Why Healthcare for Profit Sucks

shop.pngAfter 15 years working large corporations I’m now self employed. I’ve decided to be one of those people Conservatives so love to hold up as the example of all they try to protect – the American Small Business Owner.

During my 20’s and 30’s I paid (and paid) into the private insurance industry and took very little back out. Sure, there was the occasional sinus infection or table saw accident, but all things considered I used a tiny fraction of what I paid in to the “system”. Knowing my entrepreneurial aspirations I saved more than 30% of my (really our – my wife Kelly is in this as deeply as I am) income. We set aside the money we would need to fund a startup and support our family.

Short version – we are the kind of Americans the Conservatives love to point at as the example of everything that is right. The irony is, it is their insanity that is killing everything we are doing that the claim to value so highly.

Here is the thing – I can afford the insane price of health insurance (for a while). I can even deal with the fact that it isn’t nearly as good as what I had when I was willing to sell my work to a Fortune 100 software company. What I can’t deal with is that there is virtually no point in having insurance if you have to buy it on the open (free) market.

Last year I had a Kidney Stone. I had no idea what was causing the severe pain – so I did what you are supposed to do, I went to the emergency room. They gave me a CT Scan and diagnosed me with Kidney Stones. Now, I know they are there. My primary care doctor knows they are there. I have a standing order for a days worth of pain medication and if they come back I can fill it and suck it up until it passes.

The problem is, no Insurance Company will cover me for Kidney Stones. Oh, they will sell me Insurance, but they won’t cover ANYTHING having to do with Kidney Stones. I’ll have insurance, but for the only thing at all likely to happen, I‘ve got nothing.

As a businessman, their decision makes perfect sense. Why would they cover me for a potentially recurring affliction? It wouldn’t be profitable. Since, in the free market, businesses make decisions based on profit their decision is not only reasonable but laudable. After all, who would invest in an Insurance Company that repeatedly insured people who were sick?

It isn’t a big leap to imagine what happens next… what happens when you have insurance and get sick? Sure, they’ll pay for the colds, bumps and bruises – but what makes you think they will pay when it gets serious? After all, as good capitalists and free market business people they seek profit – and sick people aren’t profitable. So the game becomes, how do they avoid covering you?

  • Did you fail to disclose something (not something big, but ANYTHING, like an old knee injury)?
  • Did you lie (in a vain attempt to get coverage for Kidney Stones)?
  • Did you make a mistake (make sure you get your kid’s social security numbers right)?

imgres.jpg Trust me, when they are facing hundreds of thousands of dollars costs they have to pay they will get very, very thorough. I know, I would. As would any other business person facing a contract that suddenly is going to cost them hundreds of thousands of dollars.

Listen, I’m not suggesting insurance company employees are bad people – any more than I am for trying to make as much money as possible with my business – what I’m suggesting is that there are things which don’t function well in a profit based system. As hard as that might be to accept – it is just plain true.

Sadly, the Republicans (I’m not talking about Conservatives here, but the Republican Political Party) lost their way. Instead of a rational debate about the role of Government – one which focuses on questions like:

  • Is Healthcare best accomplished within the free-market private sector?
  • What mechanisms can the Government employ to balance profit and the well being of society?

we get a debate about bogey men and death panels. We get ideology and dogma.

I’m no left wing nut job – I’m a capitalist trying to build my own business, and I freely admit I don’t know everything, but I know this:

My healthcare shouldn’t be about profit. Neither should yours.

I’m no fan of government control, but I’m not desperately afraid of it either. Where profit isn’t a good motive the government is as good an option as any other. Frankly, if you’ve got a better suggestion I’d love to hear it, but if you just want to scare me about how awful my healthcare will be when the government runs it – you can forget it – I’m scared enough right now dealing with private health insurance.

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