Originally Posted by oldgoat
You are so right. I just signed up for Medicare. Hope the guvment doesn't come in and mess that up!!
(Medicare has far lower administrative costs than private insurance. Signing up took me 10 minutes on line and it was processed in 5 days. And anyone who thinks that private insurance does a great job has never had to fight for coverage with their private insurance company.)
This is so much the truth (the private insurance fight- too young to have first hand experience with medicare).
I am a neurologically interesting person that happens to be predisposed to problems like epilepsy. I have also had a LOT of concussions- NFL player style levels of concussions.
A few years ago, all of that coalesced into me having a migraine that lasted 4 months, with both audio and visual aura, along with a new icepick-stabbing pain in my temple that has now become the precursor aura that I get just before I have a good fun migraine.
I couldn't see well enough to read, was dizzy, nauseated to the point of vomiting, couldn't be in a lighted room, was completely unfunctional. I lost somewhere between 70-80 lbs. because I couldn't stand to eat and often couldn't keep it down anyways.
The first specialist I go to recommends an injection into the nerves causing the problem to deaden them for a few years- to give more standard prophylactic migraine meds a chance to take hold. Otherwise the drugs are useless because the nerves are pissed off pas the point of no return and never stop doing their thing.
But, my insurance just happens to be the only one of the major insurance companies that do not cover the procedure because the injected drug costed about $10,000. Instead, they called the treatment "experimental," which they get to do at their sole discretion no matter the amount of peer review studies validating the treatment. So despite the fact that I had tried every other method of treatment available, no dice.
I got a second and third opinion. All doctors concur that the other treatments have been ineffective, and this one is it. Meanwhile, I am out of work, racking up medical bills, and if I my employer had any other insurance company, this would be over.
I appealed the decision not to cover the drug. In my appeal, I explained we had attempted all other treatment methods covered with no success, and if the insurance company refused to cover the consensus treatment option, what did they see as the next thing to try in the way of treatment?
The response to the appeal was "Your appeal is denied, this treatment is experimental, we are not doctors and cannot give you medical advice as to treatment (although we can freely overrule your docs when it suits us), if you wish to contest this further your next step is to come out to California and sue us."
See, if the big, bad government is in control of health care, I can throw the bums out. I can find somebody to listen and make motions like they care, even if it is just to make members of the other party look bad. There is nothing I can do to compel a private company to do something they don't want to do if I can't get it to make economic sense for them. I can't even vote with my wallet, because I don't choose who my insurer is- my employer does, and I can't (at the time) get private insurance, because I have a pre-existing condition. I had no choice but to puke and bear it.
I graduated with "High Distinction" in economics. Almost all of the economists I've met, and all but one of my professors were full on Libertarians and believed in the ability of the market to sort things out in almost all situations. Most of my professors would not accept the idea that highways should be public enterprises, and would instead argue that there is no reason we shouldn't allow the privatization of all roads for efficiency. These professors made Ron Paul look like Bernie Sanders.
The interesting part is that they would accept an argument that publicly funded health care was sensible- that no part of our current healthcare system came close enough to perfect competition to expect a competitive market would result from deregulation, and certain assumptions to perfect competition, notably perfect information, is probably not possible to even approach because doctors go to med school and we don't- the consumer will almost always have a significant, insurmountable, information deficit. In the existing US health scheme largely built off of employer-based health insurance, there are very few components of perfect competition that exist or could be reasonably expected to exist with changes to regulatory framework- you can't peel back regulatory layers in the healthcare market and expect costs to go down and insured to go up- you can only expect forms to make more money.
Finally, the problem with private health insurance in the argument these professors accepted is that the profit maximization of health care firms and overall public health do not align- health insurance firms make additional profit by limiting expenses- and those expenses are health services to make and keep people HEALTHY. Health insurance companies are motivated to cull sick members from their insurance rolls, and denying expensive care to others, in many cases regardless of actual need of the individual trying to get the service. The typical feedback mechanism to this behavior is a loss of customers from poor service, but the person who receives the poor service is not the one that chose the firm- the employer did and the employer is motivated by their own profit maximization.
The argument became that our health system has become so screwed up, moving to publicly funded healthcare becomes an efficiency improvement- while at the same time also taking care of the moral problem of millions of uninsured people. Incidentally, this is also a conclusion that every other industrialized country in the world came to- which certainly does make America Exceptional in this regard.
So, this is an argument my ultra-libertarian, "the function of government is to provide for defense of the state and enforce property rights, AND NOTHING ELSE" econ professors accepted. I know this because these arguments made up my senior thesis- which was accepted, praised, and resulted in the "High Distinction" part added to my degree.