Enough About The System

I was recently listening to the October 18th This American Life on health insurance and it hit on quite a few poorly thought out, but nonetheless widely held ideas.

In one section they go over the conflict between insurance companies trying to keep prices down vs. drug companies trying to promote their most profitable drugs. The basic dynamics were presented accurately: drug companies want expensive drugs covered that aren’t always necessary while health insurance companies fight against unnecessarily costly drugs they also do so in a manner that sometimes causes people to not get the drugs they need. And then we’re told it’s “the system” and they’re just following incentives.

All well and good until you think about that fact both political parties have been tweaking “the system” fairly regularly and doing so with significant input from insurance and drug companies. Neither industry is overly interested in proposing any sort of compromise on this particular issue, so people get hurt.

We’re treated to lots of talk about how health insurance are driven by systematic factors though out the whole show. Insurance companies are made up of good people, systematically forced to do bad things. The whole train of thought holds up only as long as you ignore their own input to their own situation. Health insurance lobbyists have torpedoed reform efforts for years and done so in a ethically horrendous and dishonest manner. If the good people of the health insurance companies wanted to avoid rescission or denying coverage based on preexisting conditions you’d have no way of knowing it because they’ve spent decades pushing against the reforms that would make them unnecessary.

You hear the system excuse for denying coverage, drugs and procedures all the time. And once they find a new loophole to exploit you’ll hear it again to defend that practice. We need more discussion of the manipulation of the system instead of more excuses about how we’re all pawns.



2 comments so far

  1. jeremydc on

    I have a different take on this. You’re essentially reacting to the “don’t hate the player, hate the game” argument by saying “no, actually we should hate the player”. Yeah, the players in this case certainly aren’t blameless, but the core problem actually IS the game.

    What’s the “game” here? It’s the profit motive. Look at all the problems with our health care system. Can you name ONE that isn’t a direct result of the profit motive? I know I can’t.

    Bottom line: until the profit motive is removed from the health care sector in this country, nothing will drastically improve. There’s a reason why every other country in the advanced industrial world has universal, single-payer health care, and it’s the same reason why all of those countries spend waaaaay less on health care than we do. They’ve figured out that the profit motive and health care don’t mix well.

  2. Christopher on

    “Can you name ONE that isn’t a direct result of the profit motive?

    Every industry has a profit motive, but they don’t all act the same way. Sometimes they encourage regulation, sometimes they’re passive, sometimes they run slanderous ads attacking the President. They could have supported efforts to reform, just like some fossil fuel companies have encouraged cap and trade, but they made the choice to encourage the system.

    Also every country has universal coverage, but not single payer systems.

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