Thursday, November 17, 2005

What I learned in Contracts today: WE HATE INSURANCE COMPANIES. We will rule against them every time, even if we have to make up a new legal doctrine to do it.

7 comments:

Monica said...

Gonna make sure I get you for my contract problems. :- ) Besides, after debate, I bet we can make up legal doctrine by the boatload. And rediscover it every week too. ;- )

The Bard said...

Wicked, tricksy, false companies. We hates them, yes, we does. Family experience. They seem to be one of the few lines of business that can screw people without suffering market consequences.

The insurance companies do tend to lose the reported cases, and sometimes the courts get creative with the law. Why? Is it just that we hate the companies? Or do we hate seeing the little guy get screwed, so we bend the law, and the insurance company loses because it is the one most likely to screw people? Or do most judges have an inherent sense that most of the time the company is going to get away with being bad, so on those few occasions where the big bad company is in court, the judge makes sure the company gets smacked to make up for all the times it gets off.

Rhonda said...

It's sad that we spend lots of money paying for different kinds of insurance--just on the off chance that we may need to use it.
I think everyone would be better off if we all paid for our own health care, instead of everyone paying for others by insurance. HC costs would definitely go down!

Monica said...

You know though, maybe HC costs wouldn't really go down. What if it really did stratify health care availabitliy even more than it is now? I'm not fully convinced that MDs would need the business so much that they would lower prices. They could probably just keep their prices the same and have a richer clientele, or they could raise prices and cater even higher on the social scale to make up the difference.

Becca said...

There could be truth on both sides. HC costs could go down some (at least some doctors probably have a conscience), but Monica is probably right that there will still be people who can't afford HC. Could it be, though, that insurance isn't the bet equalizer because it's in it for profit (and a lot of it)? As much as we hate socialism, does it have a place at all in HC? At least in part of it? Maybe not the research sector, or some areas of advanced medicine so as to continue to incentivize development, but maybe in at least some general practice (read "preventative health" areas. Of course, good luck getting THAT through Congress with all the lobby power of the AMA...

Monica said...

A little socialism might work in theory, but I don't know how much it would work in practice. It requires us to trust that there are at least some people that aren't self-interested, and I'm not sure there are enough to make a program like that work. You know? If you leave parts of it incentivized, it kinda makes sense that the MDs are going to gravitate to that part. There would have to be some pretty strong incentives in place to keep the docs from setting up their own for-profit practices. Maybe the gov could subsidize their income, but that's going to be based on the avergage of everybody else's salary, and that would make it prohibitively expensive again.

Monkey Lung said...

Just to provide the unpopular perspective (I'm training to be a doctor and by dad works for a major insurance corporation) on behalf of those being libeled here with such grave accusations as "self-interest" (oh my)....

Let us not forget that the purpose of buying insurance is not to make a claim. It is to reduce ones risk of making a claim. Insurance is just what it says it is, making steadfast certain things in your life vulnerable to catastrophic events. The goal when buying insurance is not to make a claim. No one buys car insurance hoping they will get into an accident, no one buys health insurance hoping they will get sick. Therefore the incidence of one of these events which require the big bad insurance company pay out the money they have been hoarding from its poor, miserable, unwilling customers is not what justifies the purchasing of a policy. Rather, it is the reduction in risk to you posed by the potential of such an event that justifies the cost.
The partially socialistic medical schemes to which Becca refers do exist in some localities and I will remind the readers here that it is not the indigent (who qualify for medicaid) about whom we are primarily concerned but rather "the working poor," those with full time or more than full time jobs whose employers do not provide them with health insurance or whose income precludes its cost. Here, the primary determinant of morbidity and mortality (and thus ultimate cost of HC to society) is the existence of primary (preventative) care. Many localities have approved modest sales tax increases and partnered with willing local physicians to provide care in this manner. The savings to society achieved by providing this kind of low cost care are tremendous. ER visits are far, far more expensive and the amount of secondary and tertiary care sought by the uninsured goes down immensely when primary care services are provided.
In closing I will advance two other potentially unpopular ideas:
1. Doctors and insurance companies may not be out only for themselves, an idea I will defend more staunchly if challenged directly.
2. The attitude that insurance payed in but never payed out is a "tragedy" is the greatest enemy to providing comprehensive health insurance in this country. It is precisely this kind of mentality that prevents employers from purchasing health insurance for their employees and devalues health insurance among the working poor who need it but may not have an immediate risk to their health. Far too many who might be able to afford insurance gamble without it and lose because of this attitude.