Michael Moore raises the question in Sicko: why exactly are we tolerating for-profit health insurance companies that make money by denying us the health care that we've paid for?
What sense does that make?
I recall Luis Gutierrez (who, here's my prediction, will run again in 2008 for Congress) at a town hall meeting in 1993 or 1994 on public television called for abolishing the insurance companies and the crowd, previously passive and polite in that public television way, erupted in applause. The host (probably John Callaway) asked for calm and then asked the insurance company spokesperson to justify the industry's existence. "What do you do?" he asked.
"Spread risk" was the answer.
The health insurance guy could have said "suck resources out of health care like a parasitic middleman to build skyscrapers, run commercials and make our investors rich" which would have been more honest, but the economic basis for the health insurance industry's existence is "to spread risk."
Well, you spread risk by getting a bunch of people in the same big pool. So if there are 5 people in a small business who are paying for their own health care and one of them gets cancer or gets hit by a bus, then those 5 people have a lot of money to pay. The goal is to get 10,000 people in a big pool so when someone gets cancer, the cost is absorbed and spread out among everyone.
I've got a big pool we should all get into: Americans.
The whole country should be one big pool. That's what we do with Americans over the age of 65. It's called Medicare. And there isn't any role for private health insurance companies to make money. That's why it's so cheap to administer.
I wish I had access to Medicare.
I pay Medicare taxes. Why can't I have Medicare coverage?
Because for people under 65, we have to make health insurance companies rich to get access to the doctors and hospitals.
The best thing we could do for our economy is expand Medicare for everybody to end medical bankruptcies and encourage small businesses to grow (who now have to make insurance companies rich).