Christofoo Review

Someone has to say it: in order to curb health care costs, we have to get between you and your doctor.

(Insert tortured screams, train wrecks, nuclear disaster, etc. etc.)

Wait, let me back up. Health reform means a few different things: 1) regulating health companies to incorporate the concept of human right into health care, i.e. they can't drop you when you become ill, etc. 2) increasing enrollment by various means, the idea being that un-enrolled people are leaches on the Emergency Room, which is a very inefficient way of maintaining health, 3) adding a public option, which behaves like an insurance company but is operated by the government.

I'm talking about #3, the public option, or at least, this is what I interpret conservatives as referring to when they talk about the government coming between you and your doctor. As far as I know, we aren't discussing dismantling the FDA or HHS, which are the existing federal agencies that already get between you and your doctor, and largely to your benefit (give or take your child's vaccinations, depending on what side of that issue you fall).

Moving right along, health insurance companies are already in between you and your doctor, in the sense of potentially denying you coverage.

• One Story
• House Hearing
• House Hearing part 2 (response)

Second of all, it is almost certainly true that someone has to be in between you and your doctor if you want to have keep costs down. When you buy insurance the whole point is that you aren't directly responsible for the costs, therefore you have no motivation to weigh the value of a dubious extra test against the cost, and heaven knows the doctor doesn't want to risk getting sued, he'll order the test if you want it. There has to be some kind of third party responsible for assessing the efficacy of proposed treatment, and making a judgment call on necessity - if you want to control costs. On the flip side, there should never be any kind of agreement in place that restricts you from paying for a service yourself. The worst the insurance should be capable of doing to you is denying payment (which somehow needs to be done before treatment), this is not the same thing as denying service. This is one finer point I can't seem to discern in the current health care debate - where is it?

Third, just because I want someone to get between me and my doctor so that I can have lower costs doesn't mean that someone needs to get between you and your doctor. By all means, you should have the option to buy an unreasonably expensive insurance plan that covers whatever you want it to. We are talking about a public option, are we not? (Which means my title is wrong. It should read "Figuring Out How to Get Someone Between So-and-so and Their Doctor to Save So-and-so Money," but it just isn't very catchy.)

References:

• "This American Life" had a nice special on health insurance costs, listen to the podcast.