Thursday, January 09, 2014
One more reason we need single payer
One of the major flaws in the Affordable Care Act is that, as with Medicare Part D and Medicare Advantage plans, it puts the burden on the consumer to wade through a lot of complicated choices and try to pick what's best for that individual. So, another open door crashed through: most people don't have a clue about key concepts of health insurance.
Since the link is to a subscription-only journal, I'll do my usual unpacking for you. The survey didn't actually test people's knowledge; it just asked if they were "confident" that they understood concepts such as co-payments, co-insurance, deductibles and premiums. Most people said they were not. But I'll bet it's even worse than that -- if you ask people whether they understand something, they'll say "yes" even if they don't. Because a) they don't want to seem ignorant and b) you don't know what you don't know.
And for people with limited education, cognitive impairments, mental illness, or just plain too much in their lives to deal with, having to take the initiative to do this and wade through complicated choices they don't understand is just not going to happen. The ACA did of course provide some money for "navigators," people in community organizations who can help. But Republican governors are doing everything they can to sabotage the navigator program, and even where it is available people have to be connected with a community organization to avail themselves.
BTW, are you confident that you know the difference between premiums, co-payments, co-insurance, and deductibles? Do you feel confident that based on knowing about these, you know how to pick the plan that's best for you?
If we had universal, comprehensive, single payer national health care, everybody would automatically have good insurance, already paid for through progressive taxes. It would cost less overall and deliver far more. Insurance company executives wouldn't be hoovering up the cash, it would be much easier to detect fraud, control overuse and control prices, and care would be much better coordinated. Anything else is a travesty.