After “Am I going to die?”, and sometimes even before, “Is this procedure covered?” has to be one of the most asked question of Doctors. And, frankly, I resent it. I resent the fact that Insurance companies have forced their way into my Doctor/Patient relationship. I resent that they have the ultimate veto power over my health.
But, most importantly, I resent that I even have to think about Healthcare insurance.
Go ask anyone with a health condition how they are doing. I guarantee that their answer will veer towards their health insurance. They’ll tell you about their hassles with the insurance company, the number of bills they received marked as “not covered”, the number of phone calls they made trying to rectify the matter, and/or the amount they ended up paying out-of-pocket. Along the way you’ll meet a couple of people who boast of how they didn’t have to pay a cent – their ecstatic tone far more suited to winning a lottery than receiving an MRI.
And this is the problem. Health Insurance plays too big a role in Health Care. And since their goals are diametrically opposed somebody ends up losing. The loser is usually the patient who is either denied treatment or ends up paying for the denied treatment themselves.
Truth is, Health Insurance has nothing to do with your health. It has to do with making a profit. Their standard procedure seems to be deny, deny, deny, followed by delay, delay, delay – and hope that the patient grows weary of jumping through hoops and just pays the bill themselves.
In 1992, Allstate Insurance retained McKinsey. In fact, “McKinsey’s advice helped spark a turnaround in Allstate’s finances. The company’s profits rose 140 percent to $4.99 billion in 2006, up from $2.08 billion in 1996. Allstate lifted its income partly by paying less to its policyholders. Allstate spent 58 percent of its premium income in 2006 for claim payouts and the costs of the process, compared with 79 percent in 1996, according to filings with the U.S. Securities and Exchange Commission.” You might question how an insurance company can make such a dramatic increase in its profits in just four years.
During court proceedings McKinsey was forced to divulge 13,000 documents relating to the “advice” it provided Allstate. McKinsey told Allstate things like “sit and wait” regarding claims. Delaying claims could, and most likely did, discourage policyholders from pursuing their claims. This delay forced many policyholders to just walk away. One less claim to pay means one thing for insurance companies: more profit.
Insurance companies have run their business like a Las Vegas casino: The house always wins. It’s time to change the odds. How changing the odds manifests itself is still unknown. But what is known is that we can no longer afford the status quo, and the old bogeyman of the Right has been exposed as a lie. …Or am I the only one who remembers those 1990’s Harry and Lousie ads? Good thing we avoided those “gatekeepers” and price increases, eh?