Insurance companies need competition

There have been several health care commentaries from the right with important ideas for the debate on health care. John Mackey of Whole Foods has been unfairly beat up for his ideas (read it here). There have been others.

But they often contain one important flaw. They seem to assume that if something goes wrong, it is the fault of the patient. He or she eats too much or smokes too much or drinks too much.

But not all health events are a matter of choice. Everything that happens to us is not the result of bad habits.

I appear to be healthy, I exercise, I am not overweight. I don't smoke and haven't had a drink in decades. I don't do soft drinks.

But I was refused health insurance because I have high cholesterol. Not heart disease, mind you, but high cholesterol, a condition that could cause heart disease. About the time I decided to address this issue with drugs, unsuccessful with diet, I had to change doctors because of a dispute between the insurance company and my doctor's company over how much money insurance would pay for my visits.

My new doctor ordered a battery of tests. Tests that insurance companies don't like to pay for, because they don't really affect treatment. If you have high cholesterol, the treatment is to take statins, it doesn't really matter why you have high cholesterol. They claim the doctors order the test to make more money.

But my doc wanted to know, because it might dictate how to attack my high cholesterol. It turns out I have a genetically-caused situation. I don't know how to describe it, other than remembering that I had something like three markers for the genetic issue, and if I had the fourth marker, chances are I would already be dead, or face dementia because of plaques in the brain, or worse.

The point is that I have a genetic condition, not modifiable by diet, that could affect my health. And for that reason, I was denied health insurance by private companies. I had to scramble to find a "public option" that would take me.

I am not alone. Many have conditions that allow the insurance industry to decide, after being paid many tens of thousands of dollars, as I paid them, that a patient isn't worth the risk. Heart disease. Broken bones. Family history of cancer. Diabetes. Go away.

The game is rigged in their favor. I know this as a citizen, and having watched them from a chair on the Oregon Board of Medical Examiners. The market mechanism does not work very well when talking about health care, nor insurance.

Our system is broken. We can get great care in America, and I know that, too. I have had exemplary doctors, and I am a demanding patient. But the "system of health care" is broken. There is too much paper work. Doctors face unnecessary lawsuits. Insurance codes are designed to deny payment and coverage, not make it better.

It's time for a change.