Why pay for insurance if the insurance company isn't going to pay for the services that you signed up for them to pay for?

Kos, proprietor of Daily Kos, lives just up the road in Berkeley and has had a heck of a time trying to get his insurance provider, Blue Shield, to pay for an anesthesiology procedure. "Of course, we never asked them to process this at the 'preferred rate'," he says. "We ask [sic] them to pay for the service. That's why we're paying over $800/month in insurance premiums. To be insured." He concludes, "How could a government-run service be any worse than these unaccountable, unethical, disgusting creeps?"

Opponents of government-run healthcare claim that such a system would be inefficient, but in the United States, people with private insurance often have to deal with each physician individually if they're taken care of by a team of physicians (e.g., if a person had surgery, that person may have to deal with each doctor's billing individually). Furthermore, even though you're paying hundreds of dollars per month for that insurance, there's no guarantee that the insurance company will pay for your treatment. This goes back to what I said the other day: insurance companies are more than happy to pay for a prescription here or there, but when it comes to expensive procedures, they don't want to pay, and they insert language into your contract that gives them the right to waive payment for expensive procedures whenever they want. You may think that you're covered, but for any given procedure, there may be a loophole that exempts the healthcare provider from paying for it.

The price of healthcare (guess what? It's steep)

A study published by the Kaiser Family Foundation in 2004 found that the price of healthcare is rising faster than employee wages:

“Since 2000, the cost of health insurance has risen 59 percent, while workers wages have increased only 12 percent. Since 2001, employee contributions increased 57 percent for single coverage and 49 percent for family coverage, while workers wages have increased only 12 percent. This is why fewer small employers are offering coverage, and why fewer workers are taking-up coverage,” said Jon Gabel, vice president for Health Systems Studies at the Health Research and Educational Trust.

Let's be completely clear: "employer-provided" does not always mean that the employer pays for your healthcare. What is more likely than not is that you pay a certain amount per month for your healthcare. At my job, $30 is deducted from each paycheck to pay for my healthcare plan, if I elect to enroll in a healthcare plan (which, of course, I emphatically do).

And for the people out there who insist that, if you don't have employer-provided healthcare, you should just purchase your own: let's crunch the numbers. Purchasing your own healthcare is very expensive; in fact, it could be considered a regressive tax (the tax rate increasing as income decreases), since people at the lowest incomes are less likely to have jobs that provide them with healthcare, forcing them to obtain private healthcare at a cost many times that of what employees with employer-provided healthcare pay. The Kaiser Foundation found that people who purchase their own insurance pay an average of $308 for single coverage; as I mentioned above, I pay $30 a month. Does it make much sense that the people who are least in a position to pay a lot for healthcare are the ones who are most often going to pay a lot for healthcare?

Or you could just go without healthcare. President Bush feels that we have a very robust healthcare system for those who don't qualify for Medicare or Medicaid, or don't have their own insurance. "The immediate goal is to make sure there are more people on private insurance plans," he said in Cleveland on July 10. "I mean, people have access to health care in America. After all, you just go to an emergency room." Bush is technically correct in that federal law requires emergency rooms to treat patients regardless of their ability to pay; however, this near-sighted philosophy ignores the fact that (1) emergency room care is very expensive; and (2) the cost of treating the emergency patient could have been significantly reduced had the patient had access to preventative care, eliminating his need to use expensive emergency care.

But, to paraphrase Kanye West, George Bush doesn't care about poor people. He has demonstrated time and time again that it is more important to allow private industry to make money than it is to permit people to survive -- and by "survive," I mean "not die." This is also the situation in Iraq, where incompetent private contractors get no-bid contracts and then proceed to not do things they said they would.