Disclaimer: The following diatribe is likely of no interest to you. Nothing unusual there. What is unusual is that it should be. While it concerns a subject that directly affects only those 43.7% of Charleston AMA members* who pay for their own health insurance, the rest of you are indirectly, though very significantly, affected by what follows, but you’re probably blind to the connection.
Many members of this august organization are sole proprietors who must secure their own health insurance. Even with new regulations, that can lead to sticker shock when the bill equals the GDP of a small African nation.
The reason for this is that America’s health care system is a Rube Goldberg contraption more complex and demoralizing than the rules of courtship, where the paying customer is rarely the person receiving the service. We abuse our bodies and then consume more care than we need, or is even wise, with dim regard for its cost, driving up the price of service faster than inflation every year since the Boer War.
Try calling a health care provider and asking how much some procedure will cost. Not only won’t they answer, the question will baffle them. It’s absolutely no wonder that we have the most expensive and over-used health care system on the planet and yet suffer from health conditions hitherto unknown to humankind. We have conflated health insurance with health care, and health care with good health. Eat real food in moderate amounts and break a sweat now and then – there’s your best health plan. (I don’t mean to belittle anyone with a real, unpreventable condition or disease. I’m just noting that the conditions “couch potato” and ‘fast-food consumer” are highly preventable.)
It’s no coincidence that the cost of Lasik surgery has dropped dramatically over the past 20 years while the quality and speed have increased. Why? Because it’s not covered by health insurance, which means customers paying their own way shop for the best price and quality and have forced the providers of that service to compete on those terms.
At the risk of venturing into partisan political territory, this is the reason I’m no great fan of the Affordable Care Act. The problem is not that it distorts the current health care system, as most opponents bemoan, but just the reverse — it’s more of that same appalling system, the worst possible one you could devise. And it’s likely to have as little impact on ever-skyrocketing health care costs as anything else short of scrapping this disastrous system.
A Much Better Idea
Health care would be less expensive, more responsive to customers, higher quality, more focused on prevention, fairer and more cutting-edge if we could ditch the current maze and replace it with a lightly-regulated free-market system disconnected from employment. (I recognize that we would still have to accommodate people without assets, but it’s not as if they are being well-served now.) Under such a system, sole proprietors like you could still insure themselves – against the unexpected and calamitous, the way you buy life insurance, car insurance and homeowners insurance.
The free market is that wondrous creation on the order of the baseball glove, the Oreo and Ronii Bartles. Through all of its inter-locking mechanisms, consumers like you, me and the mayor of Buford, Wyoming (population: one) are empowered to make purchasing decisions that are the best for us. It’s time we applied our best economic device to our most important purchase.
*very specific number a total figment of my imagination. It might be more like 9%, what do I know?