Wednesday, March 28, 2012

Care vs. Insurance

So, this isn't exactly a food topic, but if you eat like I do, sooner or later you're going to need healthcare. And when you do, it would probably be good if you had health insurance to pay for it.  For, of course, healthcare and health insurance are NOT the same thing.

That point really shouldn't need to be made, but unfortunately it does. I've been following with particular interest the coverage of the Supreme Court arguments on the constitutionality of the Healthcare Reform law (a.k.a. ACA), and, fortunately, one of my old pet peeves has bubbled up again.  This isn't just a quibble about a common usage sneaking into a few man-on-the-street-interviews but occurs with annoying regularity in the actual reporting of some of the most respectable media outlets.  Like NPR, one of whose reporters just this morning a reporter stated that the ACA "requires all Americans to purchase healthcare," and then proceeded to use that same term again and again and again.

For the record, the ACA does not require Americans to purchase healthcare. It requires them to purchase health insurance (for example, a PPO policy).  If they get sick they have the option (but, when you think about it, aren't necessarily required to) purchase healthcare (say, an EKG or an angioplasty).  And, their health insurance will (in theory) pay for at least part of that healthcare.

I'm sure that most people, if you slowed them down and made them think about it for a minute, would be easily able to articulate the difference between the two terms. But, the fact that we so easily conflate them, I believe, is much more than just a language issue. It's a symptom of our convoluted, by-accident system where just about every element conspires to make things opaque and confusing and upside down:

(As a sidenote: I've been working in the healthcare . . . no, wait . .  the health insurance field for the past 6 years, trying, among other things, to design software that guides consumers quickly and efficiently through the process of shopping for and purchasing health insurance.  I'm not sure it can be done.)

Ultimately, I think, the reason that so many people say healthcare when they really mean health insurance is because, deep in our hearts, healthcare is the only thing we really care about. We all want healthcare, whenever we need it, and preferably as easily and efficiently as possible. The only sticking point is who's going to pay for it.  

Precision is in order here, if for nothing else so that we can--in the heat of all the impassioned rhetoric on all sides--be sure we are at least arguing about the same thing.

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