March 24, 2010

Random thoughts on healthcare

I haven't fully digested the bill yet, but I'll post a few random thoughts.

For one thing, anyone who says "the current system is the best in the world and doesn't need to change" hasn't been paying attention. We spend the most per capita, yet we have lower life expectancy and higher infant mortality than many other "Western" countries (not by a huge amount, but for as much as we're spending we should be the best in all these categories, and we're not!)

Part of that is lifestyle, certainly, and changes should be made there, but it's NOT as simple as "so lose weight and go out and buy insurance" like I hear so many people saying. In this country, under the "current" system, it's legal for insurance companies to deny coverage for conditions that are unavoidable. For example, in a pure free market system, no sane insurer is going to cover a Type 1 Diabetic (and KNOWING how much I cost them, I couldn't blame them -- but THAT'S the problem, profit shouldn't be the motivating factor when it comes to people's LIVES). I'm fortunate enough to live in a state that requires coverage of "pre-existing" conditions (after a one-year waiting period -- if I let it lapse, ever, the clock starts ticking again and I'm paying for everything out of pocket) for an employer who provides coverage (companies are NOT required to sell to me as an individual, and even if they did the rates would be astronomical -- thus preventing me from ever taking the risk of opening up a gamer-friendly tea shop)

Some states don't require coverage of diabetes supplies at all. That kind of INCONSISTENCY needs to change.

So, require insurance companies to cover preexisting conditions? Fine, but that opens a DIFFERENT can of worms - people who choose to not have insurance, then get sick and buy it. This completely changes the dynamic of insurance companies' intake vs output, and would bankrupt them in short order. Thus the need to require everyone have it -- that measure is for the insurance companies' BENEFIT, but I don't have a problem with it.

The new rules AREN'T socialized medicine. People who say "now we're trusting the government to make our health care decisions instead of us and our doctors making them for ourselves" are forgetting that in many cases, we ALREADY don't make our own decisions. If you have insurnace, then the insurance company can and will dictate what it covers (again, I know this all to well from experience, having had to fight for almost a year to get coverage for my continuous glucose meter), and if you DON'T have insurance then the decision is based on your budget.

I have concerns and questions about the new rules -- what's it REALLY going to cost, will it REALLY improve coverage, etc., but SOMETHING had to be done, at least now we're talking about it.