An insurance “crisis”

A bruised leg
Bike Accident

I caught part of a discussion on the local NPR station on yesterday’s Health Care Summit meeting while doing errands this morning.

One of the discussion panelists succinctly captured my take on the entire health insurance debacle by asking why isn’t there an auto insurance or life insurance crisis in this country?  Answer – individuals own those insurance policies and they aren’t part of compensation.  A person can change jobs, move to a new state, get divorced and they still have that insurance (provided they pay their premiums on time.)

I’d like to go a bit further with the comparison.  When I brought my 2003 Hybrid with 130k miles in for service this week, State Farm did not pay the 282.00 for service.  Nor did they pay the 59.00 for renting the Charger so I could continue on my day.

Why should my health insurance pay for a physical?  I want my health insurance to pay for a catastrophic event – cancer or trauma.  I want my premiums to be set based on my lifestyle – not smoking, keeping a healthy weight.  I want a safety net to exist for the chronically ill – which make up a small percentage of our citizens.  I’m more than happy to have my taxes sponsor that.

To ask insurance companies to accept people with pre-existing conditions is to ask them to lose money.  Insurance companies work on actuarial probability.  Catastrophic events are by definition rare – the premiums we pay to insure a dry head on a rainy day are the monies used for those in crisis today.

Note I’m not saying that there aren’t abuses in the insurance companies.  They frequently deny claims as a matter of course in the hopes that the customer will walk away.  Health care costs are too high and too many unnecessary procedures are taking place.  There is room for more preventative care – I believe Kaiser Permanente, a non profit organization, is leading the way.  Better nutrition, more exercise, no tobacco products – this would cut health costs across the US population dramatically.

This post will probably piss off everyone – I’d like for most people pay for their own health insurance.  I’d like to see the medical and health insurance industries reformed.  I’d like to see a safety net created for those who can’t fit the model – and I’d be willing to pay more in taxes to do so.

A few words about Kaiser.  They had a bad reputation years ago; I’ve been a customer for 15 years.

I had a serious health crisis in March 2009 and I received world class care and months of treatment thereafter.  I paid a total of 300.00 to cover the cost of the ambulance (250.00) and the emergency room visit (50.00).   My after care was part of a one-of-a-kind program in Northern California and a handful of programs in the country.  I didn’t even have a co-pay.

There are successful models which don’t require 100% government sponsorship or an exclusively for-profit based approach.  The degree of complexity surrounding this issue is too sophisticated to the single election cycle and sound-bite producing rhetoric of the US Congress and Senate.

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3 thoughts on “An insurance “crisis”

  1. I have Kaiser, also, and they’re decent. I preferred my old doctor when I had Blue Cross. He seemed like a better doctor.

    That said, I don’t see any reason for the government to not provide an insurance option so we don’t have to pay for multi-million dollar bonuses for insurance company CEOs. They don’t add any value so why are they making such huge profits just to take my money and hand it over to the hospitals.

  2. Exactly! This is a really excellent point that I haven’t heard anyone else articulate. I agree 100%.

    I think the biggest objection to this would be that people would go without health insurance when they are most healthy (i.e. least likely to need it) and sign up only when they got older or sicker. Auto Insurance has a clue there, too, though: Auto Insurance isn’t voluntary, it’s mandatory. I think health insurance would have to work the same way. And if health care coverage can vary at all, there would have to be some mechanism to guard against people buying “bare minimum” coverage when they are hale and hearty, but wanting to switch to a plan with more expansive coverage when they get more fragile.

    Politically, do you see a way to get from where we are now to a system that works as you suggest?

  3. I have no health insurance. Partly it is a financial decision. I tired to get a high deductible major medical policy and was denied because I am too fat. Interestingly, I don’t have the medical issues my thinner friends have. Overall, I am VERY healthy.

    I agree with your post. What I want for health insurance is an HSA (health savings account) where the money not spent on health care is mine. I want a high deductible major medical policy that kicks in at $5,000 (or higher if I choose) and keeps working after that for the particular issue. I want to be able to send all my medical bills through for the “insurance treatment”. That is where they say, $100 is too high. We will only pay $80. And there ya go. I am willing to take on all the smaller bills / issues.

    I totally agree that people should pay on their own. Much like taxes. As a self employed individual, I have to pay all my own taxes. Perhaps there should be a one time adjustment for pay rates wherein the employee never sees the difference in pay. What they will see is the full amount of taxes paid by them (previously on their behalf.

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