Dr. Feelbad.

How have you been feeling lately? Good, I hope… because if you’ve been ill, you’re probably discovering how massively expensive it is to get treatment, even if you have health insurance. In America, it really takes a major illness to know whether or not you have what could be termed adequate coverage (and if you’re one of the 47 million who have no insurance at all, the question doesn’t even arise). But the utter failure of this system shows up in the little details as well. Not to bore you with my personal foibles, but for the last five or so years I’ve had dental insurance… which means, in my case, if I have any substantial work done – crowns, for instance – I can expect to pay $1,000 out of pocket instead of $1,600 (assuming it happens no more than once a year). Don’t know about you, but that grand is a little hard to put my hands on, so I tend to throw it on the old credit card and whittle it down month by month. That, in miniature, is one illustration of how people can get into serious financial trouble simply by being unfortunate enough to get sick or injured.

Okay, I’m probably considered a bad example of what’s wrong with this system. But sometimes bad examples like me can illuminate the problem as much as the good ones do. I’ve got a decent job, good health insurance, okay dental, and generally good health thus far. Not so very long ago, though, I had one of those no-frills policies that politicians (who enjoy superior government-supplied coverage) often recommend for us ordinary folk. And it’s real easy with a plan like that to end up thousands in the hole if just a couple of things go wrong at the same time. At one point, a trip to the doctor and some blood work ran me $500. My plan picked up $0. (That’s right: $0. Never saw a dime out of them.) With a plan like that, even relatively routine preventive care kicks the shit out of you financially. I don’t even want to contemplate what a prolonged hospital stay would do.

This is the magic of the marketplace. As a prole, I was supposed to be pumping money into the health insurance company at that point, not pulling money out. I know I’ve mentioned this before in these pages, but it’s worth saying again – our mostly-privatized health care system is an example of “lemon socialism”; privatize the profitable part of a business and socialize the costly part. The government provides coverage for the elderly, the poor, the infirm, etc. … all of the folks who require more care. That leaves the rest of us to the marketplace, where these massive private health insurance companies can decide who to cover, whose bills to pay, etc. Young and middle aged workers tend to pay in more than they take out of health insurance – by leaving them out of the government system, we create a situation where that system will inevitably run massive deficits over time. If we all participated in the same system, the healthy would compensate for the chronically ill, the elderly, etc. That’s the way it works in other industrialized countries – it could work here.