Sunday, October 04, 2009

The Failure of the Free Market Health Care System

Our national health care debate has included numerous anecdotal accounts of the failures of government-run health care policies. From the blogosphere to the mainstream media – and unfortunately today that includes the Fox network – people have come forward to recount how their relative in Canada, Great Britain, Germany and even Norway suffered illness and eventually died.

The fault is, of course, "socialized health care." Never mind that all of the countries named above have widely different systems of providing health insurance to their citizens. Disregard that not all of these countries practice "socialized health care."

Most of all ignore the fact that under any system, sick people will die and bereaved relatives will be offended and will find fault. Sometimes the faultfinding is justified. Many times grief clouds judgment.

What follows is an account where no one is sick, no one dies. It is anecdotal. Nevertheless, it is a true representation of what happens under the free market capitalist system of health care in the United States of America

A worker for a small concern purchases a high-deductible plan that is combined with a health saving account (HSA). It is the dream plan of the Republican Party. Contributions to the HSA are tax-deductible. Funds from the HSA can be used for the high deductible and health care costs not covered by the health care plan.

It is nice that health care savings are tax-deductible. The worker, however, works for a small firm and has an income that is congruent with working for a small firm. Contributions to the HSA necessarily come after paying for daily living expenses. Then there are the health care costs that drain the HSA even while the worker is trying to build this account with tax-deductible contributions.

This system requires constant vigilance.

Happily, the worker is healthy. The worker has healthy habits. The worker exercises regularly. The worker has a healthy diet. The worker is no athlete, and is not young. The worker is responsible and takes full advantage of the yearly physical examinations and screening tests covered by the high-deductible plan.

The worker pays the premiums of the high-deductible plan for two years, during which time the premiums increase no less than three times.

This is where the tale gets interesting.

After the first examination, a condition is revealed which in and of itself is not life-threatening, but could be serious. There are no symptoms of illness. There is only the possibility of illness.

The premiums for the high-deductible health plan go up again. The worker applies for a lower premium plan from another company. The worker's income has never gone up to meet the increase of the premiums.

The healthy worker is denied coverage by the alternate company because of the non-life-threatening condition revealed in the earlier examination. The worker is stuck with paying a higher premium.

The Republican Party has advocated that the free market system offers workers the freedom to make choices congruent with their income. Citizens can choose their health care providers. They can choose their doctors. They can control costs.

The Republican Party needs to return to planet earth.

The only freedom the present system provides is the freedom of heath care insurers to deny coverage and increase profits.

Anyone who is otherwise healthy will have a "pre-existing" condition simply because they have some existence.

The present system of health care provides no freedom for those who have employer-based insurance. It tethers them to their employer. The present system of health care provides no freedom to those who do not have employer-based insurance. They are at the mercy of companies who can deny coverage for the least reason. The present system provides no freedom for the 45 million who are uninsured. They ignore their symptoms until they need the emergency room. Or they die.

The citizens of the United States are at the mercy of so-called health care insurance providers whose motive is profit and not health care.

Read this essay again. It is not the tale of a sick person needing health care. It is the tale of a healthy person trying to pay for health care in this so-called free market and finding no freedom at all.

This is not my story. I have no health care insurance. I have too many pre-existing conditions. I will probably die before there is a civilized health care system in this greatest country the world has known.

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