How it works for me

How healthcare works for me:

1) My employer decides whether I will have any coverage or not. The coverage that I will have will be decided by my employer, including which illnesses and procedures will be covered, based on the impacts of those costs on the cost of the plan. My employer decides what it will cost me, based on the level of contribution he desires to make.

2) I have the option of providing my own health insurance. If I am willing to pay four times as much for half the coverage, I can obtain my own health insurance. I cannot, however, cover anything that may have caused an insurance company to lose money previously.

3) The doctors can prescribe medications or procedures which may or may not be covered by my plan. He can change these based on medical efficacy, the fact that the drug rep is hot, or any criteria that he chooses, and that may increase the cost to me and my insurance company. There is no mechanism for me to review or understand his decision, other than trust.

4) The hospitals, technicians, and administrators decide what fees are appropriate for a given course of treatment. This can be based on actual costs plus overhead, plus whatever the market will bear, plus how ambitious the principles are. There is no way for me to review these decisions. My only decision is which hospital system to use, but that is largely based on the decision of my employer in 1).

So.
Whether I am covered at all is decided for me.
What conditions will be covered is decided for me.
What it will cost is decided for me.
What the treatments will entail is decided for me.

This is a free market? What do I get to decide?

I am told that an ideal market will correct all of these inefficiencies, by driving poor performing hospital systems out of business. But it is obvious to anyone that the most poorly performing hospitals are the ones that still practice a very old-fashioned care ethic : treat the sick. For the others, where is the incentive to provide better care supposed to come from? The humanitarian spirit of free enterprise?

This would be the same free market that extracted half the value of my house from me last year. The same free market that has been expelling jobs from America for the last forty years. What in hell am I supposed to trust?

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3 Responses to How it works for me

  1. Snowy says:

    By contrast, I in my socialist, communist, Marxist, government run, Nanny state universal health care system can go to the government subsidised doctor of my choice, be prescribed government subsidised medication without referral to any health insurer, can receive hospital care at no cost, and also take out top up private health fund insurance if I so desire. And my employer has nothing to do with my health care. All at half the cost of the U.S. health care system. Yep, as you say, Doug, the "benefits" of that good ol' free market system sure are apparent to those who care to look.

  2. spot on!My 'summa cum laude' daughter, who did not find employee befitting her education, makes just enough to miss medicaid. When she had a severe burn a year ago, her employer paid out-of-pocket for her to get it treated. He says he can afford to be helpful some of the time but he cannot afford to insure his ten employees and he is probably correct. I am not allowed to carry her on my policy as she has aged out. Doesn't matter how much current health care costs are – they are out of reach when you are making $10 an hour. If she was not working at this place, someone would be and they would be uninsured.

  3. Doug says:

    You remind me that, while I have a rant that I feel is justified, it is much much worse for others. If it's broken a little bit for me, then it's broken a lot for people with real health problems.

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