Why Republican "Solution" to Health Care is Bullshit

If you listen to as much right-wing nuttery as I do, you cannot have missed the argument that emerged a couple weeks ago. The Republican party has no interest in health care reform because while the insurance companies violate us by not covering us or dropping us in the name of the Holy Dollar, it's Republicans (and some Democrats) who are getting the reach-around to chubby up their wallet. But in the light of Democratic pressure to do something to reform the system and include a public option, saying NO just seems heartless and uncaring. So in order to appear as though they give a shit, here is the new conservative offering: Drop all state border restrictions and allow insurance companies to compete in a nationwide free market! Yay!

This is an explanation of why that suggestion is bullshit.

How It Works Now

When a doctor wants to negotiate with an insurance provider, it goes something like this:

Doc: I'm going to charge $200 for an office visit.
Ins: Woah, there. When the patient insured by us comes through your doors, we'll gladly pay you $30
Doc: Hells no! How about $50?
Ins: We can work with that.

Every doctor has to do that with every insurance company they work with every year for every service they offer. That's why you see a small practice with 2 docs and 2 nurses and 3-5 office people: insurance companies are a pain in the ass to work with.


Let's Say It Happens

For the sake of argument, let's say we travel to an alternate future where everyone lauded the Republican non-solution and it miraculously passed into law. What would change? Not a damn thing.

But now insurance companies who have set up shop in one or more states can technically insure anyone in America. Companies can compete on the national stage. Yay capitalism!

And businesses can shop all over the nation for their pick and doctors can decide who they want to do business with.

Yes? Not so fast.


The Players

The system solidly in place right now is a state border one. And removing those borders isn't going to let loose a rampant sprawl.

The Insurance Companies

Insurance companies might be willing to spread out a little, but in order to do that, I'm guessing there would be some sort of fee or tax for each state in which they operate. Then they have to actively sell themselves to businesses, individuals, and doctors. All over the country. That sounds like a lack of direction and a whole lot of money. And we know how much insurance companies love their money.

The Doctors

Doctors already have enough overhead from the insurance companies they do deal with. What would drive doctors to increase that overhead and haggle with even more companies? Especially when there would be little guarantee that they would end up finding patients who carry that insurance and, again, waste money?

The People

About 60% of all Americans - insured or not - get insurance through an employer. So they are at the mercy of whatever plan their employer has on tap. And why would individuals or businesses that, say, live or operate in Ohio go fishing for a cheaper company in some other state with no guarantee they could find any local practitioner who might accept that insurance?


Location, Location, Money

It's a localized system for a reason: you need a person or business to purchase insurance coverage from a company that will be accepted by a doctor. A borderless system will basically remain unchanged.

If it were so easy for doctors to deal with insurance companies, wouldn't you think they'd do that now, within one state, in order to draw as many patients as possible? If it were so easy, then every doctor could accept every insurance and every Ohioan could go to any doctor or hospital in the state.

But that ain't so, now is it? And multiplying that potentiality by 50 isn't going to be more efficient or cost-effective, just more confusing.


The Real Problem

The real problem is the insurance companies. They keep hiking up rates by leaps and bounds and blow out mad profits in a recession. They blame their rate hikes on those evil lawyers and frivolous lawsuits and absurd awards to the point where they've got doctors blaming the lawyers and joining the lobby for tort reform. But the truth is that there has been no explosion of frivolous lawsuits or huge court awards. The insurance companies just want more money so they charge more; they push for tort reform because capping everything - even obvious wrongful death - would raise their profits.

The people of this country are being lied to over and over and over and until health insurance is instituted in a not-for-profit manner, we the people will suffer because of greed and shady politics.

And while the Republicans have found their health care "we care" rally cry, it's really just a facade, just some wisps of smoke with the lingering odor of bullshit.