Tuesday, August 18, 2009

Alan's Soapbox - The "Health Care" Racket

I've been watching the "news" about the 'health care' debate. It makes me sick. (good thing I have insurance...) I'm bothered by a couple things. First, there isn't any discussion of health or of care. It's all about insurance and access. Second, we, the people, are not even at the table.

I understand that we are a democracy (or a republic). We are "represented" by our elected officials, and they watch out for us. But we don't have any money so we don't have any clout that counts when decisions get made. That's our system. It is less than perfect, but it is better than all the others. Still, it would be nice to have a place at the table as health care is discussed.

My main concern is with the nature of the discussion and the fixes that are being explored. Everyone is worried about insurance. I understand that. It is very difficult to access the medical system without it. But that is because the medical system is flawed. Insurance is a scam. When the gangs move into the neighborhood and start threatening businesses if they don't pay for protection we call it a crime. The protection they offer doesn't make the businesses run better, make the community healthier or safer. It just makes you a little less afraid. But only a little less. If it removed the fear you would stop paying. Insurance is the same game. It doesn't make you healthy. They want you to be reasonably healthy, but they also want you to be afraid. If you are not afraid of getting sick, why would you pay? Insurance doesn't promote health. It doesn't promote care. It controls access. It is the only gamble where you want to loose. You don't want the payout. It's not like Blackjack where you know the house will win most of the time but you hold out hope that you will get lucky. You don't want the insurance to pay because you will either be sick or dead. Who wants that? The insurance doesn't want to pay either. They don't want to pay to keep you well, because if we got good at staying well we wouldn't need insurance. They don't want to pay to get you well if you get sick. They only pay the minimum they think they can get away with so you don't feel too ripped off. For the insurance industry it is all about making money, and they make the most off of a reasonably healthy population that feels access is limited and is afraid. Their best strategy is to keep access limited and fear quite high.

Then there is the medical system. I'm not talking about individuals here, they mostly want people to be healthy and try to help them in that direction. I'm talking about the delivery system and the suppliers. They only make money when people get sick. They are not at all interested in promoting health. They are also not really interested in improving access. If the thing you want or need is limited you will PAY. It is in the medical systems best interest to have people who are sick and who have limited access to services.

These are the two players at the table. They sit down with the government (our representatives, many of whom were elected in campaigns funded in large part by the two money players at the table) and they are going to "fix" the system. Except from their perspective it isn't really broken. It just needs to be spun out again so the masses will stop complaining.

I don't hold out much hope for a real fix. What ever happens the big players will still make lots of money, and our access will still be limited.
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