By Brian C. Joondeph, M.D.
One of the many aspects of Obamacare adding overall costs for both patients and insurance companies is the feature called essential benefits. This means that Congress and the administration, in their infinite wisdom, have decreed that anyone purchasing health insurance must have a policy that includes emergency, maternity and preventative care, whether or not such coverage is needed or desired. For example, a middle-age man, such as myself, must have, and through the cost of my insurance, pay for, maternity coverage.
This reminds me of how television channels are bundled in cable packages. For example, the basic Comcast plan includes everything from MTV and Nickelodeon to CNN. Why not let cable viewers design a channel package suiting their viewing preferences? For example, liberal viewers would choose a cable package sans Fox News while conservative viewers might want only Fox News as their news choice. Those who only watch movies might skip news stations altogether, or vice versa. How many senior citizens watch Nickelodeon or MTV?
Advertisement - story continues below
Instead all cable TV purchasers get a large selection of channels they never watch – much like anyone purchasing health insurance, whether through their workplace or individually, is required to have, and pay for, coverage for drug rehab or pediatric care. Why not a la carte features? This concept has always been standard at restaurants. Want just a salad and entrée and skip the dessert? Absolutely. How about just soup and some bread? How eager would you be to visit a restaurant that requires you to purchase a five-course meal regardless of how hungry you are?
The hotel industry is discovering this concept. Don't need your sheets and towels changed daily and don't need wi-fi? Then why pay for it? If you don't plan on watching TV or flipping channels, you can even skip the TV remote and save yourself $7 a night. The net result is that consumers buy only what they need, saving money in the process. Skip all the extras and you can get a hotel room in London for $68 per night.
Home insurance allows a la carte purchase of various riders – flood and hurricane insurance, for example. If you live in New Orleans, below sea level, or along the Mississippi River where flooding is common, you would be prudent to, but not required to, purchase flood insurance – just as a newlywed couple looking forward to three children would be wise to purchase maternity coverage. But living in Colorado, I would be foolish purchasing hurricane insurance, just as a teetotaler would be for purchasing insurance for alcohol or drug rehab.
No wonder health insurance premiums have spiked and continue to do so. Unbundle all of these benefits and allow everyone to purchase only the types of insurance they need. And watch the costs drop. When the government controls the health-care insurance industry, it may not technically be "single payer," but for all intents and purposes, it still is since government dictates what is covered and what it will cost.
Advertisement - story continues below
Although he voted for Obamacare, Sen. Al Franken is raising the alarms about a Time Warner merger with Comcast because it "would harm competition and raise prices in cable television." Less industry competition creates more take-it-or-leave-it cable packages with many customers purchasing access to 500 channels and only watching 15 of them. The result is higher prices, whether for cable TV or health-care insurance. The only difference is that there is no individual mandate for cable TV requiring its purchase or risk a visit from the IRS.
The insurance companies will kick and fuss if mandated benefits go away. After all, people are currently forced to buy insurance benefits they will never use. Much like Comcast would object to subscribers opting out of buying access to channels they never watch. So we are left with the consumer holding the bag, forced to purchase insurance, or TV channels, they neither need nor want.
Brian C Joondeph, M.D., M.P.S., a Denver-based physician, is an advocate of smaller, more efficient government. Twitter: @retinaldoctor.