Note to Obama: Just Say No to the Massachusetts Health Care Model

A short story: I need what should be a minor medical procedure, except that I have an HMO and I live in Massachusetts. The details aren’t important, but the gist is that I could have a simple 20-minute operation done in my doctor’s office at minimal risk of side effects. My HMO, Tufts—a company whose perfidy deserves to be named—will authorize the surgery, but they won’t reimburse my doctor for rental of the equipment he needs. They will, however, allow him to perform a more invasive surgery with a much higher risk of infection in a hospital setting using antiquated equipment. And here’s the kicker—the old procedure is not only riskier, it’s more expensive.

Enough woe is me. Anyone with an IQ above that of a potted fern knows that the American health care system is broken. President Obama certainly knows this, but he’s gazing in the wrong direction for Rx. The Massachusetts health care system—which requires all residents to purchase private insurance—has been touted as a fix for America’s health care woes. What a farce! If you’ve not noticed that Massachusetts leads the nation in improved health care or driving down costs it’s because it hasn’t happened. And it won’t because the problem is the “private” part of the equation.

Can we please grow up and stop pretending? Health care will not be fixed by private insurers—ever. All of them are just like Tufts—they tout wellness programs and low-cost premium care, but private health insurers don’t give a sqwanker’s farley about making you better or preventing illness. They are for-profit companies who invest your insurance premiums in the stock market. Now that the market has tanked, their focus has shifted to doing what Tufts did: trying to dissuade policy holders from using their benefits. It’s not that Tufts wants me to have one procedure over another; they want me to have none at all. In their ideal world I’ll get so angry that when my employer’s fiscal year ends I’ll dump them and let their competitor Blue Cross, which does pay for the procedure, pick up the tab. (The only good thing about MA law is that Blue Cross can’t refuse me.)

That’s probably what will happen; on July 1 I’ll become a Blue Cross member. But this solves nothing. At some point in the future the wheel will turn and I’ll be mad at Blue Cross and bolt back to Tufts. And someday I’ll be on Medicare, probably with a plethora of unfixed ailments that—like a building suffering from deferred maintenance—have deteriorated from cheap, easy-to-fix problems to expensive, complicated ones.

We could parse medical care until Haley’s Comet fizzles out, but it comes back to the same thing. If all we care about is enriching private insurers, end the sturm und drang of health care debate and leave everything exactly as it is. If we really want to fix health care, all of the private insurers must go: Tufts, Blue Cross, Aetna, Kaiser… the whole lot of them. Enough nonsense—breathe deeply and repeat this mantra: single-payer health care, single-payer health care, single payer health care …. And while we’re at it, mandatory lobotomies for all the idiots who try to scare you into opposing single-payer health care. They are Bernie Madoffs in medical drag.--LV

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