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Oh, I’ve ranted on the state of healthcare in the US often enough. Including on this blog. But you know what? I’m starting to think it’s not necessarily health insurance per se that’s the problem with this, even if you ignore the fact that it’s a benefit for society as a whole to have everyone covered for free.

The thing is, it’s more like if commercial health insurance worked the way it was supposed to, it would be a low-profit-margin industry. But it’s really not. And the reason why it doesn’t work the way it’s supposed to is because Wall Street has a very poor tolerance of low profit margins – the primary purpose of a corporation which is large enough to have CEOs is to maximize benefits for its shareholders. Providing goods and services are merely the means which they do so. Corporations which don’t follow this model usually get destroyed or absorbed by the competition. So therefore, from an evolutionary perspective, the “fittest” ones are the ones which deny needed care to their users – but not so much that no one would ever pay them for it.

So in other words, if there were massive reforms to the way the entire financial system works, then most of the problems inherent to commercial health insurance would probably go away on their own.

[There’s also the little issue of how I’m pretty sure every doctor’s office in the country has at least one (and in some cases one per doctor!) full time employee who’s only job is to cope with insurance company red tape. Private insurance company red tape. And yeah, Medicare isn’t a cakewalk either but it’s not just way more predictable and, according to several office managers I’ve talked about it with, way less capricious than private insurance. Again that’s in part because Medicare doesn’t actively work to increase doctor’s administrative costs. (One insurance handler said one minimum-wage insurance phone-operator could keep 20 or 30 doctor’s offices on hold at once, and that virtually every call she made had to be escalated to a “supervisor.” Eventually. Before they could even find out if a procedure for one particular patient was covered by one particular plan from one particular company. And they obviously had hundreds of patients and dozens of companies each with dozens of plans. Point being that the cost and/or profitability of insurance companies isn’t even the primary metric of how efficient the system is — they measure their efficiency by care not covered, not services rendered. Thanks, Nightfall. —fl]