Said Bechta: “It doesn’t lead me to conclude that I can make an educated choice about a hospital and say I’m going to save the system money by going here, because the next person who has a different insurance plan is not saving money by going there, and they’re getting the exact same test or procedure that I’m going to get.” Bingo! Betcha nailed the contradiction presented by all this shopping stuff. Reporters should explore this contradiction further. It would make for much better journalism than passing along more quotes from Kathleen Sebelius and others about how easy shopping will be thanks to the Obama administration.
After all the study and frustration, Bechta decided to stay with her traditional HMO. Most consumers will do the same, taking the easy way out of a task they’ll inevitably hate. No, shopping won’t be like buying a can opener from Amazon.
More examples of the "tyranny of choice." Electric power deregulation presents us with the same problem. A consumer's time is limited. His brain is finite.
If reporters, or someone, would do the requisite systems analysis they would soon see the underlying issue. In health care, as in electric power, and probably in many other complex human endeavors, much of the expense is locked in the system to pay managerial expertise. Actuaries, insurance executives, utility executives--they all cost, because only they have the knowledge and ability to operate these unwieldy systems.
In a fully regulated market, the interests of these executives can be more or less aligned with consumers. In an unregulated market, their interests immediately diverge with those of consumers. The executives develop ever more complex marketing systems to entice those consumers, who end up paying full overhead costs for the complex system that is, in large respect, working against their interests.
The payoff? "Choice." "Freedom." And the obligation to become an expert in every field so deregulated.
Somewhere, Ayn Rand smiles.
#1 Posted by Edward Ericson Jr., CJR on Tue 13 Mar 2012 at 03:51 PM
To be frank, this isn't up to Trudy's usual standards. What she completely leaves out is any comparison of buying health insurance through a state health insurance exchange to the current hodge-podge buying situation. It does no good to compare to some ideal; there should be a comparison to the impossible situation for the individual insurance buyer now. Yes, shopping and comparing health plans is difficult under the best of circumstances, but the proposed state health insurance exchanges at least would offer apples-to-apples comparisons on benefits and prices, unlike the current system. Trudy also leaves out that buyers in 2014 won't have to worry about being excluded from benefits based on pre-existing conditions, which hugely complicates buying choices for consumers today. It's misleading to project what the 2014 state exchanges will be like based on the Massachusetts model, because the rules are likely to be different, and are likely to vary state by state. There's no question that it would be better and easier for consumers if there were one standard benefit package, or a limited number of slightly different packages, as Alain Enthoven originally envisioned in his managed competition model. But unfortunately due to political pressure, exchanges will be offering a range of more- to less-generous packages. Still, consumers will be better able to shop and compare under the new exchange system than they are now, knowing they won't be discriminated against based on preexisting conditions and that they'll receive income-related subsidies to make the coverage more affordable. Trudy needs to put this and her other criticisms of the Affordable Care Act into context, comparing what the ACA offers to the current, completely dysfunctional system. It ain't single payer but this is the political reality of 21st century America.
#2 Posted by Harris Meyer, CJR on Tue 13 Mar 2012 at 06:23 PM
Trudy wrote: "Bebinger explained that insurers use a complicated formula of quality and cost measures in order to determine a physician’s tier"... "Most consumers will do the same, taking the easy way out of a task they’ll inevitably hate"
padikiller responds: This is just the latest iteration of the leftist "People are too stupid to buy products on their own" stupidity...
The same screwy lefties who admit (as Trudy does here) that regulation inevitably creates a quagmire of complicated policies, loopholes and pitfalls, also tell us that the answer is always more regulation.
These pundits would have us believe that while the average American far, far too stupid to be entrusted with buying health insurance on his own, or to be permitted to buy a home or a car without the Gubmint looking after him... These same hapless dupes should collectively be entrusted with a greater voice in government and private enterprise.
SUCH is the state of liberal madness.
#3 Posted by padikiller, CJR on Wed 14 Mar 2012 at 10:17 AM