When discussing the delivery and financing of healthcare, it's common for the topic to conjure up images of big hospitals, crowded clinics and the like. Personally, I'm pretty pleased that this doesn't apply here in Alaska; when I am due for my regular routine Preventive Maintenance, Checks, and Services (PMCS), I go to our little local clinic and see the doctor (actually a Nurse-Practitioner) who the whole community knows. I like her; she has a steady, no-nonsense manner about her, and she takes a rational approach to many issues - like my one-or-two-a-week cigar smoking, which she admits at that level will likely never hurt me.
Also, she has warm hands. That counts for a lot in a doc.
Here's the thing: When we talk about healthcare in the United States being in some crisis, we're not usually talking about the delivery of healthcare. We are talking about the financing of health care, which is an entirely different kettle of fish. For most folks (my wife and I are covered by the VA), that means a health insurance plan, either private or covered in part by an employer. With the murder of United Healthcare's CEO Brian Thompson recently, this has been an issue that's much in the news. This event has also fired up the socialized medicine advocates, in particular the "Medicare for all" activists. Those people should be resisted at all costs. Here's why.
There are three primary reasons why insurance providers, while not perfect, are nevertheless an important check and balance on the country's major healthcare provider systems.
First: Large healthcare chains, like any business, operate on the profit motive. So do the insurance companies. However their goals with the pricing of services are opposed; the healthcare chains have an interest in keeping prices higher, while the insurance companies have the opposite motive. The purpose of any insurance is to mitigate risk by spreading said risk across a population, but the insurance providers also have some leverage that the healthcare providers lack. Some examples of these kinds of negotiations may be found here and here.
Second: Dishonest billing.
As lawmakers consider ways to address healthcare inflation, there is one solution on which they should be able to unite that would make a significant dent: ending hospital “dishonest billing.”
Your doctor’s practice may be owned by a large hospital group. And when you have an appointment, that hospital may secretly reclassify that visit as a hospital-based service in order to charge more money. That’s “dishonest billing.” On average, care labeled as “delivered in a hospital” costs 300% more than the same care delivered in an office-based setting. In one instance, a patient who experienced dishonest billing was slapped with a bill more than ten times the appropriate amount.
Again, it's a matter of incentives. Most of us don't see itemized bills from health-care providers and wouldn't know how to fully interpret them if we did -- I wouldn't, to be honest. But the insurance companies do, and again, it is in their interest to identify this practice and contest it. They have the resources to do so. Individual citizens generally do not.
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Third and finally: Obamacare. Yes, Obamacare. This ill-advised legislation - passed in the dark of night by a simple party-line (Democrat) majority - has had the effect of driving some healthcare providers away from small private practices into the major healthcare systems. In other words, it takes away some of the providers' discretion - replacing it with "billing by bureaucracy." And remind me - what happened to the Obamacare repeal we were all reading about not so very long ago?
Every action, as they say, has an equal and opposite reaction. Two opposing groups - healthcare providers and insurance providers - whose incentives are, if not opposed, then at least differently inclined, can keep things on a more even keel.
Our current system of paying for health care isn't perfect. Too much government interference, for instance, can (and always will) result in rationing, in one form or another. Our current hybrid system of having some covered by government-financed health care (the VA, Medicare, Medicaid) and others by private insurance companies can surely use some improvement. But pols like the execrable Sen. Elizabeth Warren (D-MA) and other far-left nuts want to toss the baby out with the bathwater to implement something like "Medicare for all," which will only result in a decrease in delivery and, yes, rationing. And we can be sure that the same Congress that passes any such law will surely exempt themselves from it.
That's another reform, by the way, that's desperately needed - but that's a topic for another day.
