Today in Poor Arguments (Health Care Edition)
From a column in the NYT, What the Republican Health Plan Gets Right
I learn from my patients every day about the benefits, limitations and contradictions of their health insurance. One charming 60-year-old with severe seasonal allergies insists on seeing me every few weeks this time of year, even though I tell her she doesn’t need to — her antihistamines and nasal spray treatment rarely changes. But she worries that her allergies could be hiding an infection, so I investigate her sinuses, throat, lungs and ears. I reassure her, and her insurance (which she buys through New York’s Obamacare exchange) covers the bill.
If she was responsible for more than a small co-payment for these visits, I’m sure I would see her less often.
Why shouldn’t a patient who is risk-averse pay more for coverage she might never need, while that construction worker be allowed to choose a cheaper insurance plan that might cover only the essentials?
Ok, these are not invalid points, but the reason I noticed them, and why I am commenting on them, is because the basic dynamic being described is a pre-existing condition (if I can use the term) of our health insurance system. While the AHCA does provide for more high risk pools it does not, as best as I can tell, really address the problem of the allergy lady in the anecdote.
One of the aspects of the health care debate that drives me a bit crazy is that every aspect of our system that is problematic is blamed on the ACA. Now, on the one, fair enough in the sense that the ACA deepened the pre-ACA system. But, on the other, it is not intellectually honest to pretend like a pricing system in which patients pay a co-pay and insurance pays the rest is the result of the ACA (or to act like the AHCA fixes the price distortions in the system).
Of course, the example in question underscore that a) we do not have a pure market for health care, and b) health care decisions are not always perfectly rational.