If our private health insurance system worked, we wouldn’t need reform. That’s the view that Joe Paduda of Managed Care Matters takes, and he makes some really good points.
Most of our health care industry (including private health insurance) is profit driven. This is the case with most private industry in the US, and for many of them, it’s a good model. It drives innovation, fosters competition, and spurs our economy. But one has to wonder if health care might be different (and should thus be treated differently) from other industries. There aren’t many other industries where one’s very life may depend on being able to afford a certain product. But we know that people who are uninsured are more likely to die than their insured neighbors. A person with cancer who isn’t able to pay for treatment has a pretty grim prognosis when compared with another person with the same cancer and a good health insurance policy. In my opinion, this sets health care in a category apart from material things like cars and clothing.
Even shelter – undeniably necessary when temperatures drop below zero the way they have in much of Colorado this week – can be found on many different scales. A person can escape the cold in a mansion, mobile home, public housing, or even shelters – all will protect against the elements. But a person with kidney failure needs dialysis, and a person with type I diabetes needs insulin… no matter what their financial status might be. Health conditions are a good equalizer; people get sick regardless of their ability to pay for care.
We’ve discussed how health insurance – especially in the individual market – isn’t really a good example of a free market commodity. People with serious health conditions simply can’t purchase private individual health insurance in most states. But we often find that people are unaware of this fact if it doesn’t impact them or someone they know. People who are covered by an employer plan, or who are healthy enough to get an individual health insurance policy, might think that things are just fine as they are. And sometimes those people will comment that government should stay out of free market affairs. But then that person will get an annual premium increase of 25%, or be declined for coverage by a private insurance company, and their question for us will be something along the lines of “is that legal?”
Basically, we can’t have it both ways. If we want smaller government, we have to accept that it comes with fewer regulations. And that means more control in the hands of industry and less in the hands of consumers. If we want regulation over things like premium increases and pre-existing condition limitations, we have to accept that it means more government intervention. In the case of health care and health insurance, we’ve obviously got some flaws in our current system. In some states, a person without access to an employer-sponsored health insurance policy cannot get coverage at all. That is a problem any way you look at it.
Yes, some of the problems stem from personal irresponsibility (although hopefully mandatory health insurance will help to address this issue). But some of the problems are built into the health care system, and that is why reform in the shape of government intervention is such an important task. Because a consumer versus an industry isn’t really a fair match-up.
I found Joe’s article in the Health Wonk Review, hosted at Workers’ Comp Insider.