Single-payer won’t be perfect, but better than this
References to “people who want to keep their health care plan” abound as talking points in the Democratic presidential campaign.
As the enrollment period ends, I’d love to know who these people are and why they cherish their private insurance so much.
Unless they’re union members who are enjoying lavish coverage, it just doesn’t compute.
My experience is that the hybrid Medicare/private mess that most of us over 65 deal with is largely incomprehensible.
Does anyone enjoy those cryptic “explanation of benefits” documents we receive every so often from Medicare and the private carriers? Does anyone enjoy poring through a formulary to decipher which are “tier one” or “tier two” drugs and which are so special that they don’t fit into any tier at all?
Sounds like a play on the lyrics from “White Rabbit.”
Insurance companies make decisions about what treatments or drugs are appropriate for us, even though they have never examined or even met us.
Decisions — often “no” — are made hundreds of miles away by overworked functionaries who likely are judged at least in part by how well their decisions enhance the profitability of their company.
A case in point. Following hip surgery, my wife was experiencing unexpected, chronic pain. She went to the surgeon, who prescribed two drugs. At CVS, one was available for pickup, but the other needed “preauthorization” from the insurance company. By midday the next day, that approval had not yet occurred, so the wait continued, and she lost a day’s worth of benefit from the medication.
Meanwhile, a bunch of people were involved in this little tempest, and not one of them added any value. There’s my wife, repeatedly calling the doctor’s office and working through the phone tree, dutifully spelling her name and providing date of birth. Then there’s the person who eventually answers the call and presumably takes some action or other to resolve the issue. Then there’s the pharmacy, hands tied, waiting for an OK from someone many miles away who probably isn’t even a medical professional.
When approval is ultimately received, my wife drives a 5,000 pound car on a 24-mile trip to pick up a vial of pills.
Imagine, this vignette must happen millions of times, every day, all around the country. Of all the questions that can be raised, one stands out: Who benefits? Not the patient, not the doctor, not the pharmacy. That leaves the middleman, the insurance company.
Insurance companies raise their rates pretty much at will. Our supplementary plan went up about $25 a month for next year, and our drug coverage will go up about $24.
I’ve asked both carriers — in writing, since they are inaccessible by phone — whether these increases mean that we will be receiving enhanced benefits in some way. I think I know the answer.
So, much as I’d miss the endless waits on hold on 1-800 lines, and the fat mailings riddled with arcane insurance terms, I’m in favor of a single-payer plan, sight unseen.
Given what we’re already paying for health care, one way or the other, wouldn’t it be worth paying a little more if it meant that everyone would have coverage? If it meant that emergency rooms could focus on true emergencies? If it meant that all of us could walk into any pharmacy or doctor’s office and flash a single card to receive treatment?
I’m not naive enough to think single payer will be a panacea or work perfectly. But it’s clear that the fragmented, public-private system we have now does not work well. The thought of turning the whole thing over to the government terrifies my conservative side, but the idiocy of our present course scares me worse.