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Health insurance vs. medical care

March 19, 2017

The terms health insurance and medical care are often used interchangeably. They are, however, quite different concepts, and once understood, who benefits or loses becomes apparent.

For decades, Americans have been fed a lie that health insurance ensures receiving medical care. The truth is that there are many obstacles in our way when that care is needed. With the passage of the Affordable Care Act (ObamaCare), the old lie was advanced, not just in name but in deed. Under active debate is its repeal, hybridization or replacement. But are these just false choices?

Insurance is a product sold based on risk. While it can protect me from myself, it can also serve to protect me from you or you from me. So, what is health insurance protecting?

If, as the name implies. it insured health, then it would be selling preventative services for injury or illness. The problem is that injury is often unanticipated and there are few ways to prevent illness. The old adage that you don’t see a doctor when you are well by and large has more than a grain of truth.

So perhaps what we have is a misnomer and what pays our medical bills when we are injured or ill is actually medical insurance. The question though, no matter what it’s called, is how is it working out for us?

Part of the basic definition of insurance is an “agreement by which a person pays a company and the company promises to pay money if the person becomes injured.” ObamaCare requires that most of us purchase a health insurance policy or pay a ‘penalty’ for what we may not want, use, or find financially beneficial. So, what’s the motivation for requiring us to possess health insurance?

To understand human motivation is to acknowledge the role of money and power. Once that’s accepted, the question becomes “who stands to gain in forcing every citizen to have a health insurance policy, with its numerous exclusions, many of which can’t be anticipated, and which benefits mostly the underwriter, not the insured?”

The punchline is: not the average Joe. Though the list of who benefits is relatively short, those on it are quite powerful and from that power flows a stream of monetary gain. It arises from the creation of a law that’s purposely ill defined, nearly impossible to understand, and requires from here to eternity to clarify, thus ensuring job security. Its culmination is the creation of companies in support of its mandates. The list of those benefitting includes: politicians, lawyers, the judiciary, the press, and CEOs of health insurance companies, hospitals and government mandated medical organizations.

Now having clarified the scam that is health insurance, what does it have to do with medical care? Unlike health insurance, medical care is what patients actually benefit from. So how will medical care be obtained without Obamacare? Though not comprehensive, here is a broad outline.

The poor will always be with us. The truly poor will always have some form of government assistance. For the elderly, Medicare should continue but be phased out over time, with younger generations hopefully making better life choices, taking better care of themselves, and limiting the effects of their choices on society. Over time, most people can be reconditioned to pay for what is routine, such as they pay for food, housing and clothing. Catastrophic plans can and should be recommended and marketed for children and most adults. Situations like the VA and certain public employees can perhaps be approached with a different lens, that of a quid pro quo.

But how do we address the cost of medical care? I believe we will be pleasantly surprised at how the cost of care declines once needless middlemen are removed and entrepreneurs resume their rightful role. At one time physicians were involved as such, but with the takeover of our society by the legal guild, decades of their societal intervention essentially strangled private medical practice.

There certainly is room for participation by pharmaceutical companies, devise manufacturers, hospitals, etc. Regarding hospitals, they need to be restricted to a core mission of maintaining an emergency room for emergencies, operating rooms for inpatient surgery, and hospital beds for inpatients only. Since most hospitals are financially propped up by taxpayer-paid government subsidies, once their unnecessary expansion into the medical marketplace is reversed, physicians along with the nursing profession can resume their role in patient advocacy and care.

Medical care is available though it’s strangled through the bureaucracy of the politician’s creation and their business associates involvement. Once health insurance is outed for what and for whom it actually benefits, we can focus on what we actually need: medical care.

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