In most states, you can't choose a health insurance plan that doesn't cover gambling and sex addictions, psychological counseling, speech therapy and prenatal care -- even if you plan on never having children.
Health insurance companies don't need to compete for your business -- they're all offering the same product, anyway. Moreover, because of government regulation concerning how health insurance is taxed, most people aren't choosing their insurers. Their employers are.
As a result, insurance companies have become outrageously unresponsive to both patients and doctors. Insurance companies need only concern themselves with satisfying government regulators and corporate purchasers. Meanwhile, doctors have to please only the insurance companies, which don't particularly care how patients are treated, as long as it's cheap.
This is a third-party-payer problem, or as the proverb goes, "He who pays the piper calls the tune." All third-party-payer systems are disasters. The customer is trapped, forced to pay for something he doesn't want, with no one to complain to and no possibility of taking his business elsewhere.
An example frequent travelers will recognize are the online discount hotel brokers. These can be great -- unless you arrive at a hotel and there's no WiFi, or there's massive construction going on, or your room isn't available until four hours after check-in time. But you've already paid the full price to the booking company.
If you had paid for the room yourself, you could walk away and find another hotel. (Even if you used a credit card, you can reverse the charges because, again, credit card companies would go out of business if they didn't refuse payment for scams.) But if you booked through a third party, the hotel tells you, "Sorry, take it up with Expedia."
Ironically, Romney is proposing that all Americans have the same ability he has to hire and fire insurance companies and doctors. The rich already can do this. Why can't the rest of us? We hire -- and fire -- our own appliance stores, pet groomers, restaurants, hairdressers and computer companies. Why not health providers?
And why are the media so desperate to avoid that conversation?
We need a free market in health insurance, which Congress could accomplish with a one-page bill stating, "There shall be interstate commerce in health insurance." Once we were allowed to purchase health insurance across states lines -- prohibited by law today -- everyone would be buying insurance from companies based in states such as Utah, which have the fewest mandates about what health insurers must cover.
Insurance companies would be responsive to us, the people buying their services, and not the government or corporations. Most people would choose to buy insurance only for what insurance is intended for -- catastrophes -- while paying for regular checkups themselves, the same way we pay for our own cell phones, computers, baby sitters, manicures and everything else that's been getting better and cheaper, unlike all government-regulated services.
Doctors would then have to be responsive to us, not to our insurance companies. Nothing improves the quality of a service like being able to fire the people providing it. The media don't want you to think about that, so they edit Romney's remark and call it a "gaffe."
For better service right now, for example, the American people need to fire Barack Obama and hire Mitt Romney.