I think it is foolish to put a bureaucracy between people and their primary health care provider. Health is about the well being of a person. Personal well being is best handled through direct person to person contact. No matter how you cut it, the bureaucrat in the middle detracts from that realtion and detracts from health.
That said, I don't think all insurance is a rip.
Areas where insurance works great are Workers' Comp, General Liability, Auto Insurance and Catastrophic Insurance.
In workers' compensation, employers are paying directly for liability exposures created at the job site. Workers' Compensation is great for the economy as it allows risks created by an activity to be correctly reflected on the balance sheets. As workers's comp is an expense of the employer and not the employee, having a third party in the mix actually makes the payment of the claim easier. Actuarial analysis of workers comp claims provide a strong basis for risk management. That is managers are able to take the claims experience of their company and similar companies and use that data as a basis for Risk Management and risk reduction.
General liability and auto insurance work in the same way. In both cases you are buying coverage for an identifiable entity that has associated risks.
This style of insurance that tacks a liability onto a entity or action work great as it allow people to judge the risks associated with the entity. The only serious problems come with fraud. For example, I've seen cases where a person broke their back on Saturday. They sit around writhing in pain over the weekend then have someone drag them to work on Monday to get workers' comp.
Liability insurance works extremely well.
Interestingly, socializing medicine would actually have a harmful effect on employees. Sadly, many employers are scum. Employers want to move costs from their balance sheets. If we had a system of socialized medicine, employers would try to divert their liability exposure to the public at large.
Liability insurance forces companies into better risk management practices which reduce exposures of their employees and customers. Socialized systems where the government pays for healthcare reduce this liability.
This is actually one of the prime reasons why working conditions in left leaning countries are generally worse than those in free societies.
Catastrophic insurance is an other area where insurance works. I will address this in a later post.
Anyway, I think one of our problems is that that political mind wants a one size fits all approach to health care. Insurance works extremely well in certain areas; so politicians knee jerk and say that it should be applied to all health care concerns.
I believe that, by expandiong insurance beyond what it does well, you actually create a worse situation for people. Sticking an insurance agent between a person and their primary care provider detracts from that care, and it detracts from the ability to accurately assign liability risks to exposure.
We learned another side of the story from our experience in New Zealand with my husband's back country hiking accident. New Zealand has the Accident Compensation Corporation, which seems to be Worker's Comp writ large. Hurt in an accident, under any circumstances, and your medical costs are covered. Car wreck, on-the-job, skydiving-think no-fault medical coverage for accidents. By taking the medical costs out of the equation, the result seemed to be a lowering of liability insurance to affordable rates for small businesses. Only with the ACC, we figured, could a country of 4 million people develop their extreme sports tourism industry, which is mostly made up of mom-and-pop enterprises. In the U.S., a start-up would never be able to afford liability insurance for the bungee jumping invention. Maybe it could only be done in a country already set up with national health insurance. But it keeps the lawyering expenses out of the national aggregation of costs, a choice the kiwis seem happy with. We ended up paying about $US20 for 4 nights of hospitalization, surgery, aftercare and medications, and the quality of care was excellent.
ReplyDeleteI believe more entrepreneurs would create more jobs if we had national health insurance. People seem much more willing to risk their family finances than their family's health to go it alone. And it's nearly impossible for the starting entrepreneur to find reasonable health coverage, especially for a family. We all pay the costs of forgone innovation as a result.