Just the other day, I received this note in the mail from an insurance company many of my clients use:
“Dear Provider,
As of 8/21/2000, the attached Uniform Treatment Plan (UTP) is mandated by the Maryland Insurance Administration (MIA) [a government body — Ed.] to be used by Maryland providers to request treatment authorization for members residing in Maryland. Providers seeing members who reside in states other than Maryland may use this form, or an alternate instrument with equivalent information.”
In short, this means: the People’s Republic of Maryland (excuse me…the State of Maryland) now determines the means by which insurance companies are to authorize or not authorize mental health care for residents of the state.
Because of this new regulation, the supposedly “private” insurance company — who covers millions of insured “members” — must send out this same form letter for every single patient currently in mental health therapy. Imagine the time, energy, and cost involved — for the postage alone! (The U.S. post office monopoly must be smiling!)
Interestingly, the new UTP form differs in no significant way from the old form the insurance company previously used for the same purpose. So this massive mailing had to be undertaken simply so the government could make itself look like it’s “doing something” to improve health care when in fact all it did was create more needless bureaucracy.
This is the true meaning of managed care.
Managed care does not refer to private companies, ultimately answerable to their customers, deciding how to best please those customers in order to make a profit and stay in business. Managed health care actually refers to government bodies determining who will receive what treatment and in what manner, based on totally arbitrary or politically correct standards.
The next time you feel like cursing your managed care insurance company, just remember one thing: It’s not capitalism you’re cursing. It’s not free enterprise you’re bemoaning. It’s not voluntary contracts between individual companies and individual consumers you’re hating. Managed care is a government-run, government-managed, essentially socialized system causing all this pain and confusion.
Yet, in a sense, what we have in health care right now is worse than socialism.
Normal socialism would not hide the fact that government is running the show. At least under socialism, the government must take the heat when its policies fail.
What we have in the United States today, in health care and other fields as well, is government largely running the show while we all pretend that it’s capitalism causing the problems.
From government’s point-of-view, this is an awfully good deal.
Politicians take all the credit for what goes well (which, of course, under socialism is very much the exception and not the rule); and then those self-same politicians pass the buck for what doesn’t go well, blaming it all on those “greedy capitalists”, or those “greedy doctors”, or those “greedy insurance companies” — the very ones who are weighed down by ever more regulations, like the one I just described.
So if you don’t like the state of health care today, and all the managed care, then don’t blame capitalism and freedom. Blame the government regulators who keep making it all possible.