Surgery on the Middle Man
Peg on Apr 23 2008 at 4:06 pm | Filed under: Economics, Health Care, Peg's Page
We all expect to eat - but we don’t get insurance to guarantee food. We all need various sorts of transportation. But, other than some insurance to cover the value of a valuable vehicle, we don’t need insurance to make sure that we can get around.
Why then, do we need health insurance for routine exams, medications, doctor visits and the like?
Jonathan Kellerman, professor of pediatrics and psychology at USC’s Keck School of Medicine asks some insightful questions and provides some well grounded and thoughtful answers.
Insurance is all about betting against negative consequences and the insurance business model is unique in that profits depend upon goods and services not being provided. Using actuarial tables, insurers place their bets. Sometimes even the canniest MIT grads can’t help: Property and casualty insurers have collapsed in the wake of natural disasters.
Health insurers have taken steps to avoid that level of surprise: Once they affix themselves to the host – in this case dual hosts, both doctor and patient – they systematically suck the lifeblood out of the supply chain with obstructive strategies. For that reason, the consequences of any insurance-based health-care model, be it privately run, or a government entitlement, are painfully easy to predict. There will be progressively draconian rationing using denial of authorization and steadily rising co-payments on the patient end; massive paperwork and other bureaucratic hurdles, and steadily diminishing fee-recovery on the doctor end.
Sphere: Related ContentSome of us are old enough to remember visiting the doctor and paying him/her directly by check or cash. You had a pretty good idea going in what the service was going to cost. And because the doctor had to look you in the eye – and didn’t need to share a rising chunk of his profits with an insurer – the cost was likely to be reasonable. The same went for hospitals: no $20 aspirins due to insurance-company delay tactics and other shenanigans. Few physicians became millionaires, but they lived comfortably, took responsibility for their own business model, and enjoyed their work more.
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