The Wall Street Journal points out that your health insurance company is trying to deceive you. If you know anyone who was tried to get private health insurance, or worse tried to actually use it, you know that the health insurers will spend a lot of their own money trying to keep from paying you.
For example, I was taking a medication for blood pressure that costs $85/month. Although it worked, I asked my doctor to prescribe something available in generic form. I tried two different drugs that were available for $12/month. The first one caused some significant side effects, but the second one seems to be working without side effects. Because I started a new medication within the firs year of my coverage with this company, a review of my coverage was triggered. Some corporate analyst is now going to decide if I’m still eligible for coverage, if I should be charged more, or if just my doctor’s visit to try a new medicine is ineligible for coverage.
Ironically, the cost of a doctor’s visit is less than the amount I save each month by switching prescriptions. Further, I have a high deductible policy, so the insurance company has, in fact, not paid a single dime in benefits. So, in the last several months I have paid $94/month in premiums (teaser first year rate), but the insurance company incurred self inflicted administrative costs for my enrollment and underwriting review, processing my doctor and prescription claims, and now the cost of reviewing five years of medical records from my doctor. The insurance company is losing money on me just to be sure they don’t have to pay any benefits.
I’m one of the lucky ones, I was able to switch from an expensive drug to an inexpensive one. Many people are finding that even with health insurance, they can’t afford their medications.
To quote Paul Krugman: Don’t trust the insurance industry.
The thing is, this example describes the norm and not an isolated case. The cost of health care is higher in the US than in any other country, but the quality of our health outcomes is not higher than in other countries. In quality of health care the US barely makes the top 20. The market for healthcare is clearly inefficient, and the costs to society are larger than just adding up the dollars can portray. The health care industry is responsible for over 60% of bankruptcies in the US. (which is bad news for everyone).
I don’t personally know the optimal solution to our problem, but the health care industry as a whole has admantly proven that they just aren’t up to the task of solving it themselves.
