President Obama will likely abandon a public option and let our health insurance industry reform itself. This will not stop impeding disaster. Here's why
1. Choosing an insurance policy is not choosing a physician. If your physician does not participate in your policy, you don't see her. If you change jobs or move, you change physicians. If you lose your job, you might lose the chance to see any physician at all.
2. No one knows the best insurance policy for their family. Does anyone understand exactly what their policy will cover? What conditions? What therapies? Which physicians? Can anyone be certain their particular policy is more cost-effective than the hundreds of others? You won't know if you have chosen wisely until your family faces a serious illness. When the bills start pouring in, that's a rough time to discover you should have picked another policy.
3. Neither private nor public health insurance will prevent medical bankruptcies. Even if you are lucky enough to acquire a covered disease, your deductibles, co-pays, medications, and maximum payout limits can drive your family into financial ruin. Half the American bankruptcies in 2007 were precipitated by medical crises in families who thought their private health insurance would protect them. They paid a high price for being wrong.
4. Freedom to buy health insurance is not freedom to get health care. Before your insurance company pays anything, you must first pay premiums and deductibles. If your condition is covered (can you be sure?), you must pay for drugs and co-pays. If your family is struggling to put food on the table, no health insurance policy will ever enable you to get essential health care.
5. Health insurance does not improve public health. The very concept of insurance deters us from seeing physicians until we are ill, eliminating early detection of preventable complications. West Europeans, all of whom enjoy universal health care, see physicians twice as often as we do yet spend half as much with better results. Are we proud that our country ranks 37th in world public health measures?
If you want a great investment, buy health insurance stocks. But if you want health care, the insurance industry solves not one problem. It does not reduce costs. It does not provide essential health care. It does not stop medical bankruptcies. It does not improve public health.
What to do? House Resolution 676 would provide universal health care - that means you, your family, and your friends wherever you are, employed or not. It is a remarkable step toward bringing the US into the community of industrialized nations. Read it (it's only 28 pages of big print). Better still, ask your Representative to read it. But do not rely on your health insurance company for health care.
As long as Americans must chose between paying for health care and paying for food, we cannot call ourselves a civilized country.
Published August 24, 2009 as the "“A doctor's voice: Don't mistake health insurance for health care” in Oregonian (on-line edition) and The Stump
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