My Health Care: A New World

I am all for universal coverage. I think health care is a public good and a human right. It’s not a private good, like buying a car. In my opinion, we should stop pretending that health care delivery is a business. It really is a state-sponsored service.

But, will we manage the bumps as we transition the system? It is a new world for health care. Here are three recent personal examples.

First, my health care premiums just went up 31%. No advanced warning from Blue Cross Blue Shield. Just an invoice. I haven’t polled around but have heard the same from one of our entrepreneurs and my business partner, Eric.

Second, I had to wait four weeks for my insurance company to approve a routine prescription. My doctor’s office went back and forth with Blue Cross to argue that I truly needed the medicine. The nurse practitioner says that the insurers are doing that across the board: make you jump through hoops.

And, third, I recently called for my annual physical. It’s a wait of five months, when I’m usually seen in just a few weeks.

We live in the state of Massachusetts, which is one of the leaders on universal health care, outcomes management, electronic medical records,  and the use of online exchanges. So, I’m not sure what’s happened with my health care. Are things getting better or worse?

FWIW, I never believed the politicians when they said that the health care reforms could do the following:

  • Expand coverage to all
  • Allow for pre-existing conditions
  • Not make changes to your current plan or doctor
  • Lower costs

I’m not in the medical field, but I think of health care as a Thanksgiving dinner. You invite more people to the dinner and there’s simply less turkey to go around. So, the idea that you can expand coverage to more people without adding cost to the system didn’t add up to me. And, you simply cannot overnight create a bunch more doctors.

That’s why I think we’re go to end up with a form of rationing. Some will make do with less turkey so that others can eat. Every other industrialized nation has a “single payer” system (the federal government, and not insurers, reimburses hospitals and doctors), and the U.S. is the only exception. If you’re for universal coverage, I think you cannot have an “all you can eat” health care system. So, someone has to step in and ration care.

In the end, I’m actually OK with it. I’m OK paying much more in taxes and health care premiums, if that’s the price for others getting health care. My concern is how woefully inefficient the system is. I don’t mind paying more, but I’d love to get more bang for the buck.

Last, I just have the feeling though that 95% of Congress, which is approving the legislation, has no clue as to what they’ve done. I truly believe there’s no one driving the bus on this topic and really understands all the complexities.


9 thoughts on “My Health Care: A New World

  1. “Some will make do with less turkey so that others can eat.”

    To me that’s the key point to all this. Yes some people will pay a bit more, yes some people will have to wait longer for things.

    But when I see stories like this:

    And remember that we are talking about healthcare here, for millions of people who couldn’t get it before, and that many lives will be saved… I have a hard time saying it’s not worth it.

    1. Thanks for writing, Andrew. It will be interesting how the mid-term elections affect the legislation. IMO, the reforms have been very poorly sold and implemented. The politicians promised all things to all people to get the legislation passed. They were either naive or knowingly fibbed.

  2. Definitely agreed on that point. I’m not really sure what to make of all this — no doubt the website rollout was a spectacular trainwreck and blatant lies were told repeatedly (still not sure why these lies were thought to be a good idea, when it is an absolutely certainty that in any sort of major health reform, some people will lose their plans and doctors). Not sure if the law is going to work despite all of that, or will fail from the government’s inability to manage this thing.

    Next 6-7 months leading up the elections will be very interesting.

  3. I’m also okay with paying more taxes and higher premiums to get the under served medical attention BUT not at the expense of my medical attention or quality of medical attention both of which suffer when rationing enters the picture.

    Why not privatize this? Set up a national risk pool – open to all, premiums capped and/or subsidized – but the private delivery systems remain unchanged. In fact, docs/hospitals would be motivated to treat sick to increase billings. AMA motivated to add med schools/Drs/PAs/NPs.

    The system would be open to same manipulation and fraud as Medicare BUT 1) we have systems in place to deal with it 2) private companies are much better at controlling fraud.

    The move toward a single payer system is a cynical one that takes advantage of poor and leverages them for votes to keep politicians in power. Again, USA has first class politicians and second class leadership.

    1. interesting idea, Rob. would love to know if this has been done in some states or nations. my comment about a single payer system isn’t that I prefer it, but I wonder if it is the only thing that works. over time, all other industrialized nations of various ideologies have tinkered with various systems, but all, except for us, have converged on a single payer system. when something is the norm, it begs me to ask: Why?

  4. PS – Did you tweet this? I didn’t see it.
    PPS – Facebook has become more vapid without your intelligent, thoughtful posts. However, I no longer feel inadequate on Sundays for not roasting a pork loin stuffed with dried sage and black cherries, served over organic 5 grain wild rice and hericots very. 😉

  5. Jo

    Good post. I think you’re missing one important point about expanded coverage in your Thanksgiving analogy. The uninsured were showing up for dinner anyway, uninvited. They were already get treated in the most expensive way (ER) at the most expensive time (acute). Maybe with expanded insurance coverage we can change that. I don’t know what the statistics say in MA about that. I’d be interested to know.

    1. good point, rob. you’re right. re: ER visits, here is a surprising early study: ER trips increased after expanded Medicaid (see here).

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