One of the inherent problems with our hodge-podge health insurance system is that doctors can pick and choose which health insurance policies they will accept, and health insurance companies in the individual market can do the same when it comes to which applicants they will take. Advocates for a “free market” system of health care like to talk about how a government run health care system would take away our freedom of choice with regards to our own health care. But our current system – a combination of private health insurance, government-run Medicare and Medicaid, and state-run high risk pools – only provides true choices to those with perfect health who can be choosy about their health insurance policy, or those with an employer who offers lots of coverage options.
Because there are so many health insurance options in the private market, it can be overwhelming for a doctor’s office to accept them all. Each company has different billing and claims procedures, and a doctor could spend half the day tracking down rightfully-earned money instead of seeing new patients. And then there’s the Medicare and Medicaid dilemma. They send lots of patients, but they don’t reimburse nearly as much as private health insurance. Dr. Mahar at Health Beats writes about seeing more and more Medicare patients as other docs in the area stop seeing them. Since doctors can choose which health insurance plans they will accept (including Medicare), many are choosing the higher pay that comes with private health insurance, and providers like Dr. Mahar are seeing their schedules fill up with low-paying Medicare patients, leaving little room for patients with private health insurance. Thank goodness our legislature stood firm this month and prevented a cut in pay for physicians who see Medicare patients. Otherwise, docs like Mahar would have lines outside of their offices.
A uniform health care system – with the same coverage for everyone – would actually be a lot more fair. Each doctor would only have to deal with one health insurance system; billing and claims wouldn’t be as much of a hassle, and pricing would be consistent from one patient to the next. Tax dollars could be used to help physicians pay back their school loans (or pay for a portion of their education in the first place), and to pay them a salary that is fair and in keeping with the amount of time they put into learning their trade and caring for their patients. Then it wouldn’t matter whether they saw patients who were rich or poor, old or young, employed or not. They could focus on caring for their patients instead of being forced to focus on the business of medicine and the bottom line.
We like to think that we have a free market health care system and can make our own choices about our care and our health insurance. But for a Colorado resident without an employer-sponsored health insurance policy, and with pre-existing conditions that put private health insurance out of reach, Cover Colorado is the only real option for health insurance. Not much choice involved at all.