the healthcare industry, care will suffer." On this, you and I are in agreement, and we can build on common ground.

So here's the deal: let me have a public option to choose from, based off Medicare spending and cost projections from thin air, and I'll support the tax breaks so you can purchase whatever insurance you want, independent of your employer.

If the public option plan doesn't work too well, you'll be the first to get my report.

Dante said...

I should've been fair to thin air. It has no agenda. The Congressional Budget Office exists to rationalize foolish spending decisions (and/or tax cuts, depending on who is in charge). I'm sure they have other duties but none that people are going to get hired and fired over. It's not that I discredit any source, just the fox sent to guard the henhouse.

As far as your deal, how is making the government the client any different than making the employer the client? At least my employer gets more than a single vote out of me. If you really want to shake things up stop letting insurance companies pay healthcare providers directly. Until very recently, that's how all other forms of insurance worked. You got made whole again, passed the proof onto the insurance company, and they cut you a check. If you get by cheaper than your estimate to be made whole again, you keep the change.

Cousin Pat from Georgia said...

If you get by cheaper than your estimate to be made whole again, you keep the change.

Unfortunately, health care isn't an area where going from place to place to get estimates is a very effective way to secure treatment. I mean, I could get away with it when I catch bronchitis, and can call several docs to figure out how much they're going to charge me to write a zithromax prescription.

But when a baby is having siezures, and you have to get them stopped, and the docs can't give you an estimate because they don't know what's wrong, what are you left with?

And that's my problem with health insurance, and what I think is the main point of Dr. Rigamer's article. When profit is the only motivation, only healthy people with money get covered. That is the only way the for-profit model works.