Scott Wahlin, CGCS said: John Kauffman said: Sean was right. PPACA isn't about helping anyone. PPACA is about changing who pays for health care and how much they pay. Some will contribute, but everyone will pay more. Many will receive less.
Sean is a very convincing guy, but he manages golf courses not health care systems. In my case I am completely locked into a system where if I should lose my job for some reason I am dead. Under the current system if I lose my job I get COBRA which I can afford for about 15 minutes. The hospitals will literally let you die on the sidewalk outside the ER. I have been there before. It sounds dramatic and it is, but I can remember hearing my wife crying and seeing the tears on the giant orderly's face as he carried me (all 250#) to our mini-van. My liver had completely failed and I was denied medical service by my HMO because my doctor assumed I was a drug addict. I was subsequently given a 5% chance of survival. We need a descent healthcare system in this country and unless you have the money or the hubris of a Republican you fully realize we do not have one.
I think Sean's a great guy who offers a perspective that many of us haven't seen, as I think you are a great guy who offers a perspective that many of us haven't seen. But, medical insurance (or any other type of insurance, for that matter) is infinitely more complex than what I can understand. I think that nuclear physics would be a cake walk compared to insurance. Maybe this is why its hard to keep posts about insurance short and readable.
Your situation was certainly unfortunate, but it wouldn't be any better under a single payer system. My mother-in-law's brother in Canada died outside the hospital in his hometown of Winnipeg (not really a small town), because it wasn't his turn to receive care. I don't think we want that type of situation here.
But, we have to remember what health care is – a service and a product. If I believe in freedom for all, I can't demand that this service or product be delivered from someone else to me at a price not of the provider's choosing, unless I am willing to let others determine my compensation without my input. An insurer is taking risk by agreeing to pay medical claims for a member. We shelled out a little over $3,000 for our son's birth (normal, no complications), while insurance picked up the remaining $25,000. I had only paid about $2,000 in premiums from the time I joined this insurer until the birth.
However, I think that using insurance for anything but catastrophic events is precisely the problem that has made health care in the US so expensive. When you go to the doctor, do you know what it actually costs to see the doctor? Most of us with insurance only look at our co-pay, but check out the EOB (Explanation of Benefits) you get after the visit. The first four columns are usually a service code, service date, then a billed charge and a contract adjustment. The insurance company doesn't pay what you would if you had no insurance – it costs them something different than it costs you. But, the patient usually doesn't know either one.
Most of us wouldn't dare buy a pair of pants without knowing the cost, but we'll go to the doctor without knowing the cost – then be upset when it's expensive! Free market function depends on information. The more prices and quality of service are hidden, the more expensive the product becomes.
Insurance is precisely why things are so expensive now.