At the Colorado Health Insurance Insider, we’ve often written about the “free market” in health care. And we’ve discussed the moral quandary created by the health insurance industry operating in a capitalistic fashion. Bob Laszewski from Health Care Policy and Marketplace Review has written an article about the dramatic failings in the health care industry over the last 15 years since the Clintons tried to inject government control into the system.
Basically, Bob’s point is that the health care industry got handed a diamond in the rough when the Clinton health care plan went down in flames early in Bill’s presidency. Health care was solidly in the realm of private companies and the free market, as nobody was going to want to tackle health care reform again for a good long while. And yet here we are, 15 years later, with all sorts of messes in our health care system. Jay and I write from the perspective of agents in the individual health insurance market in Colorado. In our corner of the industry, there’s really only a free market for the healthiest of applicants. Those with pre-existing conditions can’t get some polices no matter how much they’re willing to pay. A person who has a serious health condition may find themselves “stuck” on their current policy and unable to exercise the free market behavior of shopping around. For some people, Cover Colorado (our high risk pool) might be the only choice they have. And even that can run out, leaving some people truly without an option for health insurance.
Our health care system has worked very well for some people. If your employer pays for your health insurance and offers a low out-of-pocket policy, or if you’re a top executive at a hospital or health insurance company, or if you’re a provider in a high-tech specialty, you’re probably doing pretty well. And of course no system is going to please everyone. But the problem with our system is that over the last 15 years, the number of people it’s worked for has been shrinking. There are nearly 10 million more people in this country without health insurance than there were in 1992 (of course our population has grown in that time too, but the fact remains that there are more people disenfranchised with our health care system now than there were 15 years ago). As more people struggle to afford health care (either directly or through health insurance premiums), the cry for government intervention gets louder. We can assign blame all over the place, but Bob’s right – a relatively unregulated health care industry hasn’t done a very good job of serving the American people well.
I don’t think we need to scrap our health care system. But we need to make it work for more people, and that will probably require some measure of government regulation. Hopefully we’ll get it figured out before another 15 years go by.
Many thanks to Joe Paduda, who hosted the Cavalcade of Risk this week, where I found Bob’s article.
