Clearthinking!

I love your final example about the internally contradictory argument. When will people think?

Rec'ed!!!!

Being born and growing up in Las Vegas provisioned me with a different perspective about the Insurance Industry, including, Health Insurers. The insurance industry has not operated under free-market paradigms for longer than I've been alive. It's a numbers racket being run, or more appropriately, a cartel of corporate bookies, all juiced in with each other, with virtually all risk eliminated. They skim from the flow going in and going out. The Vig is directly related to the size of the handle. Any market-based efficiency cuts into their take.

Admittedly, global inundation of derivative trash, backed with poorly priced credit default swaps came close to the abyss, but face it, these were wise-guy pikers facing into the howling wind, where even egghead odds setters worked half-blind grasping at probability straws. Few had any inkling of recursive structural fail threat; such as the near fatality possibility not factored in because if its infinitesimal chance of occurring, like a US Presidential Admin, so derelict, incompetent and arrogant, it was unable to stave off housing market balloon pop until a post-2008 election reality. Fewer possessed the mental acuity to contemplate how the wind from a butterfly's wings in a fortuitous place/time might be enough initial energy to set off geological scaled change. Almost none had ever sat in a ringside chair at the top, as financial agents of an oil sheik kingdom lock-loaded-n-rolled an orderly massive tranche, and watched how many levels downward it floated before any potential real liability risk reared its ugly head. At that height and scale, sans any risks, even 1/2 point vig was avaricious excess.

When the smoke started to clear in the CDO shoot-out, it was the staid family firms and the non-mainstream player cowboys who got taken out. The publicly held well-heeled corps with deeply pocketed bureaucrats and pols, picked-up the pieces at fire-sale prices marked-down both sides with public financing.

The health insurance racket is a more base kind of game, but with added spit-balls thrown into the mix over the last several decades. They also get a piece of the total handle, so there is no incentive to decrease costs. They've got every angle locked-up, and keep it that way by tossing back a few bones to their customer bases.

Used to be, if you blew out a knee, or broke a limb or some other act of stupidity that needed specialised care, you'd look-up a phone number in your company policy folder that was a direct connect to someone at work's front-office who really gave a damn. Then you picked an MD from a long list, made an appointment, and showed up with a c-note. The MD's front-office would with a wink and a nod credit it all, then say they'd bill for any uninsured excess, but generally took the 70%-80% of insured total fee plus the credit for all, even surgery. Hospitals, gas-passers, and any extra needs assisting physicians billed in full, but most of that fell under major medical, and was covered near totally. Any reasonable post-procedure rehab got tossed in free cherry on top. Getting fixed up wasn't too brutal on personal finances.

Then insurers started whining about their over-burdened billing, because MDs and other providers weren't aggressively using collection agencies on their patients, instead piggy-back mooching free off of them. Then they went in pitching employers with false visions of savings via cost-burden shifting onto employees and providers. They locked in doubter execs, with promises to outsource employers' health insurance oversight labor costs to themselves or their contractors. The HMOs and PPOs had been born.

Insurers then went to providers guns unholstered with chambered rounds. telling them it was either their way/price, or no patients, but as a sweetener promised to take it easy on malpractice premiums, if they obeyed their self-promulgated rules. Forward-looking greed head MDs, immediately sought out capitalisation financing for expanding a private practise into salaried groups of just post-residence specialists, who liked the deal, because they didn't need to plunge deeper into debt after Med School costs, just to begin practising. These medical groups became pure cut-throat profiteers, seeking out larger pieces of the available patient pie, by decreasing their per/patient bid price in exchange for raw numbers bulk.

Patient Care was no longer predicated upon humane concern. but instead upon resource management, where any patient procedure given was viewed as a commodity outlay, that needed to be weighed with the potential for incurring liability risks if not providing it. Patients also became important revenue streams, and were charged for even pharmaceutical samples, which had been given freely to the medical groups. No more winks and nods from medical front office either. Cash, check, charge, or soon face boutique collection agencies that specialised in recouping delinquent medical accounts regardless of hardships. More health care dollars spent out of the Doctor/Patient relationship, and a sense of animosity between patients and providers, which impaired healing effectiveness.

Medical office visits became nightmarishly long reception room waits, punctuated with being quickly strong-armed by a tech into blood-pressure cuffs, stethoscope breathing and pulse-taking, along with quick-charted med history queries. If you were really unlucky, you caught phlebotomist hell, and a blood-letter who needed to needle punch both sides of a weight-lifter's firearm artery just to fill-up one test-tube. This all added to patient stress. Then the visit ended with a short uninformative and stressed MD sign-off on the chart with possible diagnoses/prescriptions. Naturally this led to missed symptoms at times, then onto to legal settlement processes, which also redistributed health care monies to attorney firms.

Insurance Providers were not about to eat the extra liability costs (remember they skim going in and out), so they upped the malpractice premiums, and whined to MDs about shysters in shark-skin suits, and illiterate jurors who only see deep-pockets of defendants, but never see through the faux pain of plaintiffs. Insurers then went politicalmercialtyzing to Medical Associations, telling doctors the problem wasn't from the insurers' end, but instead from greedy attorneys and faker patients, looking for sweepstakes easy street, and promising to help them lobby their politicians. Doctors, caught between a crock and a hard place hit the bait hook-line-and-sinker, yet didn't even notice when legislative relief came from the state capitols, their insurance premiums did not also decrease.

This has nothing to do with anything remotely resembling a free-market. It a free-license for public corporations to steal. A public corporation is driven by one force alone, and that is to maximise profitability. Give one a license to steal, and they will start cutting hearts out if regs allow. It ain't personal, it's simply business, and people are resources to be bought/trade/expended as resource commodities.