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An assumption that must be made by those who espouse a health care system based on free markets is that patients have the free and open opportunity to choose their own health insurance. This freedom would have to include both the freedom to purchase an affordable health plan of their choice, and the freedom to exit from a health plan when dissatisfied. Obviously, if these conditions were not met, than the whole notion of free markets would be false from the word go, and the highly-touted efficiencies of the healthcare marketplace would simply not apply. 

Of course, in real life relatively few individuals have any substantial say-so over their health insurance. The unemployed or the self-employed have extremely limited choices, since most insurers seem to have taken pains to price them out of the market. While many employees can choose among two or maybe three options from a "menu" of health plans, even that amount of choice hardly constitutes a free and open market. And the notion that employees have any real opportunity to exit from a plan they don't like is simply a joke.

So the idea that the average patient's biggest problem is how to choose the right health insurance (out of all their many choices) is largely a fantasy.  A more realistic problem is how they ought best deal with the insurance they do have (if they're fortunate enough to have health insurance in the first place) when it's time to get medical services. 

As part of our mission to help you understand and survive the American health care system,  YourDoctorintheFamily.com addresses several aspects of health insurance. We show you how we as a society arrived at our current sad state of affairs regarding health insurance - and regarding many other facets of health care - in Health Care 2000 - How it got this way.

We demonstrate the relationship between health insurance and managed care (a relationship more tenuous than you may think) in The Secrets of Managed Care

In Portrait of a Modern HMO we tell the sobering story of one HMO whose methods apply, unfortunately, to most health plans in existence today. 

And we offer you some advice on surviving modern insurance plans in:

Don't thank us. It's what we do. 

We're your on-line guide to understanding and surviving the American health care system.  

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