Health care choice, the panacea

To the editor:

We hear a great deal lately about choice in health care. Applying the free market model, choice spurs competition, innovation and lowers prices.

Free market health insurance will give us a choice of networks and policies that will make the market efficient. The argument goes, why should I pay for insurance that covers pregnancy when I am over 65 years old?

The notion of choice in health care insurance has a number of fatal flaws. First, is the assumption that the purchase of health insurance is, in itself, a choice? To point out the obvious, it is only a choice if you can afford to pay for health insurance.

Second, the recent push by Health and Human Services head Alex Azar to institute work requirements for Americans on Medicaid underscores another assumption of choice. Azar assumes that those on Medicaid choose not to work, whereas they may be too ill to work.

Third, getting sick is not a matter of choice. We would all choose good health. But no one knows when we will get sick, or what the nature of our illness will be. Adopting a “healthy” lifestyle is no guarantee of good health.

Fourth, there is the notion we can make intelligent choices with regard to what insurance we purchase. However, since we do not know what the nature of the illness we have not yet contracted will be, we are not in a position to know what insurance we will need.

Fifth, there is an assumption that we can make choices regarding our treatment. Even if we were all qualified as physicians, we would not all be qualified as specialists, and as laymen, we certainly could not make intelligent choices regarding our treatment at the time we purchase insurance.

The advertised benefits of choice, the lowering of medical costs, have not worked. Competition simply increases the amount of money spent on advertising, already 15 percent of our premium dollars.

One further thought. Millions of people in the United States have no access to health insurance. They can potentially spread disease before and after it becomes manifest. If mosquitoes are carriers of the disease, we could have a pandemic on our hands in no time at all. 

A health system that does not cover everyone is no health system at all.

Helen Krim