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September 20, 2006

Healthcare Blues

I have long believed that the American system of health care is nuts. Basically, Americans go to a bookie (called a "health insurance agent") and make a bet that they won't get sick. If they do, the bookie pays out. The bookie has absolute incentive to pay as little as possible-- and has the discretion on what to pay for. Americans don't have the discretion, doctors don't have the discretion, the bookie has the discretion. Does that seem crazy to anyone else?

Worse than that, when the bookie does lose their bet, they have the power to decide that they weren't actually covering you anyway. Crazy crazy crazy...

(Link stolen from Ezra Klein, who said:

We rely almost exclusively on private insurers whose primary business imperative is not to pay when we get sick. They do that by seeking to deny coverage before the fact, or reject claims afterwards. They pay for platoons of employees who have no job other than scrutinized thousands of policies a week to find sufficient cause for cancellation. Say what you will about the inefficiencies of the public sector, but can it really match the ruthlessness and absurdity of insurers spending large amounts of money so they don't have to insure? Is that sort of profit motive really what you want underlying your health care coverage?

Posted by Andrew at September 20, 2006 12:30 PM

Comments

Yep. I once had to go to the ER with potential appedicitis. Thankfully, it wasn't, but afterwards my insurance called to tell me they weren't going to accept my claim because I wasn't covered by them. I pulled my card out of my wallet and told them that yes, indeed, I most certainly was. We argued back and forth like this for about twenty minutes, until finally I had to let them go. I called my mother, whose company provided the coverage, and it eventually got straigtened out, but it was a total nightmare.

HMOs seem to be about the worst you can get, and the thing most often pushed at you by insurance reps. Sure, you have "no cost limit" on care, but it's the worst care they can manage to scrape by. It's just wrong. I don't really see how to fix it though?

Posted by: Afaeyre Maede [TypeKey Profile Page] at September 20, 2006 01:10 PM