

Why health care reform is likely to fail again



With the majority of Americans satisfied with (and probably not using and testing the quality of) their health insurance, change is scary to them.  Their self interest is the cost, access to care and quality of care for themselves.  Many of these people don’t see the real cost of their health care because most of it is paid by their employer.   The employers are paying for health care – a tax on them rather than their employees.  To move to any public system would mean the burden of paying for it would shift from employer to the tax payer in one way or another.  When choosing between having the employer pay the cost and the tax payer pay the cost, you know what tax payers will prefer.

Employers are shedding their health care burden by going to high deductible plans or canceling insurance coverage.  But not enough people who vote are dissatisfied with these plans or have lost their insurance.

Insurance companies are canceling policies and refusing to pay for needed care that most people find offensive.  But because most people are on group policies where this doesn’t happen or happen as often, not enough people who vote have been personally touched by these horror stories to be motivated to risk what they’ve got for reform.

Controlling costs is a nightmare no one really wants to face.  Yes, efficiency and quality can be improved to a degree.  But we can’t afford to give gold plated care to everyone.  And everyone wants the best care they can get.  I don’t want Walmart to do my heart bypass surgery thank you.

This means the delay or denial of care in one form or another whether through the ability to pay co-pay, or the kind of insurance one can afford.  Right now we’re angry at insurance companies for denying care.  Were we to have a public plan, we’d be angry at the government for denying care.  We can look at the lower cost of care in other countries who have public plans but they too are facing escalating costs for care just like we are.  They may have more efficient systems but technology is still driving costs up and up.  Increased quality of life and longevity isn’t free, although healthy lifestyle (diet, exercise, stress reduction) can significantly decrease these costs.  Unfortunately, the last thing Americans want to do is give up their Big Mac and fries.

Much as I’d like to see an overhaul of our health care delivery system, I don’t see it happening yet.  There just isn’t enough dissatisfaction among voters with what we’ve got.  We’re close.  But the ability of the Republicans to get away with stonewalling the issue and just say no to any reform  suggests to me that people’s self interest in reform isn’t there.  Their just aren’t enough voters mad enough or scared enough about their own situation to risk changing to something new.  (one factor may be because the baby boomers are close enough to retirement, they know they’ll be in that system soon enough and can stop worrying about their current insurance situation)

In the interim, my biggest hope is we get at least some reform about how insurance companies operate.  At the minimum, if we can stop them from not selling insurance based on pre-existing conditions and/or denying care because of pre-existing conditions, I’d call that a great success.

Categories: General
Sam Trumbore

3 Responses

  1. iknowtruthismine says:

    As long as the insurance and pharmaceutical companies have even the smallest hand in the health system, it will remain corrupted, as was pointed out by the revelations of Wendell Potter (former VP at Cigna Health) ,who cut open the bloated and fetid belly of these industries’ blatant thievery, at the cost of the lives of those frozen out of care, in-order to keep their profit margins up. It is time to eliminate the “profit” cut from health care and plow that portion back into providing wider coverage for all in a One-Payer-Plan, for starts.


    This just doesn’t feel true to me. At the small vigil I hosted last night, everyone had a story about someone they knew who had problems with the current system. It may not have been a story about themselves personally, but it still touched them. So I so hope you’re wrong! We just got to hope that compassion wins out over self-interest.

  3. Robb Smith says:

    President Obama won the election in a landslide because people who vote cared about his platform, including universal health care. Loud knownothings (Teabaggers, etc.) notwithstanding, the voters are fed up with our inefficient insurance system, which places the burden for the uninsured on local property tax payers and turns human pain and suffering into a commodity.