Alchemists of yore wasted a lot of time searching for the formula to turn dross into gold. Their modern equivalents have finally discovered the secret, although we no longer call them alchemists. Nowadays they go by "health insurance executives." They get rich by converting our ill-health into profits, an alchemical miracle if ever there was one.
It's perfectly legal and like every brilliant con, beautifully simple. We pay thousands of dollars a year in health insurance premiums in return for the insurer's promise to pay out many more thousands if we get sick. If we stay healthy, the insurer keeps our money as pure profit. The real beauty of the scheme is that even if we get sick the insurance company still profits, simply by refusing to pay up.
Of course the insurer doesn't admit to refusing to pay the pharmacy, doctor, hospital, or ambulance bills. Instead they'll insist the claim was incorrectly filed. Or that the medicine is not in their "formulary." Or that the doctor doesn't know what she's talking about, never mind her being the world's expert on the subject, because the insurer has determined we don't need that operation after all. Or that the condition isn't covered, or that it is covered but pre-dated the policy, or that it would be covered if only we'd known in advance we were going to be rushed to the emergency room and had given our insurer ample warning. Or that, tee hee, silly us – that last premium payment was short by a nickel and so the policy was canceled, never mind that we've been faithfully paying the premiums for twenty years. So we're not in fact covered for anything at all. Sorry.
Lest the truth of the foregoing be doubted, the American Journal of Medicine just released a new studyshowing that in 2007, two-thirds of bankruptcies were related to medical expenses; of those bankrupt households, four-fifths had health insurance.
All this obstructionism, profitable though it is, doesn't come without a cost. That's the major reason why thirty-three cents out of every dollar we spend on health care in the U.S. is for administrative expenses. Not to worry though, because most of the cost is borne by us: we pay dearly to deny ourselves the medical expense coverage for which we pay dearly. And we consider those old alchemists delusional!
The alchemists, though perfectly harmless, were often tossed in dungeons or burned at the stake by political and religious authorities made uneasy by their seeming potential to destabilize the status quo. Our modern alchemists by contrast enjoy the authorities' strongest protection. Just read page eighteen of the Sunday New York Times, or today's lengthy Wall Street Journal editorial. You'll learn all about the peril posed by the prospect of a government insurance plan that would compete with the private ones. Being in the business of paying the costs of our illnesses instead of profiting from them, the government plan would have a totally unfair cost advantage. In a word, it would be cheaper. Okay, two words: enormously cheaper. Why, such a plan would bankrupt the health insurance industry instead of bankrupting us! Anyone have a problem with that?