(continued from previous post…sorry, Matilda)
I don’t have a problem with, and in fact, I think it is laudable for society to support those who, through no fault of their own, are unable (not unwilling) to care for themselves.
Let me give you an example (not directly health insurance related). My last office went through major downsizing as a result of corporate reorganization brought on by the current economy. A lot of us, myself included, lost our jobs. I called in some favors and found a job almost instantly. I had to take a $5,000 pay cut and went from a 15 minute commute to an hour commute. But I didn’t have to take any unemployment insurance. (And it is my belief, based on a lot of information, that I should be getting about a $10,000 raise in about two months, along with a promotion in job title that will actually put me ahead of where I was before) The woman working next to me, an exceptionally talented person with great experience, had different standards. She did not want to take any kind of a promotion cut (in salary or job title), and she was unwilling to commute more than 45 minutes. About two months ago she was interviewed for a job near where I work now. We went out for lunch after her interview. The job would have been considered a promotion compared to her last one. But the commute would have been a little over an hour. So she decided that she was not going to take the job. Because of the commute. (Come to find out she turned down a number of other positions that were closer, because the positions would have been considered demotions: a little bit less pay and less prestigious job title).
Should I feel sorry for her? If she has a pre-existing condition that, when she actually gets a job, limits her coverage for a year, should I be screaming about how unfair insurance is?
I don’t think it is realistic to do away with insurance companies but they must be regulated.
They are all regulated. At the state level.
One idea is to make them not-for-profit entities to control the obligation to shareholders over patients rights.
Not for profits still have to operate under the same principles as for profits. My wife was, until she retired, a school teacher in a local Maryland district. Their insurance was provided by
CareFirst…a Maryland-based non-profit. They operated no differently than Cigna (my employer’s insurance provider). Premiums were virtually the same, coverage virtually the same, and so on. Their executives are high-paid. They still deny claims. They still consider pre-existing conditions.
The only difference is that their earnings that exceed their revenues are applied to some sort of community project rather than going to stockholders as dividends. Otherwise, they operate virtually in the same fashion as any other insurance (at least that I’ve dealt with)
There are other ideas out there also but one thing is clear they must be better regulated.
Remember, the whole health care delivery system must be fixed…
I agree that fundamental change needs to happen. But it’s in which direction.
First of all, we have to recognize that people have an innate desire to be healthy. That is a fundamental, God-given driving force motivating people to act. And that’s a good thing.
[BIBLEDRB]3 John 1:2[/BIBLEDRB]
But staying healthy often times costs money. Nothing wrong with that: the doctors, nurses, medical technicians, equipment manufacturers, supply manufacturers, and so on, all have a right to be paid for their labor. And if a person put his capital at risk, he has a right to collect a return based on that risk.
But sometimes the resources (a/k/a money) needed to remain healthy exceed the resources available. Then decisions have to be made. What can I pay for and what can I not pay for?
The bottom line is who makes the decision? The answer is that the person (people) making the decision is (are) the person (people) who have the resources. He (they) is the one who decides whether you do treatment “a” or treatment “b” or “none of the above.”
Even in theory…assuming everybody is 100% honorable…tighter regulation might help around the margins – 5 or 10 percent – but that’s it. (Mind you, I am a full believer in the fallen nature of man and recognize that there are going to be plenty who will game the system…whatever that system is)
No matter what the solution is, you are still stuck with the fundamental point that there is more need for the resources than the resources available to meet the need. Basic economics.
And all the electronic health records and standard data sets and cost effectiveness research and anything else will not change that fundamental equation. Decisions will have to be made on what is to be paid for and what is not to be paid for and for whom. With that fundamental equation comes the fundamental question: who should make the decision?
Those who support Obamacare, or worse, fully nationalized healthcare, are willing to turn that decision making authority over to the government. The consequence is that the government will decide what is covered and what is not covered. And those decisions will have impacts.
Those who support the status quo (a commercial insurance driven health economy) are willing to turn that decision making authority over to the insurers. The consequence is that the insurers will decide what is covered and what is not covered. And those decisions will have impacts.
Those like me who don’t like the idea of insurance say that this decision should be retained by the individual. And the impact might be negative, but it’s my impact.