Sunday, February 22, 2009

Sobre los sistemas de aseguramiento de salud

"As John Stossel goes over in Bad Medecine (21 SEP 2007, NY Sun), insurance is the worst way to pay for medical care invented. Prior to the war-time subsidies via tax-code, Americans looked after their own health care directly. Most individuals went uninsured and some purchased forms of what today would be considered 'catastrophic care' plans, although most would fall under the 'accidental death and dismemberment' concept of insurance. Health insurance, itself, while not unknown was not widely used and the need for individuals to understand their own health limited the utilization of health practitioners and medications to chronic diseases or immediate ailments. It should be noted that even the Influenza Epidemic did not cause a rush to 'health insurance', even with the death toll that came with it. By requiring individuals to pay their own way, health care costs were minimized and, yes, often at the expense of long-term health. This did not prevent overall life expectancy to continue to rise even without 'health insurance'. Today the cost of overhead to the 'health insurance' system is entirely due to the 'insurance' part and not the health part. Actual costs to the individual for actual doctor treatment time and not paying for paperwork has changed very little in America. What has changed is the need to keep and manage health insurance records, fill out forms, undergo third party governance of what is and is not good for one's health and, generally, time and effort spent in trying to keep track of all of this. That overhead has now changed the system itself to a document management system that, as a minor function, also delivers a little health care."

Nunca había caido en cuenta del fenomeno que menciona la ultima parte que de este texto.

Indudablemente nuestros sistemas de aseguramiento en salud requieren tal nivel de burocracia y papeleo que el objetivo parece haberse distorsionado.