A cottage industry of hatred for private health insurance companies has issued an apology after United Healthcare CEO Brian Thompson was assassinated on a midtown Manhattan street. As a justification for murder, this is despicable. However, this is also a misdiagnosis of the state of health insurance in America.
First, most Americans remain satisfied with their health insurance. A comprehensive survey of consumer experiences with health insurance by the Kaiser Family Foundation found that 81% of Americans will rate their health insurance as excellent or good in 2023. Ta. Other opinion polls have found similar results.
Due to the nature of their business, insurance companies struggle to ration care and control costs. These will only increase if everything is subsidized because healthcare providers don't have to worry about taking customers out of business. Insurance companies limit your options. They deny claims that fall outside the scope of policy coverage.
No one likes it, but from nationalized single-payer to people paying only what they can afford, all of this is, in one form or another, an inevitable feature of any health care system. In some countries, treatment is delayed or not provided in the first place, effectively rationing health care. But despite these unpleasant realities of life, most Americans are far from taking up arms against the insurance companies charged with this thankless task.
At the same time, public trust in America's health insurance and health care system has plummeted since Barack Obama turned the nation's politics inside out to pass the Affordable Care Act in 2009-2010. This speaks to the unintended consequences that these “reforms” have on people at the very end.
According to a Gallup poll, public confidence in the quality of American health care peaked at 62 percent between 2010 and 2012 and is now at 44 percent. Confidence in health insurance coverage peaked at 38% in 2012 (before Obamacare) and is currently at 28%. Both numbers are the lowest since Gallup began surveying this question in 2001.
The “reforms” did not yield any results. Obamacare required insurance companies to cover everyone and sought to force healthy young people into the same risk pool as older and sicker people. Instead of using tools tailored to people with pre-existing conditions, President Obama's plan advocated spreading the cost of their treatment among all policyholders.
As expected, this raised the cost of policy faster than the political system could absorb the demand for more subsidies to buy the policy. If you want something to be more expensive, subsidize it. Ultimately, public resistance to the legal requirement to purchase private health insurance, a key pillar of President Obama's plan, led Congress to repeal the hated requirement.
Obamacare also came with forcing insurance companies to cover an increasing number of items in all policies, such as mandatory contraception. Of course, requiring everyone to carry all insurance, whether they use it or not, would make it more expensive for insurance companies to issue policies. As expected, they will pass that cost on to people who buy insurance in the form of higher premiums.
Bureaucratic bureaucracy means that even more medical bills arrive months after the fact. Insurers are trying to combat “surprise claims” by requiring pre-approval for major non-emergency procedures, giving people at least the benefit of knowing when to be denied coverage without being saddled with an unexpected bill they can't pay. You can know in advance. But it also leads critics to argue that essential care is being denied.
Similarly, insurance companies are looking to speed up claims processing by using AI tools to evaluate claims. But that only leads to criticism that machines are denying human care.
Money is never unlimited. If private and public insurers have to cover everyone blindly as mandated by Obamacare, they will try to limit coverage. If insurance companies are forced to cover everything more blindly, they will take a harder look at certain claims. If insurance companies can't limit who they cover and what they cover, they will either raise premiums or go out of business.
The progressives who pushed for all these developments, from guaranteeing insurance to people with pre-existing conditions to mandating coverage, are now pushing for higher premiums and higher claim denial rates. It is a great pleasure to complain. What did they think would happen?
So now they're literally just rooting for the Messenger to be shot.
Dan McLaughlin is a senior writer at National Review.
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