Everyone in DC keeps assuring Americans they can keep the private health insurance they have now, if they like it. Yet health insurance you "like" is about the same as having a car you like, but never drive further than the grocery store. Michael Hiltzik of the Los Angeles Times explains why, asks why we’re "so intent on protecting the private option," since its biggest feat is the current health care crisis.
Hiltzik’s column is a good twin for my colleage Carmen Balber’s recent blog on how key members of Congress are raking in the bucks from the insurance and medical industries doing during their August recess.
As the health reform lobbying battle in Washington tightens, Hiltzik notes that HMOs will also flood the public with their lobbying messages:
We can expect to be overwhelmed with an industry ad campaign worth
millions of dollars (remember Harry and Louise?) exhorting us to write
our lawmakers to preserve the American way of healthcare.
So it’s proper to remind ourselves what that American way entails. For
if the insurers have proved anything over the last 15 years as the
health crisis has gathered speed like an avalanche roaring downhill,
it’s that they’re part of the problem, not the solution.
The firms take billions of dollars out of the U.S. healthcare
wallet as profits, while imposing enormous administrative costs on
doctors, hospitals, employers and patients. They’ve introduced
complexity into the system at every level. Your doctor has to fight
them to get approval for the treatment he or she thinks is best for
you. Your hospital has to fight them for approval for every day you’re
laid up. Then they have to fight them to get their bills paid, and you
Hiltzik also rightly notes that if you’re insured by your employer and not sick, or have a common problem like a medium-sized heart attack, you haven’t really had to test your insurance. But try to buy a new policy, or get a really expensive illness, and the road test breaks down.
The industry loves to promote surveys indicating that most Americans
are "satisfied" with their current health insurance — 37% are "very
satisfied" and 17% "extremely satisfied," according to one such study.
Yet these figures are misleading. Most people are satisfied with their
current insurance because most people never have a complex encounter
with the health insurance bureaucracy. Medical care generally follows
the so-called 80-20 statistical pattern — 20% of patients consume 80%
of care. If your typical encounter is an annual checkup or treatment of
the kids’ sniffles, or even a serious but routine condition such as a
heart attack, your experience is probably satisfactory.
But it’s on the margins where the challenges exist. Anyone whose
condition is even slightly out of the ordinary knows the sinking
feeling of entering health insurance hell — pre-authorizations,
denials, appeals, and days, weeks, even months wasted waiting for
And that’s among people with affordable employer-paid insurance, an
ever-shrinking cohort. The percentage of small and medium-sized
businesses offering health coverage to employees shriveled to 38% from
67% between 1995 and 2008, according to the National Small Business
Assn. Without reform, the number will continue to plummet.
Meanwhile, people employed by big companies that offer a health plan
are within a layoff notice of losing coverage for themselves or their
families, joining America’s 46 million uninsured.
Then, even if they have the money, good luck to them in getting insured in the individual-policy market. Are you over 50? Taking anti-cholesterol drugs? Got high blood pressure? Even acne? You’ll either be turned down or pay exorbitantly.