Over the last few months there have seen and heard numerous reports that the public’s approval rating for ObamaCare, more appropriately referred to as the Affordable Care Act, has been falling steadily and now rests well below forty percent.
This should come as no surprise. Attempting to fix the American healthcare system by relying on the health insurance industry is like trying to fix Congress by making it easier for people to get re-elected.
The best we can say about the Affordable Care Act is that it was a nice try but one that was doomed to fail because its design was driven more by political considerations than by an understanding of how the healthcare system actually works. All ObamaCare really accomplished was to add another layer of complexity to a system that was already unimaginably complicated.
Until we are ready to acknowledge that health insurance is one of the biggest reasons why our healthcare system fails and, of course, that human beings actually deserve medical care when they are ill or injured, our tinkering with the healthcare system will only make it worse.
Focus on health insurance, if you will. Imagine for just a moment that we all could agree that there ought to be a way to see that all men, women, and children have access to health care when they need it.
Now, think about what health insurance actually does. The health insurance industry restricts access to care to only those people who are covered by a health insurance policy and it limits care to only those services that are specifically covered by that policy.
Assuming, again, that we want everyone to have access to healthcare, why would we be willing to pay the health insurance industry hundreds of billions of dollars to restrict care to a special few individuals and to limit care to only services that have been specifically identified?
And, yes, I’ve heard the argument that we over-estimate the amount of money siphoned off by the health insurance industry. Just the opposite is true. We grossly underestimate the degree to which the health insurance industry contributes to the rising cost of healthcare. The cost of health insurance is not just the result of that portion of our premium dollars that are retained by the health insurance industry after payment of claims to providers.
The cost of health insurance also includes every dollar that is spent by doctors, hospitals, nursing homes, out-patient surgery centers, rehab facilities, lab and imaging centers, home health care providers, and hospice providers to manage the process of filing insurance claims and fighting to get the paid what they are rightly owed.
We could also add the expenditures by employers as they manage the process of selecting health insurance or managed care providers, managing the enrollment process, and mediating grievances when their employees are unfairly reimbursed for care.
And, we could factor in how much the health insurance industry pays to influence legislators. And then, of course, there is Medicare and Medicaid.
If we could recoup every healthcare dollar expended by people like you and me, and also by our employers, that does not end up in the hands of actual providers of care we could afford to provide comprehensive healthcare and prescription drugs to every American man, woman, and child.
And, if you want “to hear the rest of the story,” as Paul Harvey used to say, take a look at my book, .