Health Care Insurance: What does it really get you?
It is difficult to understand what we are fighting for when even those of us with insurance get little more than a “discount” on pricing for health care “rations.” Why call it insurance when the limits outweigh the coverage?
The concept of “insurance” is misplaced when it comes to health care. Even auto and home insurance do a better job of living up to the expectation of covering the buyer from loss. Can you imagine getting a bill after a fender-bender saying the insurance company only paid 60% of the cost and you are responsible for the balance? Shouldn’t part of health care reform be about better consumer protections against the misleading notion of health care insurance and the inflated costs of medical care and prescriptions? What is with these complicated options where you trade away and gamble against truly “full coverage” in the event of hospitalization or serious illness just to get a monthly premium within reason, only to find out the most basic preventive or routine services are not fully covered? While you are likely to pay less out-of-pocket under a HMO plan, you trade away choice and the flexibility to determine when and where you seek medical care. In other words, you pay one way or another.
Then there are dental and mental health benefits. An insurance card gets you very little these days. You are likely to pay more out-of pocket than what your insurance company pays for the services and care you receive. What I always find amazing is that having insurance does little to protect you from liability for the cost of medical care. There is often very little correlation between charges and cost. It is more about what the market will tolerate than the cost of delivering care. While insurance companies can negotiate lower charges, you still get a bill at the end of the day. So much for the concept of insurance.
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4 Responses to “Health Care Insurance: What does it really get you?”
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These could not be more exact words in my thinking of Health Insurance. I am so frustrated I cannot even speak. Thank you for speaking for me. BRAVO!
This is an excellent bird’s eye view description of the fundamental flaws in our idea of “health insurance”.
But bad as it is, what is the alternative? And once we identify an alternative, how do we overcome the effect of the old saying, “the devil you know is better than the devil you don’t know”?
After all, bad though it is, people are used to the basic idea of “health insurance”: we just wish it cost less and covered more. We need to not only publicize the fundamental flaws — as this article does — but get the public used to the idea that the alternative really does have a good chance of turning out to be better.
Of course, the insurance companies and their lobbyists have made sure that this will be a hard uphill battle. But it is a battle worth fighting — as long as we don’t get fixated on a non-solution, such as socialized medicine.
Polls report that most people are happy with their health insurance; I believe that is because most people have only used it for routine matters. It’s when you have a serious problem that the failings appear, such as restrictions on which doctors/hospitals/specialists you can consult. Every developed country, and many poorer countries, have better coverage and better outcomes than here in the U.S. at a fraction of the cost. One of the major problems is that insurers make huge profits, and that is money we spend on ‘health care’ which doesn’t produce a health benefit. Charges are incomprehensible, and variable: people pay different amounts for the same procedure or medication. HMO’s won’t pay unless you see doctors in their plan; often patients can’t go to the nearest hospital because it’s not part of their insurance plan. Are American’s really not as smart as the Taiwanese? They had a system similar to ours and decided the inequities and high costs were unacceptable. They looked at what other countries did and established a system that serves their people well. The Japanese see doctors more often than we do in the US, have universal coverage, and get MRIs frequently; they can go directly to any specialist they want to see. Why do Americans accept a system that makes medical care difficult to obtain, expensive, and unfair? Why do many Americans think that ability to pay should determine your level of treatment? A politician once said that every American should have the right to buy health insurance. Wouldn’t it be better to have a right to health CARE, rather than so-called health ‘insurance’ that fails us when we need it most? I fear that the American attitude that sick people somehow deserve their fate contributes to our callous attitude towards others; that’s why debates center around how to deny people health care, (like women who want an abortion, or immigrants,) rather than how to provide an adequate level of care for everyone. Unless we see health care as a right and not a commodity, we are doomed to the current mess.
Carol, what is your source for the claim that people are happy with their health insurance?
I don’t have polls, but my experience suggests quite the opposite: if your health is OK, then you notice that you are paying too much for insurance, but if your health is not OK, you notice that the insurance charges too many miscellaneous fees and denies too much coverage.