I have not been spending much time reading (and then blogging) about the health insurance bills that are being considered in the House and the Senate. But having said that, one thing struck me about the Senate's proposal, so far: All it does is mandate that everybody buy health insurance and for those who can't afford it, some paltry assistance with paying for it will be made available.
That's basically it. The bill looks out for the health insurance companies before anyone else. Yet the hard reality of the situation is that this country spends more, per capita, on health care than virtually any other nation and what we get for it is a system that is corrupt at its very core.
It is grossly inefficient. First, there are a number of health insurance companies, all with their own forms, their own authorization protocols and their own billing procedures. Any medical establishment, from a solo-practitioner to a major hospital, has to be able to deal with all of them.
Second, the system is geared towards encouraging that everyone buy the most super-duper machinery without any consideration as to demand so they can advertise "Bushwa County Hospital has a new, state-of-the-art, dilithium-quark imaging system". Of course, running someone through that shiny new DQIS costs three times as much as a PET Scan, four times as much as a MRI, six times as much as a CAT scan and twenty times as much as taking an X-ray.
Third, everybody tries to do everything. A sensible system would have all hospitals set up to stabilize whoever came in the door and then a regional system for specialty cases. If you needed a hip replacement, you'd go to one place, brain surgery, another and so on. By concentrating cases, the doctors who work on those would have enough to do to be thoroughly proficient; a mechanic who rebuilds transmissions every day is likely to be far better at it than one who does it every six months and the same is true for doctors. The current system rewards inefficiency.
But the biggest obstacle to fixing the health insurance mess is the health insurance industry, as any serious reform would threaten their rice bowls. Our current systems costs too much for what it delivers. The current system saddles employers with huge costs that increasingly make them non-competitive. But since the health insurance companies are able to get the best Senators that money can buy, don't look for anything to change anytime soon.
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4 comments:
Well they already did that is the Peoples Republic of Massachusetts. Here in the PRM they added a twist. If you don't get health insurance your tax bill at the end of the year is impacted negatively. Oh and they do have an insurance pool where if your not working and starving you may still pay lots for it. Best I can see it guarantees the hospitals get paid and not that you get decent or any care.
Eck!
as bad as it is - and it is bad - rest assured the ahole in congress will find a way to make it worse
Why blame the health insurance industry? They were/are only doing what our elected reps allow them to do.
The big problem is that when you whore yourself out like our politicians, you have to answer to those who bought and paid for your ass. Until that changes or pitchforks and other sharp implements are figuratively applied we will not see change in this country.
The House draft bill is considerably better. It outlaws discrimination against women, allows people in their 50's and early 60's to be charged at most 2x what people under age 30 are charged, has a public option, and considerable consumer protections to keep insurers from bankrupting you by suddenly canceling your insurance or saying you've hit some bogus lifetime limit if you have an expensive illness. If you sign up for insurance, the insurer is required to insure you, regardless of any pre-existing conditions, and is required to cover those pre-existing conditions. It also extends Medicaid to *all* poor people (right now single men and women w/o children are excluded) and extends Medicaid coverage to 120% of the poverty level. It also reforms the Medicare program to remove the subsidy for the Healthcare Options program (used by insurers to suck healthy people out of the Medicare program proper in order to expand their own profits) and eliminate the "donut hole" in the Medicare drug program.
In short, while it also contains a massive subsidy for the health insurance industry -- a mandate, and a fund for subsidizing those who make less than 300% of poverty line -- it fulfills everything Obama promised prior to his election, plus a bit more. Let's not say Obama didn't warn us what he was going to do on healthcare, he did, and the House bill overdelivers on Obama's promises with considerable consumer protections and expansion of coverage. But let's not forget that in 1993 the Clinton reform bill made it through the House, only to be killed by the Senate. The Senate appears to be way in the pocket of the health insurance industry, and my sad suspicion is that we're replaying 1993 all over again :(.
- Badtux the Health Care Penguin
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