Monday, April 30, 2007

The plural of anecdote IS data [part 1]

I've grown tired of that stoopid shibboleth: the plural of anecdote is not data. But I have grown even more tired of that other shibboleth: health care rationing. Just try to get good hard data on that from insurance companies. Pretty much leaves us with just anecdotes to analyze.

I, for one, do not believe we'd have a serious rationing problem if we went to single-payer universal health care. But if we did, I'd much rather the rationing get decided based on my fellow citizens' health care needs or even on a first-come-first-served basis outside of emergencies. I do not consider it right that rationing be based on the profit margins of corporations.

Besides, I'm old enough [just barely!] to remember when doctors were the medical experts, not accountants. I'm also old to remember when insurance companies really and truly sold you insurance, rather than just bet with you on the state of your health and then welsh on their bets. I'd really, really, really like to go back to that era. I'd even be happy with high-deductible, major-medical, guaranteed-coverage, for-profit insurance. That guaranteed coverage is a sticker though. This country has already gone way far past the point where we hold corporations to the same standard of responsibility that we demand of the fellow in the street.

Speaking of insurance company profits, check out the Industry: Health Care: Insurance & Managed Care Fortune 500 list for 2007.

So, anyways, excuse the tangential rant, back on topic: rationing. Anybody who doesn't think we already have rationing right now, here, today, in the good ol' US of A, hasn't been paying attention. Some of the forms that rationing takes:

  • waiting periods for coverage

  • partial coverage with none for pre-existing conditions

  • complete refusal of coverage because of particular conditions, past or present [asthma, once had anti-depressants prescribed, had cancer, ...]

  • not to mention deciphering all the gobbledygook in the fine print, which basically leaves them lots of weasel room when deciding how much of any one charge for any one service they will pay for [and argue with you about till you decide it's easier or cheaper to pay it yourself].

  • [add your example here]

Data to be updated periodically*

[compilation of anecdotes]

* I'm much better at starting projects than keeping up with them. If you didn't already know that, you haven't been paying attention.

1 comment:

Keifus said...

Hey now, I've used that phrase. I had no idea it was a shibboleth--I copied it from someone who I thought was being clever.

It's taken me a decade to think my way over in this direction (and you can blame the data more than the anecdotes), but I don't see a lot of ideological daylight between a government-sheltered oligarchy in the health care* sector vs. a government-sponsored single-payer insurance plan. At least the latter, in principle, would be answerable to the public.

(Not that I trust them a whole lot either--it's the same public that would vote itself rich in a heartbeat--but we are rich for the time being. Now if we could just stop breeding. [I'll never see those solvent days, thanks.])

Was thinking after reading your previous post, of the various libertarian what-if scenarios that I've read about: always involving competition between small doctors, and whitewashing the realities of infrastructure, accreditation, and, big-time, our fucked-up insurance model, which is market-based, sort of.


*Pharma, sure, but actually not clear the extent to which Uncle Sam coddles the insurers.