Why it does matter, Mitt Romney’s “I like being able to fire people who provide services to me” — even in context:
Gov. Romney is not saying that he enjoys telling people that they no longer have a job. He’s saying that, when it comes to health insurance, if a company is doing a bad job, he would enjoy telling them to take a hike. Who wouldn’t?
First of all, let’s unpack the idea that if individuals have their own insurance, the “insurance company will have an incentive to keep [them] healthy”. That’s totally backwards. The idea that people might fire their insurance companies is exactly why they don’t have an incentive to keep you healthy. Insurance companies preferentially cover healthy people, and they want those who are ill to leave, or, better yet, not enroll in the first place. Captive populations, like those in the VA, or maybe plans with long-term contracts through big employers might have the right incentive, but the types of plans Gov. Romney seems to have in mind don’t do the very thing he is saying they do. Insurance companies have a vested interest in keeping you healthy when you can’t or won’t leave.
But that’s the least of his problems. The real issue, unfortunately, is that very, very few people have the luxury that Gov. Romney is endorsing. Let’s say that you are self-employed, and lucky enough to have found a company to provide you with health insurance. Then, let’s say you develop cancer. You suddenly find out that your insurance company stinks. So you fire them, right?
Of course not. You’re screwed. Now you have a pre-existing condition. There’s not an insurance company out there that wants to cover you. So you don’t fire them. You scream, and curse, and cry, but you’re stuck. Only healthy people have the luxury of picking and choosing.
Let’s also not forget that most people don’t find out that they’re not getting “good service” until they’re sick. Healthy people don’t make much use of their insurance, so they don’t know how bad it is. They only find out after they’re ill, and then it’s too late. It’s only fun to fire the insurance company if you’re sure you can go to another company to get what you need. Almost no one can.
Mitt Romney doesn’t know this, of course, but that’s not because he’s never been in the above circumstances or similar circumstances or even anywhere within thousands of miles of said circumstances. It’s not because he’s stupid, either. It’s because he doesn’t care and, even more to the point, it’s because his livelihood depends on not understanding. It’s amazing, the things a smart person just can’t or won’t understand when understanding would threaten his station in life.