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Our Unhealthy Addiction to Health Insurance

Date: Wednesday, October 23, 2019 4:03 PM EDT

Whenever I give a talk about health care, I ask the audience, “What is the worst addiction problem we have in the United States?”

The answers are typically the same and all are good guesses—alcohol, tobacco, opiates, and sugar are most frequently cited. I agree these are all terrible addictions that need to be addressed but, in my opinion, the worst addiction in America right now is to health insurance.

The Numbers

That answer usually draws a stunned or shocked silence from the audience but the numbers bear it out. The chart below shows the staggering costs Americans spent on healthcare in 2017. Please remember, these figures are in billions of dollars, so $2,961 spent on “personal health care” represents $2.9 trillion(!).

What is most shocking about these numbers is not just the high spend but the lack of value delivered in return. As a primary care physician who has practiced within the insurance-based system and now outside of it, I can tell you Americans are paying Porsche prices for Yugo performance.

The typical American experience in seeking healthcare is not good. There are often long waiting times for appointments (usually which could have been cleared up in an email or phone call), brief interactions with an actual doctor, high co-pays and deductibles, long waits at the office, a crushing amount of paperwork, and a stunning lack of communication. Does this fit into a description of “Porsche value”—especially when one gets the mysterious, indecipherable bill for services weeks later?

Health Insurance Isn't Really Insurance

The main mistake that we have succumbed to as a society is that we have deviated from the original intent of health insurance. The true purpose of health insurance was to protect people against financial ruin in the event of an unexpected, major occurrence—just like car insurance, life insurance, and homeowner’s insurance. But things got murky when people were indoctrinated into the belief that good health insurance should “cover everything” because “everything in health care is expensive.”

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