Health Care Post #2

There’ve been a lot of statements like:

A bureaucrat shouldn’t stand between you and your health care.

I don’t want a bureaucrat making my health care decisions.

If my doctor recommends something, my insurance company shouldn’t have the right to say I can’t have it.

Let’s discuss.

Presently, with private health care, no bureaucrat stands between you and your health care. Yes, your health company can tell you they won’t pay for something, but they can’t stop you from doing it. If my health insurance company won’t pay for regular chiro care, or for acupuncture, for example, that doesn’t mean I can’t do it. It just means I have to pay for it.

And more families can afford to do that than you think. What our family did was switch to the lowest premium policy we had available to us – it wasn’t paying for anything anyway – and that gave us more cash to pay out of pocket for the health care we did want. Now, of course, not everyone can, and not everybody has the flexibility to choose from a decent selection of health insurance options. This is a major drawback of the current system.

If health care were divorced from employment, as I would like to see it, we would have more options.

“I don’t want a bureaucrat making my health care decisions.”

Now let’s talk about what would happen under government-run health care. I know there are some who do not believe this will happen. I’m not one of them. If the government says they won’t pay for something, that’s it. There’s no private pay option. Yes, yes, I know the plan Obama is pushing NOW includes private pay still, but there are so many reasons that’s not going to be an option long-term. Also, once the government is the sole payer, they can, well, force citizens to make decisions they want them to through health care. It happens now with our employer-based system, but there’s always an out with that. If I don’t want to do the health screening Nationwide wants me to, and let’s say the financial disincentive gets steeper, as I’m sure it will, I can still opt to get my insurance elsewhere. Without private insurance or private pay, there’s really no limit to the government’s power. If they want me to vaccinate my kids, they can force me into that through refusal to pay for health care for my children until they’re vaccinated. If I don’t have the private pay option (as in Canada), my only option is to do what the government wants me to. (Or seek care in another country, or go to black market providers.)

“If my doctor recommends something, my insurance company shouldn’t have the right to say I can’t have it.”

I love this one, particularly when its’ uttered by people I know in the birth activist community. What?? Seriously?

Because the premise here is that the doctor will only recommend things you do actually need. That he will never recommend something just to make money. That he will never order a test because he has a fancy piece of equipment to pay for. That he will never order tests or procedures simply to cover his butt so he can say he tried “everything.”

Doctors recommend induction of labor for non medical reasons ALL THE TIME. They recommend C-Sections when they’re not needed. ALL THE TIME. Episotomy, augmentation of labor, administration of IVs, pain medication, ultrasounds, more extensive testing, it goes on and on. Most of the time, these things are not necessary, but doctors have their reasons for recommending them. (ultrasounds in the office? that ultrasound machine was expensive and the only way to pay for it is to use it…)

Do we think OBs are the only ones who do this?

No!! Now, I don’t think the insurance company should get the final say, but as mentioned above – they don’t. So having one person with an incentive to charge you as much as he can and one person with an incentive to have you/them NOT pay as much as possible…. that brings pretty good balance to the process of making health care decisions.

The responsibility is really on the patient and I know that many of us don’t feel we have the time to research, seek other opinions, or really look into our options. But if you value your health, you should really MAKE the time to learn all you can about it. Or at least to ask questions.

That’s definitely one mark in favor of either no insurance or HD plans. (when I say No Insurance, I’m really meaning something where you have major medical only – if something really bad happens, you’re covered. Small stuff, you’re on your own. Like how car insurance is supposed to be.) When you’re paying for something with your own money, instead of your neighbor’s money or your insurance’s money, you’re much more likely to ask questions, to shop around, etc. You’ll ask that doctor if that test is really necessary. If you really need a prescription. If the over the counter medicine wouldn’t work just fine. If there’s a cheaper alternative.

It’s been proven (no, I have no studies, but I used to read about this crap when I worked for an insurance company, as part of my – yes, admittedly, bizarrely varied – job) that, the higher the co-pay, the less likely insureds are to see the doctor for stupid stuff. In no-copay plans, or $5 copay plans, people run to their doctor for broken fingernails, practically. In $50 copay plans, people are a bit more selective. That’s NOT a bad thing. When it’s your own money, you’re more responsible with it.

I also think our country could do a better job in terms of health MAINTAINENCE and optimal health, instead of just throwing bandaids on our illnesses. But that’s a post for a different day.


One response to “Health Care Post #2

  1. Pingback: Health Care Post #2 « The View From Here | AlternativeInsuranceGuide

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