2013
With the recent Oregon Medicaid study and the nearly forty-year old Rand study it’s pretty well established that the existence of health insurance does what insurance does; it protects people fromfiscal risk… who knew? Just as auto insurance does not prevent accidents and property insurance does not prevent fires and hurricanes, health insurance does not prevent illness nor in any measurable way improve health status.
Health insurance assures somebody gets paid by somebody else.
Back in the 1960s that’s not the way it worked. When I started in health benefits there was a fixed fee schedule and coverage was only for inpatient services from hospitals and doctors plus $25 toward lab work and $250 toward x-rays. There was no coverage for Rx, office visits or any outpatient services. Nobody complained about health care costs … then we started to “improve” the benefits. We added major medical with a $100 deductible and 20% coinsurance, next we moved away from fee schedules and adopted reasonable and customary fees – thereby allowing providers to raise fees at will. Whatever the basic coverage did not pay, the major medical did. And then along came Medicare.
You see, we changed the concept of insurance into a I buy what someone else tells me to buy and you pay system. Today we have gone over the edge; more and more services must be paid in full, there can be no limits on coverage, ones financial risk is less and less … there no longer any such thing as health “insurance.”
While we can apply the insurance concept to every other risk in our lives (my insurance company just raised my hurricane damage deductible for the fifth time to $20,000), politicians and social do gooders convince us unlimited health care with virtually no financial risk is a right.
Do you really wonder why the cost of health care is out of control? It’s because you really don’t care, you only care about the premium you pay.
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And then there is the side of the economic pool of folks who could not or would not pay individual “insurance” premiums. They either paid as they go or did with out and which then became societies responsibility. This is not to say all decided this was what was best for themselves but this became a reality for them and that became a cost for those of us able and willing to “join the system”.
Employers would negotiate/bargain compensation packages that included “enhanced” benefits as a retention measure. This is the way it was and now employers are changing this by offering a flat benefit amount and letting employees find their own insurance that “best” suits their needs or affordability.
Buying personal auto insurance or flood insurance is handled this way. You buy what you can afford or choose to cover.
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