MSimon wrote:This is so for insurance companies as they are large and have little incentive to provide anything more than the minimum service required to continue business, whether they're contracted to do more or not.
And that is part of the moral hazard. I was sorry to see Congress kill Medical Savings Accounts which might have had the effect of at least putting cost pressure on the lower cost procedures. With insurance taking up the slack for catastrophic events.
Sorry been out of the loop for a bit.
I tend to agree with MSimon on most things, being a fiscal conservative that I am.
My only disagreement is that companies have no obligation to be honest or express any form of morality nor ethics. They are by nature greedy and profit seeking. This isn't a bad thing, its the driving force that makes capitalism work and I like that. When companies get so big that they can sway government policy, they will always, without fail, seek to sway laws and policy's so their competitive favor. I'll get back to this point in a minute.
The balance to a companies greed is the universal laws of supply vs demand. Company's supply products, the consumers provide demand. If a Company's product is sub-par or not to the desires of the consumer, then the consumer will go to a different supplier. This is the incentive for companies to deal honestly with customers, bad publicity is bad business.
Now lets go back to a business using it's size to get policy / laws passed that favor it. If a company can do this, then it can dramatically reduce the balancing effect supply vs demand has on it. They don't need to supply a better product, they simply remove a consumers alternatives and thus force demand to their product. There is where we move from capitalism to corporatism where an economy is no longer based on supply vs demand and is now based on big business's vs consumers.
With respect to "healthcare", we're doing it wrong period, no sane person can defend the current US system. I happen to live in a democratic country that practices government regulated healthcare. It happens to be in the worlds top 11 economy's and is growing. There are no crazy long waits at hospitals. If anything, South Korea is more capitalistic then the USA. So any attempt to paint a negative picture will get rebuffed with actual experience.
The governments responsibility in healthcare is not to provide for it, but to ensure the private providers are playing fair. The laws of supply vs demand do not functional the same with healthcare as they do with widgets, computers and cars. The demand for not only your life but your good health is infinite, the supply for those things is limited and controlled by a few players who do not compete with each other. Now we can't alter the demand for your health, but we can alter the supply side of this. Mainly by allowing insurance companies to compete across state lines and authorizing tax-free / deductible (deduct contributions from income earned) MSA's that could be used to pay for health care expenses only. Doing just that would drop the price on healthcare, further deregulation would drop the price even more. You don't need to see a phD for a sniffle / cold / flu. You don't need to see a phD for small fractures (hairline cracks). You do need to see a phD for cardiac problems or other serious health issues.
Anyhow, MSA's were removed because they directly threaten the health insurance companies profits. Say what you want about that bastardized healthcare package that was passed, it incredibly favors the financial provides for the Republican Party. The mandated insurance policy's alone are worth billions in profits. Talk about infinite demand and all that.
-Edit-
MSimon, currently our insurance companies are under no requirement to actually provide the promise for service they've been paid for. "Preexisting Conditions" isn't something people made up, it is a very common tactic for an Insurance company to shed unprofitable contracts (people's health we're talking about). "Unreported medical conditions" is another one, if you had a headache at anytime and didn't report that headache to the insurance company, you've failed to report a medical condition and your insurance is subject to immediate termination. "Improper Documentation" is another one, if any documentation is filled out incorrectly, even if you were not the one filling it out, then your contract may be subject to immediate termination. And the ultimate one "invalid appraisal", basically you were granted coverage that the company felt you shouldn't be, even if you paid for it and even if all the paperwork is legit.
Right now the insurance companies are in control of
state legislation which is significantly more important then federal legislation. Trying to fight your insurance company to pay for any expensive treatment is entirely within your state legal system, and it's a battle field they control. They have bigger legal teams with lots of money and a near infinite supply of cash to fund an extended legal battle. You have your life savings and whatever salary you may or may not have (fired due to health reasons). The chances of you winning against the insurance company if they decide your no longer profitable is very slim. It's possible, especially if you get some media attention going on, but it's not likely.