Right now, health care insurers work like a virtual monopoly. They simply don’t compete in many areas. That’s because they are afraid that if one of them starts to clean up it’s act, they’ll all have to follow suit, and that would me lower profits for themselves and their share holders. So you don’t seem them advertising about how they’ll drop pre-exisiting condition clauses, or guarantee that you don’t lose your insurance when you get sick. The best way for them to make profits is to collect as much money in premiums as they can, without paying any of it out. That way, money can be paid to stock holders instead of paying for patient care.

I love the idea of insurance co-ops, and it’s one of those things that should have happened a long time ago. In a co-op, just in a banking co-op, the insurance company will actually be owned by the customers. If you are paying in on an insurance policy, you are a part owner of the co-op. There are no share holders, so all the money, in theory, can be used to run the company and pay medical bills. The problem is that co-ops will be under exactly the same pressures as the private insurance companies. They will quickly realize that they will have lower costs if no one is sick, and since healthy members will outnumber sick ones, it is easy to see what could happen. Insurance co-ops might become even more draconian than the private insurance companies when it comes to trying to keep sick people off the rolls.

The public option would give us an insurance plan run by the government that would never refuse someone, and could provide good basic care at reasonable prices. In order to be attractive, private and co-op insurance would have to beat the public option.

Just by having the option in place, a lot of waste will go away. We won’t have hospitals constantly trying to shuffle poor and homeless people out the door. The hospitals won’t have their emergency rooms crowded with people who may or may not be able to pay. Since people will have insurance, hopefully they will go to doctors before they get so sick they need emergency services. That might actually make it easier to get care

There are a lot of details to be worked out, but I believe that the best system right now would include a public option and insurance co-ops and that they should be given as much freedom to compete against private companies as possible. There also need to be provisions that will keep private insurance companies from just dumping expensive patients into the public and co-op systems. But I think we have a good start here, as long as we hold onto the public option.

Unfortunately, the option I think is the best, a single payer system where we can choose between a number of insurance companies, including public and co-op, but it’s all paid for by the government, is apparently off the table. You don’t hear about this much in the press, but if you look at the boards of directors of media companies and those of pharmaceutical companies, it’s not hard to figure out why. Take a look at this article for more: Single-Payer & Interlocking Directorates

There is a lot that can be done directly, but the various special interest want to cloud the issue so as little as possible is done. For instance, we could simply pass a law that says that insurance companies can not pick and choose. If an applicant can pay the premiums, the insurance company must accept them. No forcing people with pre-exisiting conditions to wait a year or two before they are covered. As long as you make the rules the same for everyone, it would work just fine.

When you don’t have insurance, what do you do? You don’t go to the doctor. You keep hoping you’ll get better. Sometimes that works. Sometimes you just die. But too many times, you wait too long and then you wind up going to the emergency room. By then, what you have is very serious and it costs a whole lot of money to fix it.

How do I know? Because it happened to me when I was twenty. I got sick but had no insurance. If I had gone to the doctor and been properly diagnosed, it would have costs less than ten dollars a month to treat my disease. Instead, I didn’t go in until I was nearly dead and had to be carried in by friends. I had to spend two days in intensive care and another twelve days in a ward. It cost over twenty thousand dollars, and that was almost thirty years ago. I’m sure it would have cost a lot more now.

I’ve talked to other people who have the same disease I had, which is chronic, and many of them didn’t have insurance. They also couldn’t afford the medicine. So, in one man’s case, he would be back at the hospital every couple of months. He’d use up resources and take up a be for several days before he’d be well enough to leave. He couldn’t hold down a job because of his frequent absence due to his illness. He had to get by with day labor. If he’d had insurance, his disease could have been managed as mine was after my incident in the hospital. I only went into the hospital because of that disease one more time, and that was fifteen years later, and it was to have the offending organ removed.

Treating that poor gentleman probably cost far more than my insurance premiums. In fact, I’d be willing to bet that treating him cost more in a single year than my insurance has cost myself and my employers that whole time.

I suspect that the man I’m refering to is probably dead by now, even though he was the same age as I was. Had he had insurance he could have worked a better job. He would have been a productive member of society. Instead he wound up having a miserable, and probably short, life. If I’d not been very lucky, that could have been me. It could have been you.

My father did some work for a hospital down in Florida. He was a marketing consultant. They asked him about a problem they had. They were a private hospital, but they were the only game in town, and never turned anyone away who needed care. They had just invested in a couple of birthing rooms.

Unfortunately, because of the way the county was zoned, everyone was either VERY rich, or VERY poor. The very poor women in the comunity were coming in with premature labor, underweight sick babies. The hospital often had to use the birthing rooms for these indigent patients. It was costing them a great deal of money.

My father made a simple suggestion: he told them that the best way to solve this problem was to send a van out to the poor part of the county once a week. The nurses in the van sought out pregnant women and taught them about proper diet, excercise, and the need to refrain from drug use. The nurses also handed out pregnancy vitamins and helped the women have full term pregnancies, which resulted in healthier babies.

The hospital was able to go back to charging an arm and a leg for the birthing rooms. The poor women in the community were taken care of and had healthier babies. The van and the nurses cost the hospital some money, but far less than the profits they were losing on the birthing rooms.

Good community healthcare just makes sense and it saves money.