Flirting With Relevance

There is one thing on which President Obama and I agree. The current health care system in this country is broken. Not the part that actually provides medical care, of course. For most part, the doctors and nurses in the trenches are, on the whole, dedicated and competent professionals who take pride in their role in keeping us healthy.

What’s broken, I think everyone will agree, is how we pay for it; in other words: health insurance. In the the United States, as if I need to tell you, most people who have health insurance receive it through their employers as a benefit. Increasingly people pay for at least part of their premiums but the insurance is still part of their benefits package.

The problem, if you ask me, isn’t whose paying for but what they’re paying for. If our auto insurance worked like health insurance, we would be filing claims for every oil change. We’d have to file a claim to have the air in the tires checked another to have them inflated. We might then find out that our policy covers air but not nitrogen. Fixing a broken air conditioner might be seen as “elective.”

That’s not how it works, of course. We carry auto insurance to protect us from the costs of something really, really bad happening to our car (or because of our car). That’s what insurance is (or what it’s supposed to be): a shield against financial ruin resulting from extraordinary misfortune. Our homeowner’s insurance pays for fire damage but not to have the gutters cleaned.

Health insurance, as it exists today, is apparently a shield against any costs related to our own medical upkeep. A case of the sniffles generates the same paperwork as a case of pancreatic cancer (only less of it).

This is no doubt the main reason why nurses are in such short supply (or at least seem to be). There are not enough of them to care for the patients and fill out the mountains of burdensome paperwork required by the insurance machine, paper that they hope will result in their being paid at least some of what their labors are worth.

Now, if little Timmy’s case of the sniffles does not generate any insurance paperwork, then the nursing staff could spend more time actually nursing and less on busywork that does nothing to enhance the well-being of the patient. Since minor, everyday little health crises like that make up the vast majority of work for your average doctors, eliminating the paperwork related to such visits would go along way to hemming in the runaway costs of medical care. The health care industry is drowning in red tape and it’s going to take us, the consumers, changing the expectations we have of our health insurance, to fix this mess we’re in.

I’m not saying health insurers don’t perform some very useful functions. By virtue of their size, insurance companies can negotiate with the medical providers for the best price. I don’t, however, need my auto insurance company negotiating the cost of my next oil change. I do need them haggling with the body shop over how much it will cost to reattach the front end of my car if someone wraps it around a tree.

The biggest problem is with us. We’ve come to expect our health plans to cover every little medical expense, no matter how trivial, from cradle to grave. That has forced the medical providers (our doctors and nurses, in plain English) to negotiate with the insurance companies on every little case that passes through the examining room. This is neither beneficial to the quality of health care nor is it necessary.

At this point, adopting either a national health system or a single payer system is pointless. With the medical industry in its current shape. That would be like hiring a hooker for your grandfather on his deathbed. He may appreciate it, but it isn’t going to help him.