Republicans are touting the free market as one of their utopian principles for a better health care system. They often seem to worship the free market as a sacrosanct system that is inherently superior to any public program. What does a free market health care system actually do?
“Free market” health care simply turns over health care decisions to profiteering insurance companies. The insurance industry has never contributed anything to health care except to spread the financial risk of large health care expenses among many people. The core principle of insurance is the sharing of risk to make loss less catastrophic. The larger the customer base the lower and more stable the premiums. The largest and most stable customer base would be a single system that covered everyone in the nation.
Corporations and large business owners try to maximize profits. They have allegiance only to their owners and shareholders, not to their customers. Customers are accommodated only to the degree they are profitable. Greedy companies will even harm their customers if not restrained by regulations. The tobacco industry is famous for selling a lethal product and marketing it as healthful until it was forced to restrict its marketing. Tobacco companies buried any research studies that found tobacco to be harmful, and they worked hard to create doubt about tobacco research when there was no doubt among scientists. The pharmaceutical industry also cherry-picks the research studies that get the results they want. The same tactic of manufacturing doubt is being used by climate change deniers.
As a clinical psychologist, I have more than forty years experience with health insurance companies. Health insurance companies maximize their profits and their CEO salaries in many ways, including by restricting health care and insurance benefits. I have had to pay to apply to insurance provider panels and have been denied when a company wanted to limit the number of doctors available to their customers. I have dealt with insurance employees whose job is to deny claims. I have had claim payments delayed by a company insisting they did not receive one or two claims out of a batch sent together. Until prohibited by the Affordable Care Act (Obamacare), companies used annual and lifetime limits on services and denied coverage for pre-existing conditions to improve profits. Some companies require redundant authorizations every few treatment sessions to discourage treatment. I have been required to get approval to continue services by people with no more than a high school education who are thousands of miles away from the patient I am treating. It’s a time-consuming game I have to play that is an insult to the twelve years of university training and years of experience and continuing education I have.
When politicians imply that eliminating regulations on insurance companies allows you direct access to your doctors, they are lying. They are simply substituting restrictions and limitations written by insurance company lawyers and accountants for those by independent health care experts. Left unregulated, insurance companies decide what fee I will be paid, what diagnoses I will be paid to treat, and how many sessions I may provide, all motivated by their profit. That’s what “free market” health care is.
The argument is that competition will control all of that. The truth is that slick marketing, deceptive insurance practices and a system that is too complicated for the average consumer to understand or navigate will defeat any benefit of competition. My personal experience with Medicare and the VA shows me that sensible government health care works far better than free market health care dominated by private, for-profit companies. Minimizing health insurance influence would allow health care providers to be available to ALL eligible consumers so consumers could truly choose doctors based solely on expertise and quality of services.