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 Healthcare.gov 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. Healthcare.gov 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 Healthcare.gov 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.