It's interesting that the debate about the health care crisis ignores the fact that citizens are participating in the enormous business of health care when they opt out of insurance. The other stakeholders, politicians looking for gross numbers of who has insurance rather than the quality or accessibility of health care, the insurance companies looking for profit from premiums, and the health care providers looking for payment, are angrily scrambling because the numbers of uninsured is evidence of the "free market place." So now what? Well, predictably, they're trying to make the marketplace less "free." Whether it's legislating participation in buying health insurance, or legislation making the discharge of medical expenses in bankruptcy more difficult to achieve, or mandating that people get "healthy" so that they don't need to use expensive health care, the ineffectiveness of the "debate" is because stakeholders aren't being honest. Honestly, people don't care how health care and treatment gets paid for, they only care that it is available and effective when needed. Honestly, the AMA does not care about the actors in its commercials advocating health INSURANCE, they care about getting PAID. Honestly, politicians don't care about who can pay for health care, they just want to appease big business and the AMA and big pharma in helping them preserve their payment channels. And honestly, the talking heads arguing for no health insurance beyond that offered in the "free marketplace" don't care about the fact that laws, lobbies and protected greed have created the health care crisis, they only care about some inapplicable catchline about the free market economy. Guess what, the largest group of stakeholders are reacting...either by failing to purchase the flawed and overpriced product of health insurance or by opting out of health care until absolutely necessary and then failing to pay for the overpriced and often inadequate treatment they receive.
Health insurance has transformed itself into a discount chain that no longer provides assistance in paying for health care and treatment but offers a lot of cheap stuff that people can buy such as an annual exam (that's right, we don't need to pay thousands in premiums for a $300 physical), or the services of a dietitian. For needed help in paying for health care and treatment, health insurance policies have failed as a product. Only those least likely to ever need it can obtain broad affordable coverage. Like the old joke about the guy waving his arms and when questioned says he's keeping away the pink elephants and his audience says they didn't see pink elephants and the guy responds, "see it's working," the health insurance industry is making its product affordable by providing broad coverage only to those who are least likely to need help in paying for health care and treatment.
People aren't stupid. If you are fortunate enough to be healthy, wise enough to never have picked up a bad habit, or young enough to be statistically likely not to require expensive medical care, you probably don't need health insurance because you probably won't need help in paying for expensive medical care and treatment. If health insurance kept its end of the bargain, people would be buying the product. But we are not getting our money's worth. A physical might run $300.00, a dietitian maybe $80 an hour. Why buy a policy that pays for that when it costs more than that in premiums for a month?
It is the RISK OF THE COST OF TREATING ILLNESS that we expect health insurance to assist in paying. As health insurance companies carve out exclusions, exceptions and delays in providing that basic requirement, they have failed as a marketplace product. Instead of protecting this failed product through legislation, all stakeholders should be working towards improving the health insurance product in terms of benefit and expense and improving the goods and services within the health care industry.
While people spout numbers of uninsured, and the cost of medical malpractice insurance, shockingly little time is spent on addressing the supporters of the health care industry, the consumers. For us the fact that we are ranked 34 in life expectancy is an indictment of our health care system. For us, reports prepared by other stakeholders such as a description of where our premium dollars go as shown in a Price Waterhouse Coopers assessment for American Health Insurance Plans describing why health insurance premiums are rising. http://www.ahip.org/redirect/PwCCostOfHC2006.pdf is relevant.
The report, on page two, has a pie chart, that credits premium increases to: 27% general inflation, 30% increase in the price paid for healthcare in excess of inflation, and 43% increased utilization ("consumer demand, new medical treatments,....more intensive diagnostic testing due partially to the practice of defensive medicine."http://www.ahip.org/redirect/PwCCostOfHC2006.pdf page 2).
The marketplace is speaking: We don't want to pay more in premiums to cover payments to health care providers and insurance companies when our ability to obtain assistance in paying for needed health care and treatment is being reduced. There is no solution to the health care crisis by trying to manipulate, tax, and further cripple the consumer's ability to obtain and pay for needed medical treatment. Preventive coverage benefits all stakeholders, it is not what we need health insurance for. Look at the number of dietitians participating in health plans, now look at the number of oncologists. It is the product of insurance that consumers are rejecting. We don't need health insurance unless it actually pays for what it was intended to pay for: needed medical care and treatment. By changing itself into some health care lite product that lets you keep track of your diet, your weight and get a physical every year, we have rendered health insurance a bad economic deal.
