Our system of health insurance is a disaster

One of the major arguments for health insurance reform is that we need to cover adequately all those millions who, for one reason or another, are excluded from health insurance today. Oh, if that were really true. Let's be accurate here: the current system of health insurance -- the system that requires it be provided by private insurance companies -- is an unmitigated disaster even for those who are offered it and can afford to pay its premiums. In fact, if we could find a way to cover all the excluded with private health insurance, it would actually make the problem worse, not better.

If you want proof of this, check out a study that will be published in the August issue of the American Journal of Medicine reporting that 62 percent of all bankruptcies filed in the United States last year are the result of unaffordable medical bills and, what's more, 75 percent of those people filing had health insurance. Not only that, the problem is getting worse. Only 46 percent of the bankruptcies filed in 2001 were because of medical bills.

Here's the issue: As long as greedy, profit-driven private insurance companies control payments, there is more of an incentive on their parts not to pay for medical procedures than to pay for them. Agents who find ways to deny the most claims are rewarded with bonuses. Our own insurance companies kill more Americans each year than Iraqi insurgents simply by refusing to pay for life-saving medical treatments.

The major argument the insurance companies always mount to counter demands for a government-operated single-payer health insurance system is this: "Would you rather have a doctor deciding your medical treatment or a government bureaucrat?" What a load of crap. For one thing, doctors have always and will always decide on the best medical treatment. Almost every industrialized nation in the world currently has a government-run single-payer health insurance system and in every single one of those, doctors make all the medical decisions. The problem with our current system is that you have some yokel (a bureaucrat) sitting in an insurance company deciding whether that company will pay for the treatment the doctor has recommended. Under a government-run program, that treatment will be far less expensive because one major cost layer has been removed -- the profits of the insurance company.

Not only that, most insurance companies don't even let you chose the doctor you would prefer. I would like to be able to afford to be treated by the doctor I choose and not to have payments for those treatments denied because it could eliminate the bonus to some greedy insurance executive.

A couple of days ago, I addressed the cost of such a system in tax dollars. But this cost is minimal compared to the alternative of pressing personal debts and bankruptcy.