Today, in the Wall Street Journal, generally firewalled, Jonathan Kellerman compares health insurers to the Mafia and concludes that the Mafia is better to do business with:
The health insurance model is closest to the parasitic relationship imposed by the Mafia and the like. Insurance companies provide nothing other than an ambiguous, shifty notion of "protection." But even the Mafia doesn't stick its nose into the process; once the monthly skim is set, Don Whoever stays out of the picture, but for occasional "cost of doing business" increases. When insurance companies insinuate themselves into the system, their first step is figuring out how to increase the skim by harming the people they are allegedly protecting through reduced service.
I'm not impressed with all he has to say, but no industry is likely to respond favorably to a high visibility op-ed that says they are a worse leech on society than organized crime.
His objection is that they not only take their cut of the business, but tell others what to do, when to do it, and how much will be paid. He was happy that he didn't have to do business with insurers when he was in practice.
The whole mess, of course, encourages games on both sides:
Several years ago, I suffered a sports injury that necessitated an MRI. The "fee" for a 20-minute procedure was over $3,000. My insurance company refused to pay, so I informed the radiologist that I'd be footing the bill myself. Immediately, the "fee" was cut by two thirds. And the doctor was tickled to get it.
Bottom line?
Physicians and other providers need to liberate themselves from the Faustian bargain they've cut with the Mephistophelian suits who now run their professional lives. Because many doctors are loath to talk about money, they allowed themselves to perpetuate the fantasy that "insurance is paying." It isn't. There is no free lunch and no free physical exam.
I do think that no insurance companies may be better than the current system, but I'm still completely behind universal coverage.