This is an issue that's hard to feel until it kicks you or someone you know in the teeth, but since more and more people are being kicked in the teeth, maybe it's not so hard. I'm talking 'bout the health insurance industry, having recently spent 7 - 8 hours in a conference on medical debt. I have a goodly number of elderly clients who are or have been dragged through collections because they couldn't pay their medical bills. Having some kind of insurance is not necessarily always helpful either. I learned about something that hospitals have called a Chargemaster. This is the list of the highest most detached-from-any-reality prices that they have made up for any given procedure. It is different from the actual "Cost" which is the amount the hospital has negotiated with various insurance companies and government safety net programs, the amount the hospital will actually be paid for the procedure. The "charges" have skyrocketed since the 90's with no relationship to anything other than that hospitals figured out they could gouge the government for procedures that are reimbursed at a percentage of the "charge"--for example, wouldn't you rather have 80% of $100,000.00 than 80% of $10,000.00?
California recently passed (takes effect in January) some better protection for consumers including self-paying consumers...the hospital can't charge lower income uninsured people an amount greater than the Medicare, Medi-Cal, or workers' comp rate, along with some brakes on the collections process.
So that's good. But health insurance as a for-profit industry is hurting and / or killing people and small businesses and nonprofits. My nonprofit org has been scrambling to figure out how to deal with yet another 30 - 40% hike in premiums this year. Last year they dealt with it by giving us a $2,500 deductible. One proposal this year is to have us start paying full price for office visits (currently we have a $30 co-pay). Seems like that would really discourage anyone from going in for preventive care. Thanks, I'll just wait until I'm pretty sure that I'm dying. We pay for this?
It is all about profiting at the expense of public health and security, cutting benefits (maternity care is often one of those items on the insurance companies' chopping block) and increasing the revenues. This can't go on. I think Phillip Morris and Wal-Mart have more integrity at this point than the health insurance industry. At least I can make choices about smoking and shopping but I'm just not empowered enough to perform most surgeries at home. Maybe creative solutions are out there and we're not as helpless as it feels like we are. I don't know where the breaking point will be, maybe campaign financing reforms will have to happen first, but I tell you this is the next big revolution that has to happen.
Also, I think that there is a scene in my novel in which some people appear to set themselves on fire in front of the brand X insurance corporate headquarters. Not really a solution (other than they no longer have to pay premiums and it takes care of any preexisting conditions they may have had), but sort of cathartic to think about. Especially since not a whole lot has been happening in the novel in terms of a storyline.