Monday, September 07, 2009

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.


Isa Lube said...

Not sure it will wrk out or not since other nations under same type of system say it's should be more restrained so not just anyone can get access from hard working tax payers dollars??? I don't want anyone to take food out of my mouth and give it to someone who is sitting around doing nothing-or should you/I???

Carl said...

I hear you, Isa. Certainly healthcare reform has to be pursued carefully. Yet, it's also true that a lot of the complaints about healthcare in other countries with a publicly-funded system have been overblown. The biggest indicator of this is that no one in Britain, not even the Conservatives under Maggie Thatcher, ever tried to turn back the clock to before the National Health system was brought in. Like Medicare here in the US, it's just too popular with the public.

ash said...

I'm sorry but that is not necessarily true. To quote one famous Brit - there are so many employed in the bureacracy of their healthcare system that to try and undo would be a nightmare - I mean really think about trying to undo this system once it's in place. Please before you jump so quickly understand what they are asking - 900 billion - we can't even support what we have in place - why does it have to be all or nothing. I know that you asked about those who are happy with their insurance and I am one - I pay a private policy and I am one year in remission from Diffuse b-cell (large) lymphoma. I am blessed to be alive becasue of the care I received. Just a thought...

Anonymous said...

I'm so happy you are a survivor, Ash. I wish for you many more years of health and life.

I guess it's just too bad for my 50 year old neighbor without insurance who died of breast cancer and could only wring the most basic palliative treatment from charity care. She left an emotionally disabled adult daughter. Just too bad for her as well.


Carl said...


I've lived in Britain and have been covered by National Health. Sure, it's not a perfect system. But, it works pretty well for most Brits. For those who want or feel they need them, and can afford them, there are private-pay alternatives available (and those supplemental fees are still FAR less than US doctors charge). Bottom line, a great deal more of the health care pound goes to provide actual care than does the equivalent portion of the US health care dollar, much of which gets eaten up by administrative overhead. And no one's left behind.

I don't think the British system is politically achievable, maybe not even desirable, here in the USA. But, something like the Canadian system surely is - if the lies that are being told about health care in the rest of the developed world can be refuted.

Are we Americans REALLY so egocentric that we can believe every other industrialized country is wrong on this issue, and we are right?

Our biggest problem is that the insurance companies are profiting mightily from the inefficiencies of our system, and have spread enough money around Capitol Hill, and enough lies about the horrors that would ensue from even the mildest form of public option, that it's growing unlikely our elected officials will vote in the public interest.

limo said...

Honestly, we are not happy with this insurance...actually we suffered from it..

Anonymous said...

I am sorry to disagree with you again - However, I don't believe that it is egocentric to question our government when we disagree with their "plans."

I am so sorry that someone has experienced a loss. I wish I could speak to that case but I can not. I know that there were people that I met who were and are battling cancer that did not have insurance and they received the same care that I received.

I do not need insurance companies to scare me - people who so willingly jump into things without reading the fine print will suffice. 900 billion dollars is a lot of money - and that is just speculation - kind of like building a home - or any other type of government contract - things have a way of escalating. We as a nation are looking at Social Security becoming a problem - and yet we are so quick to say sure - why not. I will not tell you that our healthcare needs to be addressed but I do not believe that we need to do what is being suggested. Yes, we do need to provide a safety net for those who need support. We also need to look at tort reform and making sure that those with pre-existing conditions have access. But please don't tell me that we can't look at those issues unless this bill is passed. I don't want this to be a mistake that can't be fixed - this discussion is worthy of debate - and this it must be now and it must be my way is a little disturbing.


Anonymous said...

I will not tell you that our healthcare needs to be addressed

should have read:

I will not tell you that our healthcare does not need to be addressed.

Bryan said...

Actually health insurance is of great help. Just make sure you have chosen the right insurance company for you.