"Rep. Ritchie Torres introduces "Anesthesia For All Act" to ban time caps on reimbursement for anesthesia services, following Anthem BCBS' reversal of controver
www.beckersasc.com
"We cannot trust insurers to do right by doctors and patients out of the kindness of their hearts," Mr. Torres said in a statement. "There is a need for legislation that prevents any insurer anywhere in America from micromanaging the length of anesthesia care in a medically necessary surgery."
That is true, of course, but the entire debate is missing the big picture.
The simple truth is that "insurance" is the wrong concept for healthcare, because everyone expects to need/use it at some point. Healthcare needs shouldn't be solved by insurance.
Auto insurance works because the vast majority of people never have a significant claim. One's lifetime of premiums and deductible outlays easily cover the typical handful of minor at-fault or no-fault incidents a person has.
Homeowner's insurance works because the vast majority of people never have their house burn down. There are cracks in this segment of the insurance industry because in some places (Florida) the expectation is that many if not most people are going to have their house flooded or blown away at some point. It doesn't make sense to sell insurance for something you
know is going to get wrecked eventually. But most people go their entire lives without making a significant homeowner's claim.
Life insurance works because the vast majority of people never die while covered. Premiums get prohibitively high for old people at risk of dying.
But health insurance? Nonzero outlay for everyone, every year. And near-certainty that during one's lifetime there will be multiple significant claims for injury, illness, childbirth. And probably dying too, because we can't let someone die without a 5- or 6-figure hospital bill to prolong life (in misery) a few extra weeks.
The purpose of "insurance" is to spread the cost of RARE events amongst many people. The model doesn't work when claims are common and inevitable, as they are in healthcare.
The notion of insuring people for pre-existing conditions is absurd. No one would sell auto insurance for an already-wrecked car. No one would sell homeowner's insurance for a house that started burning 20 minutes ago. But somehow the expectation is that health insurance companies should sell insurance to people who are already sick or injured. It's crazy.
The only rational answer for society is single payer. And the only thing stopping us from going there is the self-interest of the insurance lobby and some people who can't make the intellectual leap to understanding that burden of paying for healthcare, like national defense and the interstate highway system, lies squarely in the domain of government.
I used to think that it'd be a bad idea for government to do it, because government is either bad or mediocre at everything it does. After a decade+ of annual double-digit increases in premiums, and ongoing problems with claims, and worsening coverage denial rates even for people who are paying for insurance ... the government can't possibly do a worse job than insurance companies are doing. I used to scoff at the idea of government doing a better job of something than the private sector. But holy **** is the health insurance industry a chaotic pathetic mess.
After all that debate and angst over government "death panels" we got them anyway. But instead of panels of government drones making decisions with at least lip service toward solvency, the panels just turned out to be non-government drones in companies primarily concerned with extracting as much money as possible from patients, doctors, and hospitals.
We're a nation of perverse self-destructive incentives. Finance, healthcare, trade, manufacturing, agriculture. Self inflicted wounds everywhere.
