Instead of focusing on Joe the Plumber and his tax phobia’s, perhaps the presidential candidates should talk to Jesse the Artist and ask him or her about health insurance. On Sunday, October 19th, I visited the Bethesda Row Arts Festival in Bethesda, Maryland. I did just that. In a very unscientific survey, I talked to a number of the artists about their health insurance.
Why should anyone else be interested in artists? Because they are small business people. They are also very creative. It is this creative entrepreneurship of small businesses that candidates like to support because it is the economic engine that drives the American economy.
Artists as Small Businesses
I was curious whether health insurance was a barrier to entry for these artists. Two of the artist referred to a study (but could not name the source) that 83% of artists had health insurance. That was consistent with my own unscientific study. I talked to close to 20 people. Only three had no health insurance. But, on the other hand, only three paid for their own health insurance.
Perhaps they asked the wrong question.
Approximately six months ago our office began receiving stacks of paper claims for prescription drugs. The drugs originated in various Veterans’ Administration medical centers around the country. They were for drugs that members in our Plan had received at VA medical centers.
It was obvious that there had been some sort of new policy at the VA that required the VA to obtain payment from other payers when veterans had other coverage. The problem in this case is that our Plan had just changed pharmacy benefit managers effective January 1, 2008.
So think about this. Until recently, a veteran who also happened to have other coverage went to a VA medical center and received care. The VA paid for the service and somebody figured out how much it added to national health expenditures. Our health plan did not pay for the services and therefore nothing was added to national health expenditures, other than the cost of keeping that Participant enrolled in our Plans.
Then someone in Congress got the idea that the VA could save money by finding someone else to pay for services. Ignore the macro perspective that it increases the total cost to the system. Now a layer of bureaucracy is added to find who is liable for payment and send the bill to that payer. Remember the card game Old Maid? Who is going to be left holding the poison card? That’s what our health care financing system has come down to.
Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.
According to Merriam-Webster’s Collegiate Dictionary, 9th Edition (OK, I have an old dictionary) amazing is derived from a French word meaning “to confuse”. Obsolete meanings include consternation, bewilderment and perplexing.
Yes, health care in the US is truly amazing. Rube Goldberg could not have invented a more illogical maze of non-systems. Lewis Carroll’s might have added an additional chapter on Alice’s efforts to get those pills that made her big and small. Kafka might imagine a special Penal Colony for those responsible for this maze.
I should be careful on this last point, since I am part of that system. I administer the benefit plan for approximately 25,000 participants. I like to think that we do our best to help our members navigate what is all to often a daunting and perplexing maze.