Tens of Millions of People ‘Can’t Keep Their Doctor’

While I think a couple of the Democratic candidates (Sanders, Warren, Harris–though she seems to walk back a lot of her positions) might have gone too far in saying that there will be no private insurance*, healthcare conservatives really are overplaying the ‘people want to keep their doctors’ card. Why? Because too many people involuntary ‘lose their doctor’ every year (boldface mine):

What this source reveals is that, in a given 12 month period, 1 in 4 adults between the ages of 18 and 64 — 50 million people — face a spell of uninsurance.

Normal estimates of uninsurance miss this fact because those estimates are either annual surveys that ask individuals if they were uninsured for the entire year (Census) or point-in-time surveys that ask people if they are currently uninsured (Gallup). These are useful statistics to have, but they do not really capture how prevalent uninsurance is. To capture that, you need to ask people if they were uninsured at any point over some period of time, such as over the last year.

…one in four adults between the ages of 18 and 64 faced a spell of uninsurance in the prior 12 months, meaning that they were either uninsured for the entire 12 months or for some period of time during those 12 months. Based on current population estimates, this is just under 50 million people and that’s not even counting children and elderly people.

our health insurance system constantly causes people to lose their insurance at nearly every critical life moment: loss of job, loss of spouse, loss of parent, loss of Medicaid upon income increase, turning 26, moving states, and so on. Indeed, even those who manage to stay continuously insured are nonetheless forced to switch plans all the time, often losing their doctors and preferred providers in the process.

Only a seamless national health plan that keeps you insured no matter what happens to you, like that envisioned by the Medicare for All proposal, can finally rescue Americans from this nightmare system.

I’ve been fortunate that I’ve always been able to afford healthcare, and I have had multiple plan and general practioner switches, even when I haven’t moved (i.e., it’s not the healthcare insurance system’s fault if I move from Boston to DC and ‘lose my doctor’, but it is the system’s fault if I have to switch while in Boston). Not only are these switches a pain in the ass–I have to find another GP again–but it’s not good for anyone’s health. The care provided by our medical system is already treats you like a piece of meat to be processed, but it can’t help if my doctor doesn’t even know my name. That doesn’t help the doctor/patient relationship in either direction.

I really don’t care about the inner workings of the system, what we need is a commitment to a universal system that doesn’t require constant switching, often based on the whims of your employer, and that you don’t lose if you lose your job: Jayapal’s Medicare for All seems the most likely to do this, but I could be convinced otherwise).

*Personally, I think people should be allowed to buy supplemental insurance–if rich people want to light their money on fire, no need to stop them. Just make sure the public healthcare is very good.

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2 Responses to Tens of Millions of People ‘Can’t Keep Their Doctor’

  1. Joe Shelby says:

    The real curse is that whole idea of “in-network” (along with all of the “allowable charges” crapola that has one insurer paying $15 for a saline injection while another will pay $600…and the provider will therefore charge $1000 to the uninsured!).

    Along with that is the whole idea that insurance should be in any way associated with “State”. Health care is an individual need no matter where they are across the nation, and many people travel very often or are part of a working ‘circuit’, either in some form of traveling entertainment, or in some form of migrant/day worker (e.g., farm hands that move from state to state depending on when each is doing their harvest).

    Then throw in how multi-state (as well as multi-national) corporations are, how does a corporation primarily focused with an HQ in California deal with employees in a side office in Virginia? Picking an insurer in California means there will be very limited “in-network” options in Virginia, but picking a separate one in VA will be more expensive on the whole because fewer employees means higher bureaucratic charges.

    The way to solve that is to eliminate state-based coverage and eliminate “in-network” ideas. Both of those are anachronisms for a lifestyle that ceased to have any meaning 30 years ago.

  2. coloncancercommunity says:

    As long as the private insurance is regulated to the point where it doesn’t create a two-tiered system. There are two ways this could happen. Some doctors might decide to only take patients that have supplemental insurance that would cover higher rates in signficant numbers. The other way is if the supplemental plans could cherry pick the young and healthy using super-low rates that creates financial problems with the public option.

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