28 April 2011
I have two choices for health insurance at work:
A major national insurance company with a reputation for "losing" your claims forms and not paying doctors. If you get sick, you'll end up being tens of thousands of dollars out-of-pocket and likely have to declare bankruptcy. That's if you survive -- if you need something really expensive where doctors won't even start treatment until they've gotten pre-approval from an insurer, good luck.
A major regional HMO which avoids paying for expensive treatments by simply not doing them and hoping you die before the appeals process with the state insurance commission is complete and the courts force them to provide the contracted-for treatment. They have calculated that, for example, the cost of treating leukemia (roughly $1M) is far higher than the amount of premium income they get from a typical employer group, so even if your employer threatens to move their entire company to a different insurer, they just shrug and say "Go ahead, we're still ahead of where we'd be if we paid for your employee's leukemia treatment."
These are the companies that PelosiReidCare is forcing me to have insurance with. (I call it PelosiReidCare because Obama had nothing to do with it, other than signing the final bill). Apparently the best health care plan for me is, "don't get sick." Wish me luck :(.
Soo.... why isn't the magic free market fairy (see left) not providing me with health insurance that actually, like, pays for the healthcare I need if I get sick? Two reasons:
Health insurance is inherently anti-capitalist. Health insurance is to capitalism what kryptonite is to Superman. In capitalism, businesses make money by providing services. In capitalism, for example, a restaurant makes money by cooking food and serving it to you. If they didn't cook food and serve it to you, they would make no money. Health insurers, by contrast, make money by not providing service. The more health care they don't pay for, the more money they make. In short, health insurance simply is incompatible with the profit motive because it profits by not providing service.
Health insurance is largely provided by employers as a benefit, rather than purchased by individuals (less than 7% of all health insurance is individual policies), and employers buy the cheapest insurance, not the best. The HMO above is not-for-profit but was formed by employers to keep their health care costs down, and still pursues that mission with a vengeance. The only way private insurers can compete with an HMO that was formed to deny as much care as possible is to, duh, deny as much care as possible.
In short, the entire system was set up to systematically deny care, not provide care, and this is what PelosiReidCare enshrined as national law. I would gladly pay to buy into Medicare and Tricare like my mother and stepdad (military retiree) receive. They get the care they need when they need it and don't have to worry about dealing with insurance companies trying to deny care. But PelosiReidCare give me no option to do so, which is why when the GOP runs against "ObamaCare", it's getting resonance amongst those who don't pay much attention (who haven't figured out yet that the GOP's health care plan is "don't get sick, and if you do, die quickly"). Forcing people to be part of a system that is inherently broken is never going to be popular, no matter how much people said they wanted "the current system, just a bit improved" back when Pelosi and Reid were doing their polling to decide what PelosiReidCare would look like...
-- Badtux the Healthcare Penguin