Health Care Reform Should Really Be Health Insurance Reform

The House has passed their Health Care Reform bill and now it goes to the Senate. There are obviously very strong feelings about this on both sides, but I am living proof that it isn't as partisan as one might suppose. I am a conservative, and I vote Republican most of the time. But even though I am swimming against the stream, I applaud the Democrats for doing something about the health care disaster that our country currently has.

We seem to have the weirdest set up in the world, despite all the scare stories we are routinely told about "socialist" medicine in all the other countries. A rudimentary amount of research shows some very solid medicine practiced in other countries, with a system of non-profit insurance and government balance that seems to be working quite well for an awful lot of people. The costs and procedures are set; the insurance company has to pay what the doctor prescribes, and the patient can't sue if the procedure was approved standard procedure. This eliminates the cadre of employees necessary in America to fight the insurance company for payment, the need for over the top malpractice insurance for the doctors, the unnecessary tests the doctor schedules to protect himself from lawsuits, and the paper work and red tape in every office.

Even in our own country, the insurance plans that work the best for the largest amount of people are either Veterans' Affairs or Medicare. That's right, the government run insurance plans! As for the rest of us, we have the option of buying outrageously over priced insurance against the time that we get sick. When that time comes, the insurance company either won't cover the illness and tests at all, or the price is jacked up so high that our deductible and percentages of pay are still considerable; or we are too sick to work, thereby losing our insurance with our jobs.

Actually, I think Health Care Reform is a misnomer. I think we need Insurance Reform. The insurance companies are concerned about profit and shareholders. You, the insured, are merely a commodity. When you pay the premiums and stay healthy, you make money for the insurance company. If you get sick and make claims, you are a drain on the company. There is no incentive to keep you healthy, though, because most people do not stay with an insurance company long enough for the company to reap the benefits of preventive care. Either your employer changes plans to something cheaper, or you get sick enough to lose your job; either way, the insurance company is no longer responsible for you.

Somehow we have all been cut out of the equation entirely. The health decisions that directly affect us are made by a consortium of our employer, insurance company and hospital's or doctor's financial office. I worked in insurance adjusting for a while, and the cliche was that insurance covers everything except what happened to you. Oh, and just for the record, my employer did not pay for insurance; they offered it, but I couldn't come close to affording it on what they paid me. While I was out of insurance, I had to have a procedure that was going to cost $1,000. Since I didn't have insurance and would have to pay out of pocket, they lowered the cost to $300. I appreciated this very much, but I couldn't help thinking of the poor guy who was paying his premiums, paid his deductible, then paid 20% of the bill. Because he surely paid at least as much as I did! When the insurance companies will only pay a percentage, the doctors have to raise the base amount in order to have that percentage high enough to cover their own costs and profit margins. That means you are going to pay either way.

I wait with great interest to see what happens with the bill now before the Senate. No doubt it is far from a perfect plan. But I am apprehensive that the Senate will make it worse instead of better. For one thing, many of them have said they are opposed to the public option. They talk about the free market system, which I certainly support; but it seems to me this will stimulate the free market system. The insurance companies need competition badly. And Americans need some choices, and some relief from the impossible vice the insurance companies have us in.

My concern is that the Senators, many of whom are lobbied heavily and successfully by the insurance lobby, will turn this in to a bigger burden to the American public by making a bill requiring us to buy insurance without providing a better product than is now offered. That's what happened with car insurance and homeowner's insurance. We are compelled to get an expensive product that will not pay when something happens, cancels us for arbitrary reasons, and raises our rates for making a claim. Instead, we need a true reform of health care insurance. Then, once we have it, perhaps we can turn our attention to reforming home owner's and car owner's insurance plans!

Sources: personal experience
"The Healing of America - A Global Quest for Better, Cheaper, and Fairer Health Care" by T. R. Reid
"Best Care Anywhere - Why VA Health Care is Better Than Yours" by Phillip Longman