Tuesday, August 19, 2008

Health Care Debacle

It's the health care system, Stupid.

Currently, I carry a low-premium (not really that low) high deductible, catastrophic health care plan for my family because the family coverage through my employer is not only cost-prohibitive, but it would require that my children give up the pediatrician they've always known.  I remembering hearing that as a major criticism of the Clinton nationalized health care system, yet, alas, here it is in the same old system we're stuck with.  And, considering that my children are incredibly healthy - that is, in six years they have only seen the doctor for their yearly well visits - my wife and I concluded this is the best plan.  Though it's far from optimum, and here's why.

On vacation this summer, my daughter developed an ear infection (first time for any serious sickness) and we were faced with the issue of finding a doctor.  Normally, for ear infections there is little that can be done, and we weren't going to go with any antibiotics.  However, we had been out in rural Wisconsin, where the kids were playing in the woods which are known for ticks, and we were a little worried that something had crawled in her ear.  All we wanted was a nurse or doctor to take a look, so we visited the Urgent Care Clinic of Anderson Hospital in Maryville, Illinois.  After a quick look from a physician's assistant, followed by an even quicker look from the doctor, our fears of a tick were relieved, and we left.  The ear cleared up in a couple days.

Fast forward to a couple weeks ago when we received a bill from the hospital for $200, which is not covered by our insurance.  We negotiated that down to $160, though we were still livid, having expected it to be half that.  However, the situation got worse when we received an additional bill for another $150 from the doctor who is apparently represented by Midwest Emergency Management, Inc.  Needless to say, we are completely baffled by this ridiculous billing, and our negative opinion of health care continues to grow.  For me, at this point, future elections may be all about health care.

2 comments:

Anonymous said...

The best way to reduce the cost of health care is to put the consumer in the driver seat. First, insurance should be just that - insurance. Do you expect your home insurance to cover having your house cleaned, changing light bulbs, painting, maintenance and minor repairs? Do you expect your car insurance to include limitless trips to the gas pump? Of course not, because that is not what insurance is.
Unfortunately Americans have become accustomed, even entitled, to this concept of health insurance that covers everything with low/no deductible and then they wonder why the premiums are so high! The "all you can eat buffet" of "free" healthcare" sounds good (don't all "free" things?). But it will only drive up demand, reduce quality and run up costs. People get this when it comes to buying things, but we've been so cut off from the practice of direct participation in the consumption of health care (thanks to HMOs and employee sponsored helath plans) that it never occurs to ask what something actually costs.

I personally have benefitted by a low premium ($391.00/moonth for family of 4)/ high ($2,000.00) annual deductible plan. Even if I use up my annual deductable, I still pay less annually in health insurance premiums than I would have with a "pre-paid" high premium/no deductible plan with identical coverage. How did I disvcover this? I shopped for it.

mazenko said...

I agree with you up to a point. Clearly, the low co-pays for office visits and prescriptions is a problem. Realistically, people should carry insurance for the catastrophic - accidents, disease, chronic conditions. That's how I remember it growing up.

However, I am opposed to the idea of individuals shopping for their own care as the de facto system. The reason for this is two-fold:

One - larger pools help lower costs by spreading the risk. That is why a pool of 300 million payers is preferable.

Two - individuals can be dropped at any time, and that means when unhealthy people file a claim, they risk losing coverage.

I cover my family individually and keep costs down, but I am covered by my employer because my asthma and allergies prohibits me from finding affordable coverage (even though I file almost no claims for a condition which is well controlled.

Ultimately, the Healthy Americans Act or the extension of FEHBP to all Americans are the best and only reasonable options.