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CallaFirestormBW -> RE: Big Government v. Big Corportations (7/20/2009 10:58:43 AM)
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quote:
Why is a big national health insurance company bad, evil, corrupt and inefficient; but the thought of a big government run health provider seen as a solution? Won't they require the same organizational structure which brings with it the same inefficiencies and corruption? Is it personal preference; the desire to pay taxes over paying a company's price? Or is it something more relevant to WIITWD?
A big national health insurance company, if a private entity, MAY be bad, evil, corrupt, and inefficient, and it may not. The issue, for me, isn't the -size- of the entity (whether government or private) but the PURPOSE of the entity. If the entity exists to make a profit for 3rd party shareholders, it does NOT need to be handling our primary health care.
Additionally, we're not talking about ONE giant corporation here, but MANY megolithic, profit-driven companies. Profit is great. It definitely has a place in the greater scheme of things (though I disagree with the whole concept of "continuous growth"). However, it is well established and evidence has been provided to Congress as far back as the 1970s that profit-driven insurance companies can and -do- make medical decisions on which patients' lives rest, based on the economic outcome for the company.
The policy of basing economic decision on potential profit for the company is completely appropriate for a company where lives are not at stake, but the premise of an insurance company is flawed from the get-go. MOST people will get -sick- or have an accident and cost the insurance company money. MOST people will, as they age, require money to be spent on their medical care. Therefore, a company that -gambles- based on long odds of being able to keep more money than they pay to cover beneficiary "events" in a model where -most- of the beneficiaries are going to -have- "events", and where the remaining investment income meant to cover their beneficiaries is then -gambled- again through secondary investment in things like the Stock Market (which is nothing more than legalized gambling), and where these gambled investments mean increased costs so that the ancillary companies involved can make the most profit possible (including pharmaceutical companies, medical facilities, etc.), then it makes perfect sense that insurance companies, whose best interests are served -not- from caring for their beneficiaries but in having large payouts to their stockholders, have no -choice- but to look at factors -other- than the well-being of their customers in making decisions about where that money is going to go.
I work for a huge specialty hospital. We are already understaffed and have maintained at near-capacity (99-106%) for the past year, with the exception of 3 weeks while we recovered from a hurricane. We do a phenomenal amount of vital research in our specialty. -However-, our hospital regularly invests the income it receives from patients and donors into stocks, bonds, and other 'investments'. When these investments went bad, that meant that our already-understaffed hospital had to cut 10% of its existing staff in order to be able to pay its bills after having gambled away all that income. We were also ordered to increase our patient clinic load by 1/3... even though we are already at capacity for admitting patients who need in-patient care! It is considered -perfectly legitimate- for companies to make decisions like that about the money used to fund medical care in our current climate -- and yet, how do we manage increasing patient load when we have fewer nurses, PAs, administrative staff, housekeeping staff, patient transportation staff, pharmacy staff...? How do we continue to do vital research when there is no money for materials, research scientists, etc., because it was all gambled away in the stock market? How do we explain to patients that their insurance company lost a lot of money this past year, and is unwilling to take a chance on them responding to the treatment their doctor has recommended... what are we supposed to say to the patients who come to us for care, and whose insurance companies decide that it is cheaper to let them die than to help them get the care they need?? Every -week- our doctors have to write pleading letters to insurance companies for patients because the insurance company's 'staff medical reviewer' decides that a certain procedure is not medically necessary, despite evidence in medical research, the patient's own medical records and statements of necessity from -multiple- physicians (especially since much of our treament is done based on multidisciplinary modalities). As long as health care is a 'for profit' industry, a whole slew of people will -never- receive quality, well-researched, "Best Clinical Standards" care, in a timely manner, because it just isn't in the best interests of the for-profit agencies managing the care decisions.
Whether government-managed or privately-managed, we need to go to a single-payor system with -one set- of rules for obtaining treatment, second opinions, tests, etc., and the guiding force of those rules -must- be the physician(s) who are familiar with the patient's case. Right now, this is absolutely not possible with our existing multi-corporate system. The rules vary from insurance corporation to insurance corporation. The rules are -not- based on medical need or physician recommendation, but on profit potential and "medical loss" ratios for the company. The rules are difficult to understand, and often eliminate benefits for the most needed procedures and most sick individuals -- often individuals who have paid premiums for -decades-. If you can tell me this is "right" and A-OK in your book, then I just don't know what to say to you.
DC
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