With Obamacare debates in full swing passions are getting hotter and hotter and it's no wonder as the coming changes will affect everybody.
Reading and listening to different points of view and thinking about them got me to make a few of my own.
My points are not political though, just some philosophical observations from my twenty plus years working in health care. My experience was very diverse: working in a big research hospital and outpatient clinics both private and multi specialty ones. I also worked in a different pay systems-government paid socialized medicine, insurance paid clinics, private pay concierge type practices and a mixed pay of insurance and private pay. I came to one simple conclusion. No matter who reimburses for the healthcare expenses in the end, ultimately it has to be patient's responsibility to take care paying for their own expenses.
If one has insurance - great!
It means the person had good foresight and will have part or all expenses recovered. But insurance is just that - a reimbursement for unexpected expenses. Once upon a time in order to attract patients medical providers started to provide billing assistance. In my view that created a distorted three party business relationship which ultimately caused the healthcare crisis we are facing now.
Let me explain. We live in a free market system which is regulated by a universal law of supply and demand. Yet a huge part of the economy(healthcare) is artificially excluded from this basic regulation. Here we have a patient who is not concerned with the cost and expedience of care so long as it is covered by insurance, a healthcare provider who is paid not for providing the best possible care, but for the submitting to many insurance rules and policies and finally the insurance company who couldn't care less about patients health, quality of services and only concerned with reducing costs by finding ways to deny/reduce payments. Two most obvious results here are skyrocketing costs and free falling quality.
One most important thing missing here is responsibility. Once patient takes responsibility of paying for care this whole dynamics changes, as a paying customer patient holds health care providers responsible for containing ultimately costs, and for providing effective and expedient care and as paying client of an insurance company holds insurance responsible to fulfill its contractual obligations and reimburse for legitimate medical expenses. And most importantly responsible involvement in one's own care creates an incredible empowerment which contributes greatly to the healing process.