http://www.nytimes.com/2008/01/19/opinion/19sat3.html?th&emc=th
Whereas, in my opinion, the New York Times is right-on about the negative effects of two-tiered health care coverage--that emergency room wait times have increased thereby decreasing the speed with which the sickest receive necessary treatment--I disagree with the slant of the editorial, revealed in the first sentence, that these negative effects are mostly a problem because they inconvenience those who are on the top tier.
Let's face it, "insurance" is an immoral business. (It's called "protection" in the world of organized crime.) Corporations and individuals reaping huge profits from other individuals who fear illness and injury and the catastrophic costs associated with treatment. These same insurance companies more often than not hedge their investment by accepting only the healthiest clients or at least those who have the most ability to pay premiums, only to eventually deny claims for reimbursement at every turn until such a time that someone, often the court, makes them pay.
It is time for our society to eliminate the ability of a few to profit from the fear of illness or injury of the many. A single-payer, government-regulated system is the answer.
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3 comments:
Have you read Paul Starr's "Social Transformation of American Medicine"? It's a tome. But it really changed the way I think about this stuff.
The Times is wrong if they think main problem with a two-tiered health care system is that it can inconvenience those at the top.
But.
I have always believed that as the cost of medical care is driven steadily upward the relationship between the insurance industry and medical service industry, insurance premiums must rise, too. And as those premiums rise, the financial strain will steadily chew deeper and deeper into both the middle (voting) class and small business owners.
If there is a silver lining here, it is that economic hardship may drive small business people and family people to common ground on state-regulated, single-payer health care.
I wouldn't hold my breath that healthcare will become cheaper as a result of such a system, however. The goons will continue to make lots and lots of money (think legal mandates to stock only Halliburton & Johnson Suture Sets), but at least it will become more AFFORDABLE to common people like you and me.
The articulation between the insurance and medical industries is one source of the increasing cost of medical services. What it charged to the patient for care rendered is not how much it cost, but how much can be billed and reimbursed.
If a patient (the ultimate payer) has private insurance (the intermediary payer), the latter is billed as much as the traditional relationship between it and the medicial facility (the vendor) allows, and then some (that part of the bill which is usually denied reimbursement and so the medical facility "eats" it). In general, it is the relationship that sets the price, and costs increase because (1) personnel, medical supplies, machinery, etc. become more sophisticated and or scarce and therefore more expensive, but also (2) because insurance companies will allow for higher payments!
What do they care, they can pass on the increased costs to the consumer by raising premiums. The patient ultimately pays.
Now, can an individual by him or herself afford the costs of brain surgery? No. So we figured out that it's good as groups of people to pay into a system that collects and saves the money for us, invests it, and pays out claims when individuals who pay in need to cash out some. This could be a not-for-profit entity (a.k.a. a government single payer system) or a for-profit entity (private insurers).
The question becomes, are private insurers worried more about you and I being able to afford brain surgery, or about how they increase their profits? I maintain that the need to finance profits for owners/investors of insurance companies is just as much responsible for the increased costs of health care in the US as is any "natural" increase (e.g., inflation, sophistication, increasing hi-tech, etc.)
Don't even get me started on the malpractice insurance industry!
The need for monetary profit in the private insurance industry ruins the concept of insurance. However, if we expand our conception of profit to include non-economic gains, then the improved health of a community as a social good becomes a source of profit, albeit non-monetary in nature, and therefore (mostly) ignored by our current reliance on the private insurance industry. And some folks are laughing all the way to the bank!
right.
that is also the mechanism that drives up the price of my college textbooks!
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