Over the past few weeks, these op-ed pages have been ablaze with debate over health-care reform, with opinion severely polarized, from single-payer system on one extreme to “government keep out!” on the other.
While consumers can agree on the objective: affordable, quality care from a doctor of their own choosing, what we never hear is, “Don’t take away my insurance company!” This makes me wonder, what are those people hollering “hands off” trying so hard to protect? With almost a million Coloradans uninsured, can anyone credibly defend the status quo?
A wise business professor once taught me insurance should protect from situations where the financial burden would be so great that recovery would be impossible, but that insurance should not go further. In its early days, health insurance only covered accidents. Today, we expect coverage of everything from routine and preventive care to prescription drugs.
The assumption that insurers will bankroll all health-care needs is embedded in our language. We measure the failings of the system by tallying the “uninsured,” but more important is the number of people not getting necessary health care, regardless of where the money comes from.
Must we assume the role of the insurer as Daddy Warbucks, funding everything health-related? Insurers today are money pipes, sucking trillions into the pipe from employers and consumers and spraying trillions out to providers.
The problem is the siphoning off between input and output because of inefficiency. With Medicare, potentially the model for a new government-run plan, 3 percent of premiums fund administrative costs, while with private-insurance, 10 percent to 20 percent of premiums fund such overhead.
Insurers’ inefficiency is on display in my home office. Being a meticulous record keeper, I trap every statement – electric, water, garbage collection – in hanging Pendaflex folders, but not so with health insurance statements; they form a stack a foot high, filled with tediously complex explanations of services, claims, deductibles, coinsurance co-payments, allowed expenses, exceptions, etc.
Our insurer just inquired about our daughter’s recently injured forearm, sprained roller skating. They were fishing for another entity, an employer or business, to blame and therefore hold responsible for the X-ray cost. They call it subrogation, but I call it inefficiency that our system doesn’t need now.
At least we have our choice of companies and doctors, or do we? The number of insurers operating in Colorado is dwindling, and if you’ve ever chosen an out-of-network doctor, one unwilling to accept the insurer’s negotiated rates, you know your choice came with a huge price tag.
I’m weary of a greater chunk of my paycheck funding more complex models for growing the gap between premiums and payments, and the Bangalore phone banks and blizzards of paper needed to rationalize them to us.
Single-payer versus “public option” versus something unimagined, I don’t know what’s best. But I do know the status quo is unacceptable, and I’m convinced any option that doesn’t challenge the entrenched role of the insurer wouldn’t fix the problem.
To those opposing an active government role in health-care reform, I ask you this: in a country that leads in space, defense, information technology and even medical innovation, a country that once led in health care, are you seriously suggesting that a solution that relies on insurance companies is the best we can do?
