
I have two choices for health insurance at work:
- A major national insurance company with a reputation for "losing" your claims forms and not paying doctors. If you get sick, you'll end up being tens of thousands of dollars out-of-pocket and likely have to declare bankruptcy. That's if you survive -- if you need something really expensive where doctors won't even start treatment until they've gotten pre-approval from an insurer, good luck.
- A major regional HMO which avoids paying for expensive treatments by simply not doing them and hoping you die before the appeals process with the state insurance commission is complete and the courts force them to provide the contracted-for treatment. They have calculated that, for example, the cost of treating leukemia (roughly $1M) is far higher than the amount of premium income they get from a typical employer group, so even if your employer threatens to move their entire company to a different insurer, they just shrug and say "Go ahead, we're still ahead of where we'd be if we paid for your employee's leukemia treatment."
Soo.... why isn't the magic free market fairy (see left) not providing me with health insurance that actually, like, pays for the healthcare I need if I get sick? Two reasons:
- Health insurance is inherently anti-capitalist. Health insurance is to capitalism what kryptonite is to Superman. In capitalism, businesses make money by providing services. In capitalism, for example, a restaurant makes money by cooking food and serving it to you. If they didn't cook food and serve it to you, they would make no money. Health insurers, by contrast, make money by not providing service. The more health care they don't pay for, the more money they make. In short, health insurance simply is incompatible with the profit motive because it profits by not providing service.
- Health insurance is largely provided by employers as a benefit, rather than purchased by individuals (less than 7% of all health insurance is individual policies), and employers buy the cheapest insurance, not the best. The HMO above is not-for-profit but was formed by employers to keep their health care costs down, and still pursues that mission with a vengeance. The only way private insurers can compete with an HMO that was formed to deny as much care as possible is to, duh, deny as much care as possible.
-- Badtux the Healthcare Penguin
Source: http://snarkypenguin.blogspot.com/2011/04/health-care-reform.html
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