A Health Insurance Crisis?

With the elections right around the corner in 2008, there are few topics as hot Healthcare among the politicians, pundits and public.

The prevailing notion is that there are an insanely high number of Individuals in this country (47 million! 47 million!) without Health Insurance and that all these folks are literally tossing and turning in their beds afraid that the Black Plague will return and they'll be stuck treating it with Aspirin and Witch Hazel. In reality, it's not only a much smaller number of folks without coverage but also a good percentage of those uninsured folks have done so by choice.

I have sold Individual and Small Group Health insurance for almost 15 years and I have seen everyone from the poorest of the poor to folks who smile and Bentleys fall out of the gaps in their teeth; truly a great cross section of America. Although most of these Individuals claim that healthcare is a top priority and one of their biggest concerns, when I actually take time to meet with them or discuss their personal and business lives in more detail I discover a very different reality, one where their priorities are very opposite of what you'd imagine. A reality that shows me how backwards and impractical their thinking is and also how ill-informed they are about the Healthcare system. For example:

When I meet with poor people I often hear from that that they wish to free themselves from the ties to welfare and social service programs, which is a noble idea and something I commend them for. However, often times these folks are only seeking this free market coverage because they are being kicked off the state sponsored plans due to an increase in income. I learn this after asking some qualifying questions and all of a sudden it becomes a different discussion. It's no longer about pride but instead necessity, or at least it seems. What I generally discover at that point is that many of these folks think it's insane and unreasonable to spend $400/month or more on Health Insurance for their families but totally acceptable to have a 50" plasma TV in their homes and an SUV that averages 12 MPG in the driveway. They become angry that Health Insurance is no longer free and their three medications and follow up doctor visits will not be paid for. Suggesting they cut back in other areas to afford cobverage is never brought up in order to avoid stabbings and gunfire.

To be fair, not all lower income families are like this, many are truly poor and working several jobs to afford basic necessities but in most cases those folks have social service-based plans and deserve them and only meet with me to see how feasible it may be to break from that system in the future. It's honestly the middle and higher income folks that are the most difficult to explain the "system" to. Many of these families feel healthcare is a right and a benefit that comes with being alive and not actually a business and one that is very regualted, intricate and expensive to operate. There has never been a mother I have asked "If your child was sick, would you seek medical attention immediately?" who has replied, "No, I might buy an XBox 360" but in reality that's often times what they're doing. If every family of even modest means were to buy some form of Health Insurance, even with a higher deductible, then what you'd see across the Healthcare landscape is a dramatic shift in pricing for services at doctors and hospitals as well as Insurance coverage itself. Health Insurance is expensive because doctors and hospitals charge a fee that factors in those who never pay, which many times are folks who, had they made Healthcare a priority in their lives, would have never faced that problem if they had coverage. It really is that simple, and pathetic.

So why don't those who can afford it choose not to and instead cry for "Universal Healthcare" and the like? Probably the same reason many of those folks prefer the government to control the bulk of their retirement dollars: lack of discipline. It's far easier to spend $500 a month on various entertainment and luxury items as well as spoiling your kids, etc., than it is to toss that money at something as boring and abstract as a Health insurance policy. We have decided as a culture that instant gratification and living in the moment is far more pleasing than saving and protecting what we have through deferred gratification. I have been guilty of this myself in many ways and can understand the lure of living in the now and ignoring the responsibilities of tomorrow and the unexpected. However, with Health Insurance I have always made it a priority, as I have seen far too often the results of being un-covered.

There is no Health Insurance crisis is this country, it's instead of crisis of priority. The truly poor will always be guaranteed coverage and the truly sick will always have access to some of the geatest doctors in the world here in this country. The question is will those of us who have the means to buy Insurance do so and forego the things that are more exciting and more pleasant today? My suspicion is that we will not, and someday in my lifetime a governement-sponsored, Universal Healthcare system will be implemented, and like the DMV and the Post Office and other goverment run facilities, we'll be waiting in lines and huffing and puffing about the beauracracy. The only question is, when this drives competition out of the market and doctors are all paid the same thing and no one strives for excellence anymore, where will all the foreigners who currently utilize this type of system but travel to the US when in dire need, go to seek the best care?

Maybe Michael Moore will be chartering cruiseships to Cuba...