Everyone has a medical insurance horror story. They may differ in what end of the beast one has wrestled; (getting insurance, updating insurance, filing a claim, disputing a claim, etc.) but the blood boiling frustration is the same. It is the rare insurance experience that is summarized with; “Oh how I enjoy working with my particular carrier. I pay them and they make my life easier when I’m most vulnerable and provide much needed access to care.” It is much more likely the case that hours (if not days) have been lost trying to get answers and coverage. In the most heinous cases, professionals need to be hired to force insurance companies to pay for coverage.
Medical insurance companies are in the catbird seat. They don’t need to advertise they only need to lobby. Most coverage does not happen through individual purchases. Coverage is purchased in bulk through employers. In this way they differ greatly from automobile insurance. Which is one reason you don’t see an animate gecko or (wee wee wee) pig selling medical insurance. You’ll never see an advert of a medical emergency in which a wise soothing man with a voice like Barry White comes to the rescue. Medical insurance doesn’t need to promise (or deliver) anything except the belief that we need it to survive. And we do believe that. We have made considerable efforts to expand coverage to individuals including dependents well into adulthood. We are now moving towards insuring everyone regardless of employee plans. Somewhere along the way we’ve equated insurance with healthcare.
Insurance companies do not make money by providing healthcare. However they do increase the cost of healthcare by their very existence. There is a complex economy that exists between healthcare and insurance companies. Medical practitioners need to charge more to support the additional staff needed to process claims. Expensive tests are casually ordered if they are ‘covered.’ Insurance companies negotiate discounted reimbursement rates for pharmaceuticals and medical care, which in turn drives up the cost for the uninsured, which feeds into the notion that medical insurance is necessary.
Would it be such a radical notion to abolish medical insurance? We did not always have insurance in this country. In fact historically speaking it’s a relatively new concept. True our medical advances are quite expensive and need to be paid for in some way. We live longer now, partly due to medical interventions that cost money. But how much money does it cost to support the medical insurance beast? How much time is lost in productivity of employees pursuing claims? How many staff of every company offering medical insurance is needed to wrangle the companies and attempt to explain the plans to employees? How many medical offices could dramatically lower the price of an office visit by dropping medical insurance? But what would become of the medical insurance staff? Well the doctors and nurses whose job it is to review (aka deny) treatment for people they have never met will do just fine. Everyone else on staff has an equally transferable skill; there are no typesetters or farriers to retrain.
There is something inherently problematic with a (highly) profitable product that positions itself as non-negotiable but with which we have zero consumer input or control. What we actually need is not an inflated labyrinth payment method but healthcare. High quality, easily accessible, holistic healthcare is what is needed. What is needed is healthcare that focuses on preventative care throughout a lifetime. Adding a layer for payment processing which often gets in the way of care is not what is needed. Heralding a product whose very raison d’être is to make money not to provide care, as a panacea is not what is needed.