A Modest Proposal For Reforming The Health Insurance Industry
Published February 16, 2008
In Wealth of Nations, Adam Smith described the virtues of a market economy where fair prices result from a large number of buyers interacting with a large number of sellers. To achieve the efficiencies of a market economy, we need to reduce the role of both the health insurance cartel and the government by limiting health insurance to the traditional role of insurance - spreading and sharing the risk of catastrophic events.
You can get a tune-up for your car or get minor repairs done without involving the company that provides your car insurance. You can replace a broken window or repair a leaky faucet without involving the company that insures your home. We could achieve a significant reduction in the cost of health care by eliminating routine care from insurance policies. We should be able to get treatment for minor accidents and ailments, without involving a health insurance company.
In any given year, the vast majority of us have no need for anything more than routine medical care. Within a system where insurance functioned in the normal manner, a substantial percentage of the interactions between doctors and patients would take place without generating additional costs for both providers and insurers that result from the review and approval process and the associated paperwork. This simple change in our approach to health care would reduce the cost of health care more significantly than any other reform being proposed.
Consumers would have complete freedom to patronize any doctor or hospital. To help them make informed decisions, a complete list of the fees charged by each doctor and hospital should be available upon request. The transparency of the fee structure alone would help to control costs. The complex deals negotiated between insurance companies and health care providers make it difficult to even figure out the true cost of care.
Some insurance companies already offer plans with greatly reduced premiums and high deductibles. In some cases companies pay for part of the cost of preventative measures, such as annual check-ups, but most of the cost of health care is paid directly by patients.
These types of plans are not very common. They are often considered as a last resort for those who can’t afford the premiums for full coverage. They are also not very popular with many people who are forced to settle for such a plan. Overcoming the resistance to this approach might be difficult.
A system where employers or the government pays your premiums creates the illusion that you are getting something for nothing with regard to health care. A lot of people are addicted to that illusion. They fail to realize that the costs are passed on to them through a combination of higher taxes and reduced pay. (Shall we blame Milton Friedman for failing to convince more people that there is no such thing as a free lunch?)
- A Modest Proposal For Reforming The Health Insurance Industry
- Published: February 16, 2008
- Type: Opinion
- Section: Politics
- Filed Under: Culture: Business and Economics, Politics: Elections and Candidates, Politics: Energy and Environment, Politics: Government, Politics: Law and Rights, Politics: Policy, Politics: U.S., Sci/Tech: Health/Fitness
- Writer: Winston Apple
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Comments
The catastrophic illness plans are interesting, but may not contribute much to solving the problem of providing coverage to those currently uninsured. The product idea is not new, insurance companies do offer "high-deductibles" to cater to individuals who have affordability problems. If it is not mandatory, not all car owners may buy liability insurance. Our "health care" crisis is not just a health insurance crisis. In reality, health insurance companies are becoming the popular whipping boys. They are blamed for inefficiency, and bureaucracy, and being profit-minded (Blue Cross/Blue Shield are not-for-profit) at the expense of patients' well-being. We are not sure if we can safely remove the roles of insurance companies from our system without creating another form of crisis. Substituting the insurance companies with a government body may not be a better solution, as seen in the public transportation system or our public education system.
The aging population, the availability of more expensive advanced technology that treats diseases that were terminal previously, and even economic growth all contributed to our rising health care expenses as a nation. In the book entitled "The Fattening of America," by Eric A Finkelstein and Laurie Zuckerman, it was reported that over two-thirds of Americans are overweight or obese. Over the past three decades, the number of obese Americans has more than doubled, across the socioeconomic spectrum, and for all racial and ethnic groups, most dramatically, for America's children. According to Eric, America's growing waistline is a by-product of our economic and technological success. It has been estimated that the annual cost of overweight and obesity in the U.S. is $122.9 billion, a sum that is comparable to the economic costs of cigarette smoking.
All health care crisis has to be tackled on all fronts, and as you pointed out, reform could involve a grassroot movement. You suggested that we should band together to limit the role of insurers with or without help from the government. On the positive note, grassroot organizations have already started to direct the effort in discouraging smoking, addressing obesity, and adopting a healthy lifestyle. These are sure steps in bringing health care burden under better control in the long run.
It is interesting that most claims for reform are directed at insurance companies not the system as a whole. I find it mind bogling to believe that Americans are as foolish as many may make them out to be. The health care system is made up of three primary components: You and Me; doctors and facilities and payers.
The main problem with our current system and the direction that we should focus is TRANSPARENCY.
You and I don't actually know where most of the cost comes from in a bill. I submit that if we were fully aware of all charges from all parties we might have a basis for discussing change. Until we have this, we are simply submitting ourselves to idle chatter.
Rod Reasen II
President TriplePoint Consulting
The insurance companies have created a marvelous illusion: that somehow Health Care depends on Health Insurance. They've employed this illusion to place themselves at the center of the entire "Health Industry" and thus reinforce their monopolistic grip on that entire segment of society. They've created the notion that you can't have Health Care without Health Insurance.
Now, we have presidential candidates who are seriously advancing proposals to enslave US citizens to Insurance companies though 'mandates', which put one in mind of Indentured Servitude, which is the (only slightly) less ugly sister of slavery.
Hasn't it occured to people yet that the jury-rigged facade of capitalistic health care has completely collapsed?
Nothing could be further from the truth.




good article... Long article... really, really long, but good!
Marlowe