Health care policy debates seem to have become a war of anecdotes. Margaret Talbot of the New Yorker posted one titled “My canceled policy and my values” which is circulating the blogoshphere
… like many of the twelve million or so Americans who buy their own insurance, we received a letter from CareFirst in late October saying that our policy would be cancelled, because it didn’t conform to Affordable Care Act requirements. …I stopped procrastinating and got on the phone with CareFirst… First lesson learned: healthcare.gov is not the only balky system around.
I was on hold for forty-two minutes, mostly listening to an especially melancholy rendition of the “Moonlight” Sonata, before the agent who answered told me that she couldn’t help me with questions about individual policies, and, “with that being said,” CareFirst had been having “technical difficulties” all day. I waited another twenty minutes for a member-services representative who didn’t know why the company had increased my premium—maybe it was my age (fifty-two) or where I lived (Washington, D.C.)—or what about my policy didn’t meet the A.C.A. requirements. She transferred me to a third person (wait time fifteen minutes, listening material a jauntier, marimba-inflected Muzak), who told me that my premiums had most likely gone up thirty per cent owing to “the rising costs of health care” and then transferred me, without warning, to the D.C. Health Link, my state A.C.A. exchange. Second lesson learned: part of what is confusing and distressing about this process is that health-insurance companies don’t seem equipped, or maybe willing, to explain the implications of the new law to consumers. (Why raise a premium on a policy they must have known wouldn’t survive Obamacare?)This reminds me of the hilarious “What if air travel worked like health care?” video that was circulating a few years ago.
Now how do you react to this atrocious level of service? What do you make of this experience vs., say Amazon.com, famous for short wait times and excellent service?
An economist makes the inference, “any company who treats me like this does not care about my business, and is not facing competition from upstart innovators. They must be massively regulated, licensed and protected from competition.”
New Yorker writers conclude
The Affordable Care Act has not necessarily, at least not yet, made the workings of insurance companies any more transparent or accountable than they ever were.i.e. that more regulation and protection from competition is going to bring 3 minute wait times, and cheerful informed staff. You know, the way the Affordable Shopping Act made the workings of internet retailers more transparent and accountable.
Her story is particularly poingnant.
I’ve had high blood pressure since I was in my thirties. I take ten milligrams of a generic beta blocker every morning, which has successfully kept my hypertension controlled. By doing so, I hope to prevent or postpone some of the possible consequences of hypertension—strokes, heart attacks—which are both debilitating and costly. That’s good preventive thinking for me, and good social policy, but it also means that I have a preëxisting conditionShe is a classic case of someone who did everything right – she bought individual, non tax deductible, insurance, when young and healthy, so she would not lose coverage if she got older or sick. And Obamacare just destroyed that investment. Rather than outrage, however, she feels comforted that this theft may help those not so prescient:
So yes, I’ll subsidize someone else’s prenatal coverage, in a more effective way than I’ve been doing by default under the current system, in which too many pregnant women show up in emergency rooms without having had such care, creating problems for themselves and their babies, and all sorts of costs for taxpayers. And I’ll remember to be relieved that my own access to health care is guaranteed. But they had better work out the problems with the A.C.A.; if they don’t, and it doesn’t fulfill its promise of insuring the uninsured, I’m really going to feel like a chump.When you get that feeling, you will have company. But don’t feel bad. Many a good free-marketer, in their youth, made similar mistakes. We all have values about helping people, and eventually we learn the hard lessons of cause and effect, and what actually works to that end.