Friday, December 4, 2009

Torn on health-care nationalization

I know this will seem strange coming from me, but at times, I find myself conflicted in my opinion on nationalizing the health care system in the US (as Congress is currently debating). I'm strongly of the opinion that it will be bad for our economy, reduce the qualify of care, drive skilled and intelligent people out of the field, raise costs, be horrible for the long-term financial solvency of the country, and contrary to much of what America stands for. On the other hand, though, if ever a business and group of people is so despicable, so intentionally ineffectual, and so malignant as to richly deserve comprehensive summary execution in the business sense, the private medical insurance industry is such a beast, and the not-insignificant silver-lining of a government takeover would be to see all those people cast out like the garbage they collectively are.

Let's look at some anecdotal examples from my life, which has been (thankfully) largely medical-issue free:
- I have always had [good] medical coverage through employer plans, HMO or PPO, I'm the "easy" case
- I had an emergency room visit which took four years, multiple legal threats, and weeks of my time to eventually resolve with the insurance company, the hospital, and multiple collection agencies, which caused untold stress and unfairly damaged my credit rating
- I had a primary care physician facility which I literally could not contact over the phone to do anything (they never picked up or returned calls), and I couldn't schedule anything without going through them due to HMO restrictions
- Over 50% of my medical visits (routine checkups, etc.) have resulting in insurance billing "issues" which I have needed to intervene to resolve
- I can't get prescription drugs covered by my medical plan without manual calls to the company every single time, because their automated system is always wrong (it seems the default is to not pay anything unless the covered patient calls, waits on hold, and corrects the problem every time)
- I dread going to the emergency room, even though I have medical insurance, because I know it's inevitably going to lead to a billing problem, which will be months of work for me
- I have an outstanding bill for "lab work" from six months ago, where the other parts of the visit were billed correctly, but somehow this part cannot be fixed, or the various participants don't want to resolve it, but rather just repeatedly bill the patient
- I can't imagine how much of my time will need to be spent on just dealing with medical insurance problems if/when I have children; given my current experience, it might literally be a part-time job

I'm not harboring any delusions: nationalizing the process is unlikely to make any of these problems better. There would be ways to fix most of them, but they are beyond the Neanderthalic thought-processes of our Congress-scum. Nevertheless, if and when our government destroys private medical insurance in the US, I will not cry for these companies; they are a blight on the country in their current form and operation, and they are the most compelling argument for health-care nationalization.


  1. Nick - I understand your frustrations. They are well-earned and obvious. However nationalization would increase every item you list here x10, add more folks to the roles,(including millions of illegal aliens), erradicate the little accountability that we actually do have in our system AND bankrupt the taxpayer AND the federal government. I would say that NOTHING being done at this point is a perfect plan.

    With all due respect, opting for nationalization to spite the insurance companies,(as deplorable as they can be), is akin to eradicating free speech and burning books simply because there is pornorgraphy, libeous periocicals and books.....

  2. I agree with your thoughts on this.

    One solution to your HMO problems is to use a health insurance plan with a high deductible. That way you have fewer claims to fight with them about. It’s a bad model to pay huge premiums to health insurance companies and then fight with them every time you want to spend money on healthcare. (I know you probably did not choose your health plan. This is another problem with tying insurance to employment.)

    Most of the anxiety many people have over their healthcare could be solved by their having a little money on hand to pay for healthcare instead of going through these companies.

    If this healthcare overhaul is as bad as I think it is, I probably will go around my insurance plan for most healthcare services, simply writing checks to providers to avoid the red tape. I’ll only use insurance for huge expenses that would wipe out a significant chunk of my money, which is just what I do now.

  3. Regarding it damaging your credit rating, I think the credit rating is something bordering on a scam that banks use to promote their products. I understand the value of an organization keeping track of people’s reputation for paying their bills on time. I sort-of understand the desire to distill that reputation info into a single number.

    People take it too far, though, when they go out of their way to keep a high credit score. It puts people in the financial mindset of wanting to use bank’s products instead of the mindset of creating value and having loads of money coming in from satisfied customers. If you’re succeeding in that area, you won’t have trouble getting a loan if you need one.

  4. Nick,

    your entire blog amazes me. i seriously wasted my morning getting lost in your thoughts... :)

    i completely understand with your conflictions on healthcare...i don't think it will be good for the country but i hate thinking there are some underprivledged children who need it. however, only 50 million people in the US don't have health insurance, so why screw over the many to help the few? maybe they can compromise to cover children but not everyone...just a thought

    but i just know universal healthcare would harm so many. i have been a marine wife for the past 2 years and i know first hand the stress it takes to get and fulfill an appointment when the dr's have no incentive. when the doctors don't care you can tell. i always walk away from my appts with more questions than answers...

    i really hope the country (or atleast congress) can see past the "hope" that universal healthcare will make our country greater to they hype that will actually quicken its failure. all great civilizations have to end but i don't want ours to be from healthcare...thats too ironic.

  5. The federal government could fix US health care with a 2 page document that states:

    1) Since hospitals are required to treat ALL patients, ALL working people in America are required to have health insurance (and therefore pay their fair share for their health care), and employers are required to withhold health insurance payments from their paychecks.

    2) Hospitals and medical facilities should be forced to give 1 bill for 1 incident. That bill should go straight to the insurance company, and the insurance company should be legally required to pay that bill and is responsible for collecting the co-pay / uncovered amounts from the customer. Setting it up this way will discourage stalling on making payments as well as hidden lapses in coverage.