The many idiosyncracies of health insurance

Cranky Uncles, for Better or Worse, Will Lurk in More Exam Rooms

By ABIGAIL ZUGER, M.D., NYT

Money has always played a role in health care, even back in the good old days when Hippocrates charged a drachma or two for a second opinion. Back then it was the coin of the realm that healed the sick, and now, thanks to the upheld individual insurance mandate, it is going to be a little plastic card for all.

So nothing has really changed, right?

Wrong.

Health insurance is more than a cash equivalent. It is cash with strings attached, like a rich uncle with deep pockets but a volatile personality, munificent one minute and stingy the next. This is an uncle who takes you to the doctor but refuses to wait out front with a magazine: He is right there in the exam room with you, commenting on everything. Sometimes he peels the big bills out of his wallet with a smile, and sometimes he scowls, shakes his head and yanks you by the sleeve out the door.

Not that your uncle is stupid or misinformed. His opinions can be right on target, and often, if he has misunderstood a situation, he can be persuaded to change his mind. But he never goes away.

(More here.)