Why Can't We Fix Our Health Care Insurance Mess?

The story behind this, and all the pain that's been caused by the health insurance mess in this country, is as simple as can be, yet very difficult to explain. Insurance is a gamble. It pays off because most people never use it. The bigger the pool of insured (most of whom will never use their insurance anyway or will only make small claims) the bigger the profits, and the safer the insurance plan. Got that much? Think about it. Most of the people who have health insurance at any one time are not going to need to use it.  That not only covers the costs of those who do use it but makes insurance a profitable business. That's why BIG insurance plans that cover everybody work efficiently. It's not socialism. It's the rules of the game.

Once upon a time, long long ago, this country had a system in which each state had its own non-profit Blue Cross and Blue Shield health plan. Employers signed up its workers in these plans. It was pretty much the rule that if you had a job you could get affordable health insurance to protect yourself and your family. This wasn't quite as efficient and inexpensive as a national plan would have been, but for the most part it worked quite well because the insurance pools consisted of the vast majority of employed people in each state.

Then the private insurance companies got greedy and decided they were missing out on a good thing. Actually, they weren't, and rather quickly realized it. Health insurance is one area in which competition doesn't work well. You need an awful lot of people who aren't going to need to use their insurance to cover the expenses of those who will need to use it, and the fewer insured you have the less profit you're gonna be able to make.

Once again, stop and think about this. The insurance companies certainly did, once they realized the problems they were making for themselves. And the states had to think this over too, because Blue Cross/Blue Shield found itself stuck with the expensive, problem cases the private companies refused to take. And when you get down to it, Medicare isn't a good insurance plan, since it's insuring a very high risk group and most of its members are going to need to use their insurance. The result is that, at this point in time, health insurance is NOT a good deal for anybody. Not for the private companies because they compete with each other for a limited group of people and never have enough customers to actually be safe and certain to make a profit instead of a loss. Not for the government, which is stuck with the most expensive cases. At this point the only possible answer is some kind of national health insurance plan. Because of the way insurance works, not because anybody wants to be socialists. The private companies will kick and scream because they've solved their problem to some extent by (1) charging exorbitant rates and (2) excluding anyone who might actually be a genuine risk, brushing those cases off on the government when possible, or leaving them uninsured.

Once again, it's the vocabulary, stupid! You have to actually understand what's causing problems to solve problems.