I went to the doctor today. He told me that I was basically healthy, and given my health, age, family history etc. there was very little chance that I had certain diseases like diabetes, etc. Without coming right out and saying it, the doctor made it quite clear to me that I didn’t need any blood work for these diseases-the chances that I had anything blood tests would detect was quite remote.
I nodded and asked him one question: “Will my insurance pay for it?”
After I was sure that my insurance would indeed pick up the bill, I went ahead and had the blood-work to detect those diseases. After all, it wasn’t coming out of my pocket-any risk that it improved my health was worth it to me (I’m fine with needles). Because I had the extra blood work, the cost of blood work for the next person increased marginally. Eventually, after millions of other people in similar situations make the same choice as I did this year, insurance prices will also rise. Health care will keep on getting more expensive. The Obama health care reform does nothing to change this.
The policy solution, of course, is to shift the government subsidies from incentivizing third party payment, usually through employer provided insurance, to finding a way to get people to pay with (what feels like their) own money (health savings accounts that you get to keep the extra amount left over, etc.)
It’s easy to say that’s the policy solution. But I worry that the idea that insurance pays for even routine care is so ingrained in our culture that there’s no escaping the third party payer problem.