Friday, August 14, 2009

Health Care - Part 1-4 Ensuring the freedom to choose your health care providers

4) Ensuring the freedom to choose your health care providers.
What? Isn’t this what the opponents of health care reform are fighting for? I thought the government was going to run health care and choose my doctor for me once “Obamacare” was the law of the land. Let’s examine this for a moment.

First question: Who out there can visit any doctor they want to for any service whatsoever? That’s correct, everyone! Yes, assuming you have unlimited dollars at your disposal, you are free to visit any doctor you like at any time, providing they are accepting new patients and have room in the schedule.

So, let’s ask that question differently: Who out there is free to visit any doctor they want to for any service whatsoever and have it covered by their current insurance? Ah, now we have a different result. I can see very few virtual hands. . . practically none. In fact, the few people who have their hands up seem to be elderly. Why is that? because just about the only system that has anything even close to universal acceptance and coverage in the US is the medicare system, which covers senior citizens and is a single payer government system. Also interesting, the vast majority of seniors are much happier with medicare than most of us are with our expensive private insurance schemes.

No, medicare doesn’t cover EVERYTHING. No insurance does. However, most private insurance is much more restrictive about which doctors you can and cannot see and what you pay to see them. My PPO, for example, allows me to see any doctor I want BUT only if I am willing and able to pay a much higher out of pocket maximum per year as well as a much larger percentage of the cost for each visit or procedure. As a result, my much vaunted freedom of choice is an illusion. I don’t have the resources required to go “out of network” and so I don’t. My network is pretty good but my insurance is outrageously expensive too. The alternatives provided by my wife’s employer, who shall remain nameless, all offer more restrictive options and, though they cost less than the one we have chosen, they are still expensive. If you have an HMO you probably have little, if any, say as to which doctor you see. Only medicare is close to universal, though it too falls short.

The fact that medicare is so pervasive and well thought of while the debate about health care is so dense and full of misinformation leads to people screaming at the top of their lungs to “keep the government out of my medicare!” What fun. Want to see the lengths this gets to? Check out this gem from the supposedly respectable Arthur Laffer:

Laffer knows better and that’s a big part of the problem. Rather than represent their arguments with solid facts and figures, opponents of health care reform would rather scare monger and inflame opinion. It’s an old game plan and one that is all too effective. Of course, proponents are only somewhat better, making weak arguments for their positions and claiming more than they can deliver with half hearted reform plans. Still, that’s a far cry from the government “death panels” garbage people like Sara Palin are spreading about.

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