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Archive for 27. June 2009

The Myth of Choice in American Health Care

The free market yahoos keep at it.  They insist on maintaining the status quo of American health care by scaring us with horror stories about how a government run health care system would deprive citizens of making market choices in their best interests.   This plays into the American Cultural Legacy of individualism.  It is also a lie.

First, the Obama plan (though it is, in my opinion, not the best possible option, it may be the most politic) does not constitute government run health care.  It offers a choice for people to participate in a government single payer plan.  If they are satisfied with their private health care, they can keep it. In essence, the government is entering the health market.  If the free market is based on competition, then why can’t the US government, representing the tax payers, go into business? And if the private sector can do everything better and cheaper than the private sector, why should insurance corporations quake when faced with the prospects of competing with a public sector program.

In fact, they know that they can’t compete. They can’t do a better job cheaper.  This has been demonstrated time and again.  Administrative costs for Medicare, a single payer government program, doesn’t come anywhere close to the same costs for private insurance (even after the catastrophy that was Bush Medicare reform).  Privatized programs contracted for the VA were a train wreck that denied adequate health care for our combat vets, yet failed to compensate taxpayers with cheaper, more efficient services.

Secondly, when was the last time you “chose” health insurance coverage? In most cases your health insurance is chosen for you by your employer.  And when your employer chooses to change coverage (in their own best interest, not yours) you have nothing to say about it.  Yes, you can drop your coverage and try to find something comparable, but often you as an individual are unable to negotiate the kind of benefits that a larger employer can when they settle upon a benefits package.  So, in reality, most of us have very little to know choice in health insurance providers.

Nor do we have a choice in health insurance quality.  Most major health insurance companies offer very similar benefit packages, all of which come with byzantine rules and regulations that cost you money and save the bottom line of insurance companies.  Again, you have no choice if all of the selections are the same.  It’s like being offered ham and eggs or eggs and ham.

So, with the prospect of being able to ditch my employer chosen insurance, or a single payer plan from the government, I end up with more choices than that given by a pure, free market system.  If it turns out that the detractors are correct, that government health care is more expensive and less effective, then I can “choose” to say no.  Right now, I have no choice.