Monday, August 3, 2009

Putting private health insurers out of business - it's a feature, not a bug!

Some of us have been screaming it for years: the real problem with health care in the United States is the for-profit health insurance industry. Get rid of them, and solve 95 percent of the problem.

Now, finally, as the preventable deaths and avoidable bankruptcies and seven-figure bribes to Congressmen finally reach critical mass, the mainstream media is starting to figure it out.

Via Kevin Drum, Michael Hiltzik in the LA Times writes the obvious:

The firms take billions of dollars out of the U.S. healthcare wallet as profits, while imposing enormous administrative costs on doctors, hospitals, employers and patients. They've introduced complexity into the system at every level. Your doctor has to fight them to get approval for the treatment he or she thinks is best for you. Your hospital has to fight them for approval for every day you're laid up. Then they have to fight them to get their bills paid, and you do too.

....Why do we tolerate this? The industry loves to promote surveys indicating that most Americans are "satisfied" with their current health insurance — 37% are "very satisfied" and 17% "extremely satisfied," according to one such study.

Yet these figures are misleading. Most people are satisfied with their current insurance because most people never have a complex encounter with the health insurance bureaucracy. Medical care generally follows the so-called 80-20 statistical pattern — 20% of patients consume 80% of care. If your typical encounter is an annual checkup or treatment of the kids' sniffles, or even a serious but routine condition such as a heart attack, your experience is probably satisfactory.

But it's on the margins where the challenges exist. Anyone whose condition is even slightly out of the ordinary knows the sinking feeling of entering health insurance hell — pre-authorizations, denials, appeals, and days, weeks, even months wasted waiting for resolution.

Kevin concludes:

Sounds great to me! Why would anyone want to change this system?
Health insurance is a weird industry. Healthcare itself is provided by doctors, nurses, hospitals, pharmaceutical companies, hospices, and device makers. Insurance companies do none of this. They don't do research, they don't perform surgeries, they don't change bedpans, and they don't make diagnoses. They're just middlemen. All they do is pay the bills after marking them up 30%. They don't do anything at all to make healthcare better or more efficient.

But for some reason we're supposed to care about whether they continue to exist or not. Why? I care about the quality of my doctors, my nurses, the hospital I go to, and the drugs I take. I don't really care who takes on the administrative task of paying the bills — except that I wish they were handled a lot more efficiently and with a lot less hassle than private insurers typically do. Frankly, a world without private healthcare insurers sounds pretty good to me.

Stop dancing around the truth, guys! Here, I'll say it:

Every single thing that is wrong with health care in this country is the direct and deliberate fault of private health insurers. Period.

We will never have fairly-priced, universally-accessible, high-quality health care in this country until and unless we take it out of the hands of private health insurers.

Sure, let 'em have the high-profit boutique business insuring for plastic surgery and your 20th pacemaker when you're 112 and people who can't wait two weeks for a hip replacement.

But keep them far, far away from real health care that keeps real people healthy, strong, productive members of society.

Cross-posted at They Gave Us A Republic ...

1 comment:

RichMiles said...

Well said. It puts the whole problem in a two-paragraph nutshell, and clarifies some stuff that has needed clarity for a long time - like how much do private insurance companies mark up bills when they receive them?

See, no one, so far as I know, is advocating for the actual and total elimination of private insurance companies. Despite the inherent evil of them, most of us are willing to live and let live.

But the actions of the companies themselves might just change all that. For instance, but not exclusively, the testimony of insurance execs in recent weeks, in which all 5 of them testifying said that they and their companies would NOT stop nefarious practices such as cancelling policies when the insured got too sick, and started actually costing the company serious money. They testified to this in the Senate!! I mean, no shame whatever, and that kind of behavior shapes public opinion, and we come to hate the fuckers even more. And somehow, they can't understand why we feel this way.

When did greed become such a commonplace human emotion? I mean, it's been around for millennia, but it was until 40 or 50 years ago that it became a dominant trait in the human genome.

I propound that all those Republican administrations did it.

The assholes!!!