I have “left-of-center” stamped on my very bones. In every argument or discussion I’ve ever had about politics, my question has always been “how do we care for those who can’t care for themselves?” It is truly one of my biggest concerns. I love underdogs, I hate bullies, I wish desperately to live in a world where the powerful don’t enrich themselves by sucking life, energy and money from the weak. I want to live in a world where sick adults don’t molest, rape or murder children. I want to live in a world where its OK to be whatever color/culture/religion/orientation/gender/size you happen to be and you don’t get points docked for not fitting a cultural norm.
No, that world will never exist. I will nonetheless always seek to support a reality where people care for one another, where the ideals we live by whether we are Christians, Muslims, Atheists, Jews or Pagans include at the top of the list ”LOVE ONE ANOTHER.”
I love the idea of ensuring health care for every man, woman and child in this country. It’s an ideal well-rooted in humanitarian principle. But, my dear friends, the Patient Protection and Affordable Care Act doesn’t ensure health care for everyone. It ensures everyone has health insurance.
Insurance is not care. Having health insurance doesn’t mean we get quality health care – or affordable health care, for that matter. In fact:
A 2009 study published in the American Journal of Medicine found that in 2007, 62% of people declaring bankruptcy had over $1000 of unpaid medical expenses. 92% of those cases had medical expenses over $5,000, and 80% of people filing for bankruptcy had medical insurance. What does this tell us? That even people who have medical insurance cannot afford their medical bills.
The costs of basic medical procedures have risen dramatically since 1943, when Congress passed a new tax policy making employer-provided medical insurance tax-free. This subsidization caused the employer-provided-insurance model to become the dominant system of medical insurance in the U.S.
So why has this caused medical costs to rise? A lot of reasons. For a start, if the employer is paying 80% of the bill for my annual exam, I as an individual have nearly zero incentive to price-shop amongst medical providers for the most efficient and cost-effective practitioner. My selection criteria becomes one of convenience: How soon can you schedule me and will you bill my insurance company directly so I don’t have to waste time filing a claim?
When consumers no longer see cost as a factor, costs will naturally rise. Spending on healthcare has risen at more than three times the rate of the consumer price index since the 1970's.
I think it becomes even more complicated when doctors are required to offer certain discounts to private insurance enlistees. In order to keep their bottom line, the list price of the procedure must rise. This means that any individual who doesn’t have health insurance or for whom that doctor isn’t in their network will pay more for the same procedure than the person whose insurance network the doctor belongs to.
So cost of care is a big issue that isn't really solved by the Patient Protection and Affordable Care Act, because the system that caused prices to inflate over time is left intact. But that's not my biggest problem with the insurance companies. The biggest problem I see with Obamacare, or any legislation that attempts to overhaul healthcare whilst leaving Big Insurance intact, is in effect leaving the cat in charge of the creamery.
Over time, the insurance companies, not our doctors, have gained control over most of the decisions to be made about what courses of treatments, medications and number of visits or treatments the patient may have. When my doctor recently prescribed thyroid medication for me, the insurance company didn’t want me to take the dessicated pig thyroid my doctor wanted me to have, andwhich costs considerably less than the synthetic form. They wanted me to take synthetic thyroid medication and would only provide benefits if I got the synthetic instead. I ended up buying the natural thyroid and paying for it out of pocket. Likely my copay on the synthetic product would have been about the same as paying in full for the naturally obtained medicine, but why would I take a more expensive, synthetic product just so my employer could pay money to the pharmaceutical company? Furthermore, how could an insurance company claims analyst who has never met me have more power to determine what medication I should take than my own doctor?
They don’t, really, but over time what’s going to happen, now that insurance coverage is a mandate, is that the doctors who have heretofore been able to maintain discretion in the treatment of their patients because they don’t participate in network plans will either become tools of the Big Insurance or they will go out of business.
The other problem with Employer-provided medical insurance is the lack of choice to the consumer. We are paying for group plans with coverages some of us will never use. I’m pretty sure my single coworker Bob would rather not pay additional premium for an annual gynecological exam and birth control coverage. I’d prefer not to have part of my premium going for obstetrical care, since I’m all done with the baby-having, but since its part of our “plan” I don’t have a choice.
Thanks to the plan passed by our President and our Congress, Big Insurance is still fully in control of our health care. That means our health care costs will continue to rise, even more dramatically once there is no longer any competition in the market. All doctors will march to the orders given to them by non-medically trained personnel who process claims based on complicated algorithms about which procedure or medication is more profitable for the insurance company.
So we're stuck with a nightmare of mounting insurance costs, mounting medical costs, and more people not getting the care they really need because they can’t afford it.
If the Republicans succeed in their vow to repeal Obamacare, you can be assured that they will craft a plan equally as heinous. It might not contain an individual mandate, but you can bet your bippy it won’t address Big Insurance either. After all, Big Insurance spends millions of dollars (if not more) helping our leaders in Congress to get elected. Politicians don’t bite the hand that feeds them – and trust me, that hand doesn’t belong to you or to me.
True healthcare overhaul would deconstruct the health insurance system as it exists. It would put the power of treatment back into the hands of doctors. It would create a competitive market for healthcare providers so that doctors could choose what to charge for their services. Charge too much, you limit the number of people who will seek treatment from you, particularly if any number of equally good doctors are charging less for the same. It would reward practitioners with low costs and high success rates. It would allow consumers to choose what kinds of medical insurance they would like to carry, and provide pools of funding for the poor and the currently unemployed to obtain basic medical care. It would seek ways to assist patients with catastrophic medical issues in finding appropriate care and having some power in making decision about the courses of treatment they wished to pursue. It would address and alter the relationship between Big Pharma and the FDA.
Big Insurance has no compassion for the patient. Big Insurance cares only about profit margins. Sick people aren’t profitable, so they’ve found a way to make well people pay more all the while raking in the money while patients continue to receive substandard care and grapple with out-of-pocket costs that set them back or make them go bankrupt.
What, you ask, about the people who can now get insurance that couldn’t before because they were already sick? They’ll benefit from the pre-existing conditions clause of Obamacare, won’t they? Yes and no. I know plenty of people who have pre-existing conditions who are thrilled right now because they can finally get health insurance. But is health insurance what they really need? Or is it affordable health CARE? Wouldn’t they benefit more if the costs of the procedures they needed costs only hundreds or thousands of dollars instead of tens and hundreds of thousands? Wouldn’t they benefit more if we allowed them to see the doctors they were comfortable with rather than the doctors the insurance company says they must? With properly funded pools for the uninsured, they’d have financial support for the treatment they needed, and that treatment need not come at a grossly inflated cost.
The concept and the dream behind Obamacare, that I get. I agree and I applaud. Everyone who needs medical care should be able to obtain it.
The reality of the plan that has now passed the scrutiny of SCOTUS frightens and worries me. Our government keeps getting bigger and costlier and keeps feeding the giant corporations that are chewing up and spitting out people like you and me as if we were simply more fodder for their coffers. They grow fatter and wealthier while I put off getting my own medical needs met so I can care for my children, because our insurance isn’t so great on the mental health and autism issues, and I have two children who need a psychiatrist to manage their medications. I should have better choices than this. Thanks to legislation that continues to put all the power into the hands of my insurance company, I probably never will.
