September 7, 2009 - Happy With Your Health Insurance?

Today I heard a phrase I’ve been hearing a lot lately in news reports about the health-insurance debate. It’s the concept of people who are “happy with their health insurance.”

Are you one of those satisfied consumers? Are you truly happy with your health insurance?

You’d think there must be an awful lot of happy Americans out there, the way Washington politicians have been spreading that phrase around, thick as manure.

I suppose there may actually be a few pleased policyholders out there. The nature of insurance, after all, is that some people need it more than others. Those who don’t submit many claims tend to be happy with their coverage. They take comfort in holding that wallet card. They feel protected.

Even if their medical safety-net is spun from pure fantasy, they feel protected. Maybe even happy.

The true test comes with hard times. I wonder how many who are happy with their health insurance have chronic medical conditions? These are the people who deal with the real world of medical insurance, not fantasy.

I’m fortunate enough to be doubly covered. The Blue Cross/Blue Shield insurance I receive through the Presbyterian Church is pretty decent. The secondary Qual-Care spousal coverage we purchase at group rates through Claire’s employer, Meridian Health, is a valuable back-up. It takes a big bite out of my 20% Blue-Cross/Blue Shield co-pay – which, when it comes to things like PET scans, can add up to a pretty penny.

Even so, I’m not happy with my health insurance. I’m not happy because I know I have to watch both insurance companies like a hawk. I know their profits are dependent on their denying customers’ claims. I know they reward their employees when they find reasons to deny or reduce payments – if not with outright bonuses, then with favorable performance reviews. I know there are so many middlemen and -women involved in the whole unwieldy process, so many paper forms, faxes and e-mails flying around, that there’s a huge potential for error. Just one omitted or misplaced pre-certification, one out-of-network service booked in error, and I could be left holding the bag for big bucks.

That unwieldy insurance bureaucracy – so complex, even the doctors’ professional claims-processors can’t make sense of it – adds as much as 30%, by some reckonings, to the cost of my medical care. Ultimately, that’s the cost of employing an army of people to push paper and tap on computer keys, not to mention squeezing quarterly dividends out of the system to keep insurance companies’ stockholders happy. It has nothing to do with the quality of my medical care.

I’m not happy with that.

Then, when I imagine the prospect of pursuing cancer testing and treatment without any medical insurance, I’m even less happy – not so much for my own sake, as for the sake of my at-risk neighbors who must do exactly that. I’m not happy being the beneficiary of a system that values stockholders more than sick people.

Dr. Len Lichtenfeld, a physician, has it right, in an August 8, 2009 blog entry on the American Cancer Society website:

“We have too many instances-and too many bankruptcies-where ‘satisfied’ people suddenly found themselves not so ‘satisfied.’ I am willing to bet that you (and me) have no idea whether or not your insurance will be a facilitator or a barrier to your care if you or someone you love becomes seriously ill with a disease like cancer. You just don’t know.

So don’t stand there and rail against your Congressman or Senator because you are ‘happy’ with your health insurance. I wonder how many of you have had a serious, prolonged illness in your family. If your experiences have been positive, terrific. But don’t discount that many others have not been so fortunate.”

Those yahoos shouting their Senators down at town hall meetings don’t seem to realize that this issue transcends any individual right to happiness. Are you happy with your health insurance, Mr. Redface Shoutington? Too bad. Your happiness can’t come at the expense of your neighbor, who worked just as hard as you did over the years, but who was either self-employed or whose employer wasn’t as beneficent as yours when it came to health benefits.

It’s a moral issue. Never before, in human history, has care of the sick been viewed as sick people’s own problem. It’s always been a community responsibility.

Some anthropologists, I’m told, date the rise of the human race according to the first skeleton they ever dug up that had a broken bone someone else had set.

We’re all in this together. That’s where true happiness comes from.