Recipe for dysfunction, corporate or governmental

August 13, 2014 | By | 2 Replies More

Because of my recent divorce, I needed to make some changes to my health care policy which my family had purchased under Obamacare. Therefore, today, I spent almost 3 hours on the phone, first with the Obamacare people at and then with my current insurer, Anthem/Blue Cross, one of only two health insurers offering coverage on the exchange in St. Louis. For me, it was as revealing as it was frustrating. Significant dysfunction permeated both organizations.

For those who say that they would not trust the government to have a hand in health insurance, I would respond that Anthem was terrible. It took 15 minutes to even get a live human being on the line. After the man demonstrated that he was not able to answer my concerns, he refused to elevate my concern to a supervisor. He made claims that he would not confirm in writing. I do not trust large powerful corporations to be responsive to consumers whenever there is a monopoly or a near monopoly (e.g., health insurers and telecoms).

For those who say that they do not trust big corporations to handle health care, I would say that a big lumbering government is not necessarily going to solve your problems either. runs a dysfunctional site when it comes to people like me, who are attempting a special enrollment due to life changes. I would offer that the problem is that there is little meaningful pressure we can exert when the government site is deficient [In fairness, signing up for my family’s original policy through was somewhat straightforward].

The bottom line: Whenever there is substantial power and no direct pressure consumers can assert to force a big organization to change its ways, there will be substantial long-term dysfunction. It doesn’t matter whether the organization is a big corporation or a government entity.

Unless there is a meaningful feedback loop whereby consumers can force the government OR corporations to improve performance, we can expect dysfunction.


Category: Consumer Protection, Politics

About the Author ()

Erich Vieth is an attorney focusing on consumer law litigation and appellate practice. He is also a working musician and a writer, having founded Dangerous Intersection in 2006. Erich lives in the Shaw Neighborhood of St. Louis, Missouri, where he lives half-time with his two extraordinary daughters.

Comments (2)

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  1. Erich Vieth says:

    On Facebook, a person commented that the U.S. has the greatest health care system in the world, disparaging the health care system of Taiwan. Here is the response by Curtis Roberts:

    To say that privatized healthcare is effective in this country demonstrates an obvious willingness to ignore the truth. I read a great post once by a satirical mathematician friend of mine. He noted that the average cost of a hip replacement was $40,000 in America, but only $7,000 in Spain. Therefore if he ever broke his hip it would be the same price for him to fly to Spain (round trip $800), get his hip replaced there ($7,000), live in Pamplona for two years ($24,000), learn Spanish by immersion (free), run with the bulls (free), get trampled, break his other hip, get THAT one replaced ($7,000), then come back to America, all for about 39k. Jokes aside, there’s absolutely no way to deny that there are a few large problems with our healthcare system. The huge difference in treatment of the poor and the rich (health is a right not a privilege), the enormous price gouging (charging $1,000 dollars just to break the tape on the first drawer of a crash cart), and the fact that our healthcare system has been DECLINING in rank for a good long while.

  2. Erich Vieth says:

    My comment on this topic:

    I agree that Anthem’s near-monopoly and dysfunction far precedes Obamacare. Obamacare is a step in the right direction in many ways, but (as I’ve long held) there is nothing significant in the way of price controls in Obamacare. The fact that it forces consumers to be fleeced by quasi-monopolistic insurers is terrible. And Obamacare has virtually no provisions to combat the deep dysfunction of the price gouging by health care providers, including the so-called non-profit hospitals, who are almost finished buying up individual providers thereby destroying the ability of insurers to negotiate prices with providers. A rather amazing Time Magazine article titled Bitter Pill (see the link below) laid these problems out about two years ago, and there is little hope of fixing most of these because the mega health care providers have more lobbyists than even the defense industry. It is absolutely insane that we have not yet tackled the BIG health care problem opaque pricing and inability of consumers to exert any pressure on the big providers. That said, I reiterate that Obamacare is a step in the right direction (e.g., eliminating cherry picking based on pre-existing conditions).

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