Saturday, October 06, 2007

Cuz I get fired up sometimes

Here's the problem with "for profit" healthcare. It's in the doctor's best interest to KEEP YOU SICK. Putting the question aside as to whether a public or private enterprise runs more efficiently (clearly private enterprise does) the real question here is one of "conflict of interest". Where is the incentive for the profit making enterprise to heal people? Because if they succeed, they will then go out of business. In the US, where most people have health insurance (most meaning 84%), you would think that this would balance things out. After all, they are profit making enterprises too. And it would be in their best interest to have payers who do not get sick. So..... they reject certain people for coverage. They find ways to wiggle out of paying claims too.

I was declined coverage once. At the age of 29. 29! Why? Hard to say, but the broker had to coach me then on my answers to find another insurer. Basically, I had to lie. No I never drink alcoholic beverages. No I haven't smoked in the past year. Etc. I imagine if I had truly fallen ill once approved, the insurance company would have done their level best to find out if I had lied on the original form. Aha! We found this picture of you with a glass of wine in your hand from Christmas posted on the internet! You're on the hook for that chemo. Claim denied.

When coverage is universal and "not for profit", the incentives change. Keeping the population healthy becomes the only one.

16 comments:

Polt said...

Your last sentence sums up the argument perfectly. Of course, when you have greedy insurance companies, and truthfully, some greedy doctors as well, it's gonna be very hard for them to see it that way.

Man, I gotta move to Canada...

HUGS...

Doug said...

Medicine is an industry (or more than one industry), not a profession. Greed has driven the industry to try to milk every dollar it can from us, rather than being content with a modest amount of our money.

Midas said...

I think every thing has pro and cons. If healthcare is universal, do you have a choice of doctors or is is choosen for you?

How much tax is taken off? I know that my family of seven pays about 620USD a month for health, dental and eye coverage. Is is cheaper somwhere else?

Devo said...

I think the fact that the cost of providing it has spiraled so far beyond anything previously imagined is cause of the debate now. I prefer to not see it go private as that is clearly not a solution, looking at the US health care crisis. I also know that when our system had a lot of money in it about fifteen years ago, there was rampant abuse of it and a lot of waste so there needs to be a better balance. We still have to find that obviously.

Chunks said...

The whole health care issue in the US makes me nauseous. That the government chooses to deny basic health care rights for children shows you right there that their system is corrupt and unjust.

Or in Chunks' speak: It's fucked.

GayProf said...

It still amazes me that in 2007 people don't imagine access to health care as a basic human right.

Ed said...

It is sad that those of us who don't have health care insurance try to not get sick until we become eligible for Medicare at age 65. I have ten years to go and have been told I need certain tests that I can't afford. I have an enlarged Protstate gland, a hypothroid condition and a gnawing pain in my side that I fear is the big C word. By the time I get 65 I'll be dead. Thanks President Bush!

Lewis said...

As much as I agree with you, and get angry over the same sorts of thought patterns and injustice, I must add...how wonderful our insurance coverage is. We pay nothing out of pocket except our monthly cost...which I think is quite reasonable. We have dual coverage so whatever mine doesn't pay, his does. Nothing out of pocket. And our Dr. is a great man. He works very hard for us and get us in to whoever we need to. So, no complaints from here...on a personal level, anyway.

em said...

The theory of capitalism is well and good, but in practice it turns out that the person who corners the market and then provides shitty service makes the most money. And since the US is engaged in a class war, you need money or you are Totally Fucked. So there's no incentive to have compassion or to share.

But we are all yoked to a carrot on a stick that we might make enough money or win the lottery and then the Democrats Will Take Our Rightfully Earned Money To Help Some Loser! So we vote against our best interests.

Is it going to change? Not when the middle class is distracted trying to maintain their position in the hierarchy. Because even though we are all working longer hours and the only gains in the US "booming" economy have gone to the rich, the people who are slipping out of middle class are just lazy and stupid losers.

I'm cranky.

Enemy of the Republic said...

I lectured 3 of my classes yesterday on why we don't give out free drugs to people in Africa. I said that the health care lobby was the second most powerful one in the US, next to the NRA--irony is inescapable. The prescription companies could give out free or even at cost cocktails for HIV/AIDs instead of letting a continent die. They would barely note the profit dip if one happened because of all the money they make in the US KEEPING US SICK! You are so right. My mom was born and raised in England; free health care has quirks, but it beats this mess in the US. My students don't get it and they won't until they take a job they hate and stay in it only for the health care benefits that one has to beg for like a puppy dog.

Good post.

Truthspew said...

In the U.S. we have multiple layers of greed, from the hospitals, to the doctors, to the billing companies and finally the insurance companies. Everybody gets their fingers in the pie.

I happened to be part of the investigating team against a doctor who was committing Medicare fraud. We got his billing data and figured out that for the number of patients he was seeing each day, there was no way he could possibly bill for what he billed for.

Two nice little logarithmic plots showed the trend. He started this because the IRS was leaning on him.

The best part is we went to the billing company because I'd mentioned to the team that if the billing company had an IT systems at all, they'd have flagged the increased activity.

We met with their leadership and IT Director who lied through their teeth. How do I know this? We later hired their former IT director at my former place of employment and he told me they lied.

So Dr. Judge, next time work out payment arrangements with the IRS.

Daniel, the Guy in the Desert said...

European health care models far surpass what we call American health care.
Generally speaking, Americans are intellectually lazy, we think what we're told to think, and believe what our overlords tell us to believe.

Vila H. said...

Excellent post. I've noticed that many Canadians are becoming inexplicably enamoured of private health-care, which is being implemented in trickles and drabs here in Quebec. It is, as you note, a fundamentally flawed approach, and we need to be reminded of it as often and loudly as possible.

Patricia said...

years ago, people were up in arms at a report that listed things like the cost of a screwdriver at $300. and yet, if itemized, i'm sure that's what we end up paying for a cotton swab. it's disgusting and vile and immoral.

but then, i get fired up sometimes.

Mark in DE said...

I agree with you. When my spouse applied for private health insurance when self-employed, he was also turned down... by 3 different insurance companies. This is a man who truly doesn't smoke, drink, or do anything else unhealthy. He's never needed or had surgery and never goes to the doctor, save for a physical every few years. The reason for the denials? His height/weight ratio. Apparently people who are all muscle (which ways more than fat) are inherently bad risks. So he quit being self-employed, got employed by a company and was immediately given health insurance under the company's plan. Is it me or is there something wrong with this?

David said...

I'm not sure I agree with your overall argument. Medical care has been in existence for centuries and I can't believe in all that time doctors have been motivated by greed. It's like saying it's in the best interest of a restaurant to keep you hungry, so they really don't feed you a full meal.

I'll agree that insurance companies have their priorities wildly skewed, but a doctor who doesn't keep his patients healthy will quickly no longer have them. You can't make money if your patients drop you and choose someone else, and the Americans I know have no problem dropping a doctor they think is not producing results, and telling their friends. Most doctors don't advertise in the papers and on TV, they rely on word of mouth and referrals and if they are providing sub-standard care, the news will get around quickly.

Insurers are the enemy, not doctors. My GP is wonderful and has on occasion gone to bat for me with my insurance to make sure I'm covered.