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There Is No Way Insurance Can Solve This American Health Care Problem

We’re treated to a recital of a specific health care problem over The Pond. Our source is, of course, The Guardian. And the complaint is that without some support for Obamacare and the like then this particular woman won’t be able to get her health care insurance.

The actual problem here being that this isn’t a problem amenable to insurance in the slightest:

I woke up on a Monday with tingling hands and numb feet, my legs too weak to climb stairs without a struggle. I spent most of Tuesday in a red recliner with a plastic tube stuck inside a vein in the back of my hand, waiting while a drug made from other people’s blood plasma dripped into my body.

On Wednesday, nauseous from the chemicals coursing in my veins, I caught up on a debate between candidates running for US Senate in Montana, the state where I buy health insurance.

A journalist grilled the Republican, state insurance commissioner Matt Rosendale, about whether he would give his own family one of the controversial, low-quality insurance policies he recently allowed back on the market. He ducked the question and gave a vague answer about protecting sick people, with no details on how to do that.

Hmm, well, that treatment apparently cost some $7,000 and change.

I paid $7,348 for healthcare last week


The medication clouding my brain and quieting my immune system cost $7,348.03 this week. I will probably have 10 infusions this year. Last year, the treatment cost almost half as much, but I switched insurance companies and the price soared.

I changed companies because in less than two years, my monthly premiums had doubled to nearly $1,000 a month. My new insurance is cheaper for me, but the real price tag went up. This shell game – the ever-increasing cost of health insurance to consumers to satisfy profit margins – is part of what used to make it so easy for elected officials to undermine the law.

Whether it’s $40,000 or $73,348 a year, the price is far outside my budget. Without health insurance, I will be bankrupt or disabled, likely some ugly combination of both.

This is an ongoing, expensive, and chronic, problem. That is, one not amenable to an insurance solution.

It is amenable to a cost sharing one. We might all agree that there but for the Grace of God and chip in for that treatment. Taxation funded health care on the basis of need might work. Although she might well find that something like the NHS would refuse to pay for such treatment – it may or may not pass the NICE rules of £30,000 and no more per qualy. We could even be vile and just say too expensive love, die.

But what we’re not going to be able to do is solve this through insurance. Here is some premium and that premium is less than the cost of the treatment I might need, less by whatever the probability of my needing the treatment is. For we already know what the cost of your treatment is going to be. We’ve a probability of 1 of you needing it too. Insurance simply doesn’t work here.

There are things which can be done about the American health care system. There probably are even things which ought to be done about the American health care system. But insisting on shoehorning everything into the envelope of “insurance” isn’t one of them. Simply because insurance as a thing, while hugely useful and possibly even essential as a tool, is not the correct answer for every ail of a health care system.

It just doesn’t work to try to do everything this way.

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5 years ago

The legal definition of “insurance” includes Risk – if there is no risk then it is not insurance. A certainty of a cost is not a risk. So if she is certain to need this treatment then it is not covered by insurance but simply by a subsidy.

5 years ago

‘I changed companies because in less than two years, my monthly premiums had doubled to nearly $1,000 a month. My new insurance is cheaper for me, but the real price tag went up. ’ This is precisely what Obamacare was designed to achieve. By design some of the cost of more expensive policies required by older people, to cover maternity, chronic conditions, etc and which had higher deductibles, was to be transferred to cheaper policies bought by young, fit individuals, males who did not need maternity cover and who would accept higher deductibles. In other words Obamacare was designed to… Read more »

5 years ago

Part of the problem is that so many Americans use the word “insurance” to mean “whatever payments I make to get healthcare” and don’t pause to realise that health insurance is actually, well, duh, insurance. This is seen in such statements as “I have a chronic illness, the guvmnt should make my insurance payments cheaper”. Sorry, dear, but the government does not have the power to make the likelyhood of your existing condition go down, and while it does have the power to force the retail price down by fiat that would just result in medical providers going bust. What… Read more »

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