July 27, 2009 11:36 PM UTC

We Need Real 'Health Care' Reform, Not 'Health Insurance' Reform

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• by: cunninjo

I’m not quite sure when or where it happened, but somewhere along the line, probably in focus group studies, the term ‘Health Insurance’ was replaced with ‘Health Care’. There is a huge difference. Health care is the process of being treated by a medical professional. Health insurance is the process of purchasing security in case you need health care. One mistake most people make is they assume buying health insurance is the same as buying health care. Every business offers some sort of good or service that they sell for a profit. In other words, the more goods or services they sell, the more money they make. So the incentive is to always sell as much as possible. If insurance companies were providing you the service of paying for your health care, then their incentive would be to provide you with as much health care as possible. Obviously, that’s not the case. Paying for your health care is a cost burden, not a profit-driver. When you pay your premium, you are simply receiving the service of security. The more an insurance company provides people with security, the more profit they make.

So why are we so surprised when they try and get out of covering claims? And what makes you think a government-run insurance company (whether it’s single-payer or public option) would be any different. Sure, the government plan can get rid of the profit mark-up and make you premium cheaper, but, again, the operating principles are the same. Whether you are a for-profit, non-profit or government agency, your concerns are ALWAYS cutting costs. And paying out claims is a cost. There is no reason a government plan wouldn’t nitpick every little detail of a claim just like private companies do. This is the nature of insurance companies in all forms.

We need to move away from the concept of employer-based health insurance. What on earth does your employer have to do with you receiving health care? This system eliminates choice because you have to go with whatever your company chooses. If you are part of a union you are lucky enough to have some say, but most workers don’t have that luxury.

One choice people must have is the choice of no coverage. Even with the current plan in congress, not EVERYONE that doesn’t qualify for subsidies can ‘afford’ health insurance. There is that middle ground that gets ignored. You simply have to look towards financial aid for higher education to find the lack of an effective affordability model. It is virtually impossible to determine what people ‘should’ be able to afford. Each individual is in a different financial situation with different financial responsibilities. Mandated coverage is a horrible idea and very well may end up ruining people’s lives. We should not be setting up people to lose their house or car because they were forced to pay health insurance that they don’t use.

The solution needs to be ‘health care’ reform. Parts of the current plan deal with this, like creating more efficient streams of communication and data. Making health care more efficient is a huge step. Perhaps we could set up a system similar to Social Security where you pay into a personal account that will be used to pay for any hospital visit no matter what your problem is. This would reduce the processing costs dramatically. Doctors would receive payment immediately and the bureaucracy of approving claims would be eliminated.

We can still have insurance for those that want the security or that are high risk for injury or sickness. But, we need to create alternatives. We need choices beyond insurance. Let’s think outside the box on this. Rather than simply manipulate the current system, let’s find something completely different. That’s real reform.