Friday, November 8, 2013

HCR -- Insurance is Not Health Care

Attacks on Obamacare are getting on my nerves.

Lost in what passes for "discussion" is the simple fact that the costs and availability of health care are not the same as the costs or availability of insurance.
  • The role of insurance providers is the manage risks associated with payment
  • The role of health care providers is to manage risks associated with health care.
What the PPACA did, for the first time, is define clearly that minimal health care is now available for nearly everybody in America, and for the first time it will be "affordable."

To that end the role and limits of what we carelessly call "insurance" have been clearly defined. Those limits are still full of holes. The refusal of sixteen states to expand Medicaid has torn the holes open even further. And a non-health care industry is still sucking off twenty percent of "insurance" premiums for shareholder profits, sales bonuses, advertising, other marketing and contributions to executive compensation packages -- in addition to whatever administrative costs are incurred in managing the actuarial and administrative functions -- none of which, please notice, are costs of health care.

The fact is that most Americans were already "insured" to receive health care one way or another before the legislation, but only a few really understood how much that care is really costing. The reasons include employer and tax subsidies, a large number of beneficiaries actually receiving true "government health care" through the VA, armed forces medical services, community clinics, Medicaid and emergency care mandated by EMTALA. In none of those cases did the costs of care interfere with the availability of care -- sometimes excellent, sometimes barely minimal.

Now that those costs are being made clear through new insurance limits, many people are shocked, shocked I tell you, that those costs are so damn high.
Welcome to the real world, Virginia. No matter what you thought before your
elected officials finally did something to reveal the hemorrhage that was about to bleed the economy dry, you now know there is problem.

The problem is not, and has never been, the costs of insurance, but the costs of health care. What America is now facing is the economic equivalent of adult onset diabetes. If we don't control our appetites and cut back on sugar, we're gonna face consequences no one wants to have, up to and including a good chance of being dead.

It's time to face reality. This is about the bloated costs of health care, not the costs of insurance.

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