America's Paradox

In the days of my medical practice, I would find people in my office who had been through one romantic relationship after the other, all ending unsatisfactorily. These patients eventually recognized that they had developed relationships again and again with partners who were virtually identical in terms of looks, behavior, abusiveness, handling of money and unfulfilled promises to do better. They were with virtually the same person over and over, with the same unsatisfactory result, and rarely learned from their experiences.

For years, Americans have had relationships with insurers who act like my patients' lovers. The insurers promise a new world of health care in slick brochures, television commercials and sales presentations, provide no real health services themselves, engage in abusive business practices - such as policy cancellation or denial of services, tests, and prescription - to patients who need care, pocket large portions of the premium money entrusted to them for inflated administrative overhead, and then promise to reform. But never do . . . .

And yet, the insurers demand that we love them. Should we? Don't we ever learn?