If ever there were a case of “Right Answer, Wrong Question” it is in the government led effort to create Health Insurance Exchanges (HIE). Yes, HIEs will be helpful in some respects, but the fear of competition and required coverage has also driven insurance rates out of the affordable range in anticipation of deeper ACA implementation. With insurance companies posting record profits, doctor rates going down, and insurance company lobbyists like Karen Ignagni being quoted as “experts” by the Wall Street Journal, blaming the doctors and hospitals for raising rates, you know who will win this round. Karen Ignagni is the CEO if AHIP (America’s Health Insurance Plans) and is also credited with the “Astrotuff” fake grassroots campaign that brought down single payer healthcare reform, but don’t get me started on her, she represents everything that is wrong with healthcare and I could talk about her all day. Here is some recommended reading if you would like to delve.
Here is my point for the day. This guy to the left is John Maynard Keynes, a British Economist from the 19th century whose ideas have been in and out of favor over the years, but is essentially credited with describing the behavior of free markets.
He relates here because the US government, as part of the Affordable Care Act, mandated an efficient marketplace for insurance plans, not actual health care. While I am a free market enthusiast, especially for healthcare, this is completely wrong headed because it is about insurance, not care. This is like making a free market for parenting services where the competitors are government mandated orphanages. You would never entrust the raising of your children to a big company or a government, so why would you do this for your health? Time and again, insurance companies have shown that they don’t really care about keeping us healthy, they just want to minimize cost and maximize premiums. Similarly, while I trust the government’s intentions, it is too big of a job for any government to tackle. Healthcare oversight, payment, and management is a responsibility we should not delegate to anyone, just like the rearing of your children.
Keynsian economics (free markets) on a treatment, visit, or procedure level does make sense though because it keeps the patient involved in their own choices and keeps the feedback loop between care and cost short and uncomplicated. Insurance companies are like the Dickensian orphanages of healthcare, doing a poor job in bulk and with different priorities than real parents would have for the children. In contrast, people who shop for care on FairCareMD are saving thousands on needed or wanted care, over 33% on average. Doctors are getting paid better too.
The 30% of all healthcare dollars that are spent on insurance company costs (like advertising, executive salaries, and needless paperwork) are being put back into the system as better and faster payments for doctors and cost savings and more preventive care for patients. This is the way Keynesian economics can help healthcare. Instead, what HIEs will create is an artificial 50% increase in premiums and an equally artificial decrease in rates due to HIE shopping behavior. Remember, with insurance, just like in gambling, the House always wins and just like when Karen Ignagni mobilized 50,000 insurance company employees to create a fake grassroots campaign against the public option, the insurance industry has shown that they are willing to game the system to make sure they win. This is why after years of working to get doctors paid fairly by insurance companies, my current efforts are directed into removing the insurance companies all together from the equation.
Join us on FairCareMD and let’s make this work now, for us, for the people we care about, and for those that care for us. Free markets require choice and the first choice is for you to participate. Whether you are a healthcare provider or a patient, post your care or post your request and let’s get this market working in your neck of the woods… that is unless you like where healthcare in America seems to be heading.
Tags: Affordable Care, change we can make happen today, Healthcare Marketplace, improving provider reimbursement


