Clue­less Congress?

Modern Healthcare - - OPINIONS LETTERS -

There is al­ready tremen­dous ra­tioning of care in Amer­ica de­spite the fact that our na­tion has by far the world’s high­est per capita health­care ex­pen­di­tures. Why? Be­cause we have cho­sen to ad­min­is­ter our sys­tem through pri­vate in­sur­ance com­pa­nies. Their goal is to ben­e­fit share­hold­ers and em­ploy­ees—par­tic­u­larly top ex­ec­u­tives, many of whom have seven-fig­ure in­comes. To turn a profit, they must ex­clude those in­di­vid­u­als who are the most likely to re­quire ex­pen­sive care. This is the way that the health­care free-mar­ket works, max­i­miz­ing re­turns for share­hold­ers, not help­ing pa­tients.

If you don’t be­lieve we have ra­tioning, talk to the de­mor­al­ized doc­tors who spend so much of their time try­ing to per­suade in­sur­ance com­pa­nies to pro­vide their rec­om­mended care to sick pa­tients. A ma­jor­ity, or 58%, of physi­cian re­spon­dents in a sur­vey pub­lished in the New Eng­land Jour­nal of Medicine sup­port an ex­pan­sion of Medi­care to Amer­i­cans ages 55 to 64. This route was pro­posed, but then quickly dropped dur­ing the de­bates over health re­form. At a min­i­mum, Congress should have made this in­terim move to­ward univer­sal cov­er­age. Then, we could have ex­panded Medi­care each year to cover more of the pop­u­la­tion un­til truly univer­sal cov­er­age was achieved and costs con­tained.

Iwon­der, does Congress have a clue about what health­care cov­er­age re­ally cov­ers any­more? Has Congress tried call­ing cus­tomer ser­vice at any of the health­care gi­ants like Hu­mana, Blue Cross and Blue Shield, Unit­edHealth, to name a few? I en­cour­age any­one to call the toll-free num­ber listed for any of the gi­ant health­care com­pa­nies and just ask where that rep­re­sen­ta­tive is lo­cated. Nine times out of 10, they are go­ing to tell you they are off­shore, in the Philip­pines, or an­other coun­try.

OK, so here’s the sce­nario: Amer­i­cans pur­chase health in­sur­ance, and pay out­ra­geous pre­mi­ums that will pay for you to have one rou­tine pre­ven­tive exam plus a few screen­ings each year. If you get sick and see that same doc­tor and he files a claim for treat­ing your ill­ness, you will most likely be sent a bill telling you your in­sur­ance left you a bal­ance to­ward your ex­or­bi­tant de­ductible. So, here you are an Amer­i­can work­ing and pay­ing taxes and your huge health in­sur­ance pre­mium. You get very lit­tle cov­er­age and you can’t even get a job at one of these gi­ant health in­sur­ance Write us with your com­ments. To send us a let­ter elec­tron­i­cally, go to mod­ern­health­­ters; by fax, 312-280-3183.

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