I'm going to bitch about health care a little. This has been a long time coming, and it's been a hot button issue not only for yours truly but for the country as a whole. Unfortunately it's been politicized and I think that's a shame — because although most people are in agreement that something about health care is broken in this country, the solutions offered are largely used as political chess pieces.
And we need solutions... not punditry.
I've been a health care consumer my entire life. I was born in a hospital, had the usual bevy of shots growing up (including an emergency tetanus shot when I stepped on a rusty nail as a kid), went to the dentist, wore orthodontia, and sported eyeglasses followed by contact lenses before dispensing with that particular nonsense with LASIK surgery. I received allergy shots for a few years and went in for a flu shot once when the media was hyping it heavily and I was young and impressionable... after which I promptly got the flu.
I started paying for my own health insurance in 1995 when I got my first job with benefits. It got us through a pregnancy and birth and everything which follows during the first year of life. It also got me through a nasty internal infection and a round of antibiotics I learned I was allergic to... the hard way. We've been under some kind of health insurance plan for most of the years which followed. Some were good, some were bad, most of them have pretty much blown goats.
A few blips aside, the care I've received has been pretty straightforward. The service from the various health insurance providers I've had, though, has been remarkably inconsistent. The only things which have been consistent are increasing premiums and increasing levels of inefficiency. You can get the price down if you're willing to make certain sacrifices, like having the insurance company only cover 70% of your expenses instead of 80% or having a higher deductible, but at some point I wonder how much that differs from a shell game played in the streets. Place your bets, place your bets: Where's the rubber ball?
We don't need health care reform. We need health insurance reform.
There was an article in The New Yorker about the health care industry as a whole needing to look to restaurant chains for a model of efficiency. If Burger King varied drastically from one restaurant to the next, it wouldn't be nearly as successful a system as the one we have where a Whopper in Charleston, WV is the same as a Whopper in Los Angeles, CA. Though a lengthy read, and mainly aimed at the health care side of things, I think there's a good point buried there for the insurance side too.
And lest you think this would lead to cookie-cutter solutions, don't forget Burger King lets you "Have It Your Way" and honestly, so do lots of other fast food places, chain restaurants, pizza places, and cafeterias all across the country and the world. Vegetarian? No problem. Low-carb? No problem. Lent? No problem. Just about every major chain — and I'd wager many of the minor ones — can accommodate just about any dietary quirk there is.
Efficiently. And it works. Every single day.
That's what I want from health insurance. I want to go to any city in this land and be able to find a place where I can show my health card, get treated, get prescriptions, and be on my way. I don't want to worry about co-pays or staying in-network or prior authorization or whether or not a given treatment is covered this year. I want billing to be prompt and easy to understand. I don't care if this service is provided by the government, a system of private companies, or Mickey Fucking Mouse.
It's a numbers game, and so far, the insurance companies are winning (and presumably buying political influence). This is where the change — and reform — needs to happen first.