Private health care is bureaucratic too…

(Copyright 2008)


By Tony Walther

The argument against government-run health care is often that there would be too much bureaucracy.

Problem is, there is already too much bureaucracy in private-run health insurance.

I do not know the details, but Barack Obama’s claim is that his proposed program would allow anyone who has his or her own insurance and is satisfied with it to keep it. But for those who do not have it and are priced out of the market, it would be made available them. In some cases people would have to pay a portion of the cost and in others because they have no means of paying, they would not.

I have a hard time seeing a hole in that logic, unless you are just dead set against those who can’t pay for insurance being cared for.

But let’s go back to the bureaucracy problem. I currently (not for long) have private insurance. Doctors and other medical providers have to have people working full time just to handle the insurance claims and go through the bureaucracy of private health plans as well as the government programs. That costs us all a lot of money in bigger doctor bills.

And if you think government programs are too bureaucratic, well, private plans can be also:

I just spent some time this afternoon dealing with insurance claims. A lab sent me several bills saying that my insurance company (a prominent well known one, in fact probably the best known one) said that they could not identify me in the system.

Each time I go to that lab I give them my insurance card and they photocopy it.

I have paid my premiums in full and on time.

I called the insurance company and they confirmed that I had an up-to-date card and said they had not received the claims in question.

(And you already know one waits on hold as much as 15 or 20 minutes or more and then you often have to navigate the circular pre-recorded option message and enter the correct numbers and if you goof, you go back to the beginning and you do not pass go or collect $200.)

I called the lab billing office. The customer service representative finally determined that possibly they were billing the wrong office. It seems that my insurance company has offices in each state, but has told providers to bill the office in the state the medical service was provided. In my case they have been billing the California office most of the time. But my insurance is out of Illinois. But on one case, the lab sent a blood sample to a lab in South Carolina and so the lab billed the office there. That’s confusing, because as far as I am concerned, the service occurred in California because that is where they stuck a needle in my vein. But at any rate, while some of the California claims did not go through, the South Carolina one did. But, remember, my coverage is out of the Illinois office. And remember, we are talking about a private bureaucracy here.

And while I am on the subject, I get riled when John McCain suggests he’s going to give taxpayers a credit so they can shop around for health insurance. There’s a lot of holes in that idea, but one big one is that you don’t know how well your insurance is going to work until you get sick or injured and file a claim. You have no ability to shop around at that point. And McCain’s $5000 health care tax credit would not buy any more than five months of insurance at the most. And McCain proposes to tax private health insurance (I’m not sure how – but it sounds like robbing Peter to pay Paul). And at any rate, if you can’t work because you are sick, you can’t pay for the insurance anyway.

Back when a lot more people had jobs and partially-paid or fully-paid health coverage, universal health care coverage did not stand much of a chance of being enacted nationwide. Now with so much unemployment and people losing even company-paid insurance and skyrocketing medical insurance costs, there seems to be more of an acceptance of at least some type of more inclusive government-sponsored health care coverage.

I have cancer and am currently on a COBRA plan in which I keep my former employer’s coverage, but am hard pressed to pay the premiums ( I now have to pay the full premium). But I have a two-year wait for Medicare. What genius thought of that provision, the waiting period, I do not know. What am I supposed to do in the meantime? Beg? Die?

I personally think the idea of employer-sponsored health insurance was a bad one. It costs employers a lot and it is costing employees a lot these days. It also makes one a slave to a particular job. Fine if you are in love with that job, but not so good if you are not but are afraid to leave it because you will lose your insurance. And one thing I can tell you, bureaucracy aside, you do not want to lose your insurance, if you get sick or injured, you’re going to need it. And if you already have a health problem, new insurance often will not cover pre-existing conditions, especially if there has been a lapse in insurance. 

The people in the worst shape are those such as me, who have some amount of income but not really enough to pay for insurance, and those who have regular jobs that are low paid and that do not provide insurance. Walmart as we know provides its employees with info on how to get on the public health care dole. So we all subsidize Walmart. Ahhh that icon of free enterprise — not! 

There are state and federal programs for the chronically unemployed and disabled, but as I say, many are caught in between. And there are government-sponsored children’s health programs, but Republicans often prefer to vote against them, even though the so-called free marketplace they worship does not seem to provide an alternative.

But just as many conservatives have turned to government bailouts, just as the electorate seems to be abandoning the GOP, so too some type of universal health care, even if it’s private and government mixed together, may be in the offing.

The questioners at the debates seemed to be trying to elicit the answer that what with the current economic situation such plans might have to be delayed.

Strangely, most of the other industrialized nations decided long ago that public health is paramount and enacted their own forms of universal health care, even though it is true the cost is more and more of a challenge.

A major problem in the United States is the hodgepodge method in which we provide, and do not provide, health care. People without insurance crowd the emergency rooms putting a tremendous strain on other patients and the medical personnel and adding substantially to health care costs. I have personally been in the emergency rooms within the past year or two, bleeding uncontrollably due to my cancer and had to wait because someone ahead of me had a routine – albeit distressful I’m sure – ailment.

If we had universal health care people might have better health habits and have access to medical help that would save them from having to go to emergency rooms.

If compassion for your fellow man is not enough to support universal health care, then think of it this way: people who are healthy tend to feel better about themselves and have a better attitude toward life and are more likely to be productive citizens.

I would submit that a nation that spends $700 billion or maybe $1 trillion or more to bail out investment banks and that spends billions of dollars a week on wars of choice, can afford to have a decent and comprehensive health care system.

One Response to Private health care is bureaucratic too…

  1. James McGee says:

    You a right on target. In fact, as the adminstrator of a large employer based health plan, I’ve started my own blog to tell stories similar to your own, but how they look from the other side of the desk.

    It is amazing to me how we spend money in health care instead of on health care.

    Keep it up

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