Friday, October 2, 2009

Why Can’t We Just Have Low Prices?

I woke up to this story about healthcare co-ops on NPR this morning. And frankly, I’m now more confused than ever. I thought the whole point of healthcare reform was to lower costs? Yet co-ops don’t do that, or at least, in the few places where they currently exist they don’t:
Timothy Jost, a law professor at Washington and Lee University School of Law, is one of the few people who have researched them. Jost suggests that the expenses involved in starting a co-op and the struggle for market share would kill off most of them before they got going. He says it's unlikely they'd make medical care any cheaper.

"Where I've seen cooperatives in operation, they don't really compete on price," he says. "They compete on quality, on customer satisfaction. That's good. We need more quality. We need insurance products people are really happy with. But what we need most is cost control."

MacEwan of Group Health says Jost's argument about cost rings true. She says her company's insurance is priced in the middle range of all the private insurers.

In the end, the main problem health care cooperatives solve may be a political one. People who oppose a public option for health insurance might back an alternative that's not run by the government. And people who support a public option might look to co-ops as the next best thing.

Well no, not if they don’t solve the cost problem I won’t. Look: cost is the problem! Prices are the problem. We pay more than other countries, and we aren’t getting better care. We’re just paying more.

Frankly, it seems to me that we’re being offered a virtually untested, untried, unknown entity that has no existing national infrastructure simply because a bunch of people are allergic to anything with the word “public” attached. That’s just stupid. That is a holdover from Reagan-era attitudes and fearmongering from 20+ years ago. It’s unwarranted and it’s time we stopped letting it drive our policy discussions.

And let me say something about these “health savings accounts” which conservatives so love. HSA’s do nothing to lower costs, either. All they do is make things really confusing for policy holders.

Trust me on this. I’ve got one of them and I hate it. It’s confusing and complicated. Yesterday I went to the eye doctor for my annual visit, and I had to call my husband at work to find out if I could pay for it with our HSA card. The answer was yes. But a panel of blood work I had done two years ago was no. I don’t understand why and I’ve stopped trying. Now, I just call Mr. Beale and ask him. It’s way too Ricky and Lucy for my comfort but frankly I don’t have to the time or energy to figure out the fine print on this convoluted system. And I have it on very good authority that I’m not the only one who finds our plan confusing.

I guess I’m supposed to feel all self-righteous and grown-up for having the power to make my own decisions about how I use our HSA money. But I don’t. I'm confused and frustrated and over-burdened and unhappy. Because I don’t want to have to figure this shit out. I just want to pay lower prices.

I don’t want to pick from a list of different health insurance plans to find the one that’s right for me. I don’t want to have to read all the fine print or learn after the fact that the plan I thought would be great because it pays for all my wellness visits won’t cover the injuries from the car accident I had. Or whatever.

I don’t want to wade through a myriad of insurance offerings on the open market. I don’t want “choice” among “insurance plans.”

I just want lower prices. I want to see the doctor of my choosing for the care that I need and I don’t want to pay three times more than a similar person living somewhere else for the same thing. I don’t want it for free, I just don’t want to be fleeced by some for-profit system that charges me double and triple to pay for the obscene compensation of its CEOs.

Why is that so hard to understand?