Thursday, December 21, 2006

In response to a McQ post in which he gets behind a proposal of Democratic Senator Ron Wyden to provide health care coverage to all Americans through a pool of private insurance plans...

The biggest 'health care problem' is not insurance, but rather the high costs of medical care... which is caused by (1) advances which allow doctors to better detect what is wrong with us and to fix what they find, (2) our refusal to not knowing (No, McQ, we're not going to order the tests) and/or not treating (Sorry, McQ, we're not going to operate and cure what ails you), and (3) our failure to take care of ourselves (diet, lack of exercise, etc) which in turn creates a higher demand for medical treatment than would otherwise be the case.

And, to paraphrase the Meineke ads, we don't want to pay a lot for that treatment. We don't even want to pay the full costs for ourselves... and we certainly don't want to pay more so somebody else can get it for less than they would otherwise have to pay.

That's why Americans will never accept shifting the health insurance 'burden' away from employers. Having the employer 'pay' for it allows us to delude ourselves that someone else is paying for it. We think we get better rates through employer plans than we would if health insurance were sold through Allstate agents. And we think the insurance company is less likely to screw us if we're part of a employer plan than would be the case if we were on our own. Note: make of this what you will, we trust our employers more than we do the government to do the same.

That's also why America will never accept 'bare bones' policies or reducing state mandates. Bare bones policies are a good idea, but only until people with such policies face having to pay for (or do without) treatment for something outside the coverage parameters. Just imagine the field day TV newshows will have featuring the poor families who can't get treatment for X or Y. That they chose the low-cost model won't be relevant (for evidence of this, look at the likelihood society is going to come to the rescue of those who bought exotic mortgages and who now face problems). As for mandates, while part of the reason they exist is the lobbying by practicioners, part is a response to society saying they want services A and B and C all included in their coverage (example: new mothers upset over the push to push them out the door are screaming they should get to stay a couple of nights).

And that is why, notwithstanding the crocodile tears shed over the plight of the uninsured and the uninsurable, America will never willingly accept the higher premiums and/or taxes associated with providing health insurance to those groups.

Other than that, not a bad idea...