Thursday, November 22, 2018
The Mafia-Like Nature of American Health Insurance
Most of us understand the deeply fractured status of the American health insurance system.
We all have our personal stories. The media reminds us—albeit not frequently enough—of the corrupt, unethical, even mean-spirited nature of health insurance in America.
I nonetheless share this brief story of a recent, personal experience with corruption in American health insurance.
As part of a routine physical examination a few weeks ago, my physician sent me to the dark basement of her office building for a routine chest x-ray. Two views of the chest were obtained.
Lucky for me, the results were normal.
A few days later, I received a bill from Madison Radiology. It showed a full charge of $105, which seemed reasonable.
I then noticed that Blue Shield, my personal Mafia-Insurance-Company, reduced the “allowed amount” to $24.54.
Are you kidding me?
Twenty-Five dollars to make sure I don’t have pneumonia or something worse?
That’s two drinks at Starbucks.
That’s dinner at McDonalds for two.
How is this fair?
Of course it’s not.
How does this relate to the Mafia?
Because the American health insurance system works like a shake-down, a protection racket. Blue Shield decides what providers, hospitals, labs, and so on get to charge.
It’s a scam.
(By the way, I’m self-employed and Blue Shield is the ONLY health insurance company in California allowing me to buy an individual policy. So much for free markets and competition.)
The situation precisely mimics the Mafia forcing businesses in Sicily, or wherever, to pay them a percentage of their profits for “protection.” In legal terms, this is known as extortion.
Returning to the chest x-ray adventure, I waited only a few minutes for the exam. The technician spent perhaps five minutes taking the digital image. The radiologist probably spent just a few minutes interpreting it. However, the x-ray machine must cost several hundred thousands of dollars. Also, of course, Madison Radiology must pay rent, salaries, health, workers’ compensation, and business insurance premiums, magazine subscriptions, electronic medical records and other considerable overhead costs.
And for all that, they get $25 from me?
It’s a miracle they took two views.
It’s a miracle they didn’t keep me waiting two hours.
Here is what will occur if Medicare-for-all or other significant health-care reforms fail to pass:
- In order to preserve already-diminishing profits, providers and hospitals will see more patients for briefer periods of time, worsening the already factory-like nature of American healthcare.
- Fewer highly motivated, intelligent persons will enter the medical field because they will anticipate, correctly, they will increasingly have jobs comparable to coal miners slaving away for multi-national energy conglomerates.
Capitalism integrates nicely with socialism, as occurs in countries like Norway, Holland, and Sweden. The citizens in those countries enjoy some of the healthiest lives on the planet.
Why do we not consider fire or police departments as socialist?
Because we believe all citizens deserve police and fire protection.
Why are we the ONLY industrialized Western nation without universal healthcare or health insurance?
Because the system, pathetically, remains controlled by Mafia-like organizations.
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Alan Karbelnig, PhD, ABPP