In the country of Havahart, citizens got tired of privatized medicine and health insurance companies doing outrageous things. In one case, the insurance plan doubled its premiums, raised deductibles, and changed co-payments from a nominal flat fee to a percentage of the bill. Outraged citizens knew that the companies were playing hardball, sending a signal to leave them alone to do business as usual, to forget about health care reform. The people also grew tired of elected politicians who lacked courage to do what was right. So a bold new movement took hold among the public: they stopped paying their insurance premiums. The Great Insurance War began.
As in any war, there were casualties. But once the number of people without insurance coverage reached a critical mass – somewhere over half the land – the insurance industry had no choice but to raise rates on the smaller numbers of insured, and the rates became unaffordable for everyone. The insurance industry collapsed. Thousands of claims representatives were put out of work. Executives lost their high salaries and country club benefits.
Hospital emergency rooms were flooded as many private physicians stopped seeing patients who didn't have the cash to pay, and no insurance to cover the services. Other doctors, unable to generate enough revenue to continue their practice, simply closed their doors, adding to the unemployment numbers as medical technicians, receptionists, and lab service company employees lost their jobs.
A neighboring country, Lackahart, encountered a somewhat different health care crisis that toppled the government. The land collapsed under the crush of unemployed who lacked the money to pay for health care insurance, especially after their unemployment benefits ran out. Insurance companies running their little shop of horrors continued raising rates and feeding on those who still had jobs and incomes high enough to pay premiums. But it wasn't enough; as more and more were unemployed and premiums rose too high for the few remaining with jobs, the system collapsed under its own weight. The weight, some say, of greed and selfishness.
Other countries where universal health care is provided because all contribute through taxes and all are covered without questions or qualifying conditions began recommending that their citizens stop traveling to Havahart and Lackahart. They considered these two afflicted countries to be suffering from a social disorder known as antisocialismus, which was the root cause of the breakdown in their social and public health systems. There would be no place for travelers to receive medical care if they got sick or were injured, because emergency rooms and hospitals were overwhelmed, and many that could not get government funding had closed. Both Havahart and Lackahart saw their tourist industries collapse further depressing their economies.
Havahart eventually recovered from this social pandemic led by churches without borders and a broad coalition of secular humanitarian organizations and local community groups. New candidates emerged for elections, and those who opposed universal health care coverage were hounded out of office. Spending priorities were revised drastically. The few remaining health insurance providers were placed under strict regulatory controls. Seeing health care as a matter of national security, the model of a nationalized military served as a blueprint for restricting states' rights in this sensitive area, and instituting universal health care.
The new legislators also revised the health care and pension plans their predecessors had put in place. Because the country could not afford the blue-chip plans the previous regimes had granted themselves, their health benefits were brought into line with the coverage available to everyone. While changing the pension plans provoked a bit of controversy, once the details were explained to the public in plain language there were few former legislators who dared to oppose reform, especially when so many remained out of work.
Lackahart set a different course, and remains a shadow haunted by its recent past. It has very little economic output and is dependent upon global aid agencies for its survival. It borrowed so heavily to finance its activities that a crushing debt settled in on a people that had no jobs, no insurance, and no retirement funds. Because of the pathology of the particular strain of antisocial thinking in Lackahart, no strong or heroic leader has emerged and the country has reverted to a very stratified social order with groups of people banding together by race, religion, wealth, or their favorite sports team. The only real sport left is soccer, because the country can't afford more than a few balls and using some of its open space for fields.
We'll have to wait for historians to write the definitive history of these two countries and their misfortunes. However, it seems clear that the excesses of the free-market private health insurance industry were a significant factor in their eventual collapse.
