Here's to Your Health VII

In all the back and forth over healthcare reform, particularly in the portions of the debate that concern the insurance industry--images of Republican lawmakers getting the vapors at the thought of helpless insurers being steamrolled by government competition spring to mind--one fact is often overlooked. Namely, insurance is the only industry whose successful business models depends on NOT serving its customers.



Think about it: Does McDonalds' discourage people from eating french fries? Would Nike make money by encouraging people to go barefoot? No. But a surefire way for insurers to increase profits is to deny the coverage that people pay for. Or to refuse to accept potentially costly clients in the first place.



In certain instances, this makes sense. An auto insurer is within its rights to refuse coverage to someone with a history of causing accidents. But driving is something that people can choose to do or not to do, and accidents can be avoided if drivers are careful. Someone who has congenital heart disease is hardly responsible for his own plight, but that doesn't matter when he tries to find insurance.



We just looked at that last sentence and realized that it gets to the heart of the problem. People with congenital heart disease--or any illness--don't want health insurance. In fact, NOBODY wants or, frankly, needs health insurance. What people want is healthCARE. People want to be able to see a doctor when they get sick, and they don't want to go bankrupt in the process. Neither of these seems particularly unreasonable.



At some point, it became the province of insurance companies to act as middlemen to see that these desires were met. Unfortunately, too many people in authority now seem to think that the needs of the middlemen are equal--or superior--to those of the people actually involved in the decisions, i.e., doctors and patients.



The only way we will ever have a rational healthcare system is to stop worrying--completely stop worrying--about the insurance industry. We are not naive, and we recognize that the industry is a stakeholder because of the money they throw into the political process. But we need to keep proclaiming loud and clear: The insurance industry is not an essential component of healthcare reform. No insurance company ever performed an appendectomy or cured a disease or delivered a baby. Any direct role an insurance company ever played in anyone's healthcare has probably been a negative one: A decision to deny coverage or a mandate to pursue a cheaper course of treatment regardless of relative efficacy.



Say it loud, say it clear, and say it often: Health insurers do not care about your health; NO ONE should care about theirs.