Thursday, November 08, 2007

I Am NOT a "Healthcare Consumer"

I have health insurance through my employer. I guess that makes me “lucky” in some respects. I have also been fairly lucky with my health in general (knock on wood) and have not really had to navigate the hell that is Blue Cross/Blue Shield of Illinois.


Every November, we receive a batch of information related to the “employee benefits open enrollment period”, which allows us to make any changes to our elections for the upcoming year. Pretty basic and self-explanatory. And while there is the usual bit of frustration when realizing that I have to choose between bad or worse versions of the same one insurance provider’s plans, this year was different.

The materials that we receive include the typical instructions, changes, deadlines and related information. However, this year, there was a significant amount of “rah-rah fluff” that really, really rubbed me the wrong way. And it is this fluff that really is indicative of the major underlying problem related to healthcare in this country – even for those who are fortunate enough to have some level of coverage.

It was one thing that I got a “2007 compensation summary” that included the “value of employer provided health benefits” (as well as the employer share of FICA tax – how generous of them) in my overall compensation. As if I should be honored that I am being graced with the crumbs of coverage for which I need to (1) make 50 calls to try and find a doctor that actually takes my insurance, despite not knowing anything at all about his or her actual qualifications or getting any good solid reference information, or (2) pay $10,000 out of pocket each year for me AND another $10,000 out of pocket for the missus to go to a doctor that she actually trusts and is not skittish about.

I say the above because my wife recently had her wisdom teeth removed and went to a “covered doctor” in our area, only to have them screw up and leave the right side of her face without feeling for a few months and now a dull pain that never goes away – all of which can’t be resolved other than by “waiting and hoping” or through surgery that would either not work or possibly leave her with no feeling on half of her face.

But I digress.

What really got me is this blurb, one that was never in prior enrollment literature and really cuts right to the core of the healthcare situation in the US (text emphasis is mine):

How Do I Choose Which Medical Plan is the Best for Me? During this year’s enrollment process, you are going to make some important decisions and selections on behalf of you and your family. Just like any other purchasing decision, you want to be an informed consumer when selecting a health care plan and participating in tax-advantaged savings accounts

And therein lies the problem. We are NOT “purchasers” of healthcare. Basic medical care is not something that we should be “informed consumers” about. Especially when we are only “informed consumers” about the few crappy plans that will give us half the coverage that we need. As for those “tax-advantaged” savings accounts? Well, my response is to please not piss on my head and tell me that it is raining.

Here is my “tax advantage” – as I said above, I have the privilege of going to a doctor that we are comfortable with and trust. And as an “informed purchaser”, I get to set aside $2,700 on a pre tax basis to pay for things that the insurance company won’t pay for itself, before paying for the rest out of pocket on an after tax basis. And as I said above, in order for the insurance company to pay for anything (which is only 70% or so), my wife and I EACH have to spend $10,000 before dollar 1 gets paid for by Blue Cross/Blue Shield.

What a great tax advantage for me.

Another headline in big bold letters in our literature reads Be a savvy health care consumer with these wellness tools. The first sentence under this headline? Fundamental to consumer-driven health care is arming you with information you need to make wise health care decisions. What a farce. How can anyone make “wise health care decisions” when they either have to pay through the nose to get the service that all Americans deserve or we are stuck with two or three crappy plan “options” from the same one insurance company?

Which leads me to the heart of the matter. In addition to the 47+ million who are uninsured, there are the millions of others who are underinsured. These people pay thousands of dollars each year for maybe being covered, or partially covered for things that are the most basic of issues. By taking small measures up front for preventative care – and not being forced to wait until a problem gets very dire and expensive to treat so much money would be saved, and so many more people would be healthier.

But until we change the discussion from “healthcare consumers” and making “informed decisions when purchasing healthcare options” to one where basic and affordable healthcare is available to Americans with the ability to actually go to a doctor that they trust without sacrificing a mortgage payment or other necessities, we will never begin to address this issue.

You shop around for a car. You make informed purchasing decisions for food, housing or other necessities – even for things that aren’t necessarily necessities. Getting treatment for your health isn’t something that you should be treated as a “consumer” for. Healthcare is not a commodity. When you have an emergency health issue or if you are involved in an accident, you go to the hospital that is closest (or the one that is closest that you trust). You don’t stop and think about calling all area hospitals to get the deal you are looking for, and you certainly don’t negotiate as you would over a car.

This is a basic right that Americans should be afforded. We should not be treated as “consumers” and basic affordable healthcare isn’t something that should be “shopped around for” at the cost of proper care.

1 comment:

Mark said...

In some ways, I agree with you. The health care middle man - the insurance companies - gets in the way of our ability to be good health care consumers. I spend too much time worrying about which doctors are in my plan.

However, health care is not a right. It's not in the constitution and I don't want the government providing it to everyone. People who choose to live unhealthy lifestyles are free to do so, but I shouldn't have to pick up the tab when their health declines. Plus, this is all interconnected with more government regulation. Once the government is administering our healthcare system, it will be even easier for them to justify even more regulations based. If you want to smoke, then smoke. If you want to eat Burger King 10 times a week, then hit the drive thru. If you don't want to wear a seatbelt, then don't. I really don't give a crap either way. Just please, please, please don't come and ask to me bail you out after a lifetime of poor decision-making.