In conservative health care mythology, an educated health consumer chooses the best policy for his or her personal situation, and if the insurance company does something disagreeable, the consumer simply takes her business to another company--punishing bad the corporate behavior and rewarding the good. This way, so the theory goes, the insurance companies are always improving in a survival-of-the-fittest competition for the American consumer.
But the "free market" fairy tale ignores some major problems. Here are just two.
First, choosing a health insurance policy is not the same thing as shopping for consumer goods. Whether you're shopping around for a new TV or trying on different shirts, you can make informed comparisons and pretty much know what you're going to get when you make your purchase. With a health insurance policy, at best you have a general idea of the way your policy works. But the nuances--which have a way of jumping up and biting you--are coded in lawyer-speak and hidden in an "explanation of benefits" booklet that changes every year. Or they're in the fine print in one of the many documents you signed to buy your policy in the first place.
Also, chances are that when you learn some sordid detail of your policy, it will be at a time when you or a loved one is sick or in a lot of pain and you are under stress. You may be under financial stress too from the premiums, co-pays, and deductibles you've already paid and maybe from being out of work. You can't exactly jump into a new policy at this point. And you're in a pretty weak position to argue with the company you're stuck with. You are anything but a highly-mobile, educated consumer in a free market. You are caught in a scheme to enrich few at the expense of many.
These are just two reasons why it makes no sense for coverage of our medical expenses to be left up to organizations that exist primarily to increase their own quarterly profits and shareholder value.