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feylin -> RE: "U.S. healthcare expensive, inefficient: report" (5/15/2007 4:49:24 AM)
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It is, I believe, all leading to what my company likes to call "Consumerism Insurance." In a nutshell, this means that non-union employees will be slowly and steadily taking over their own healthcare costs. The argument is that employer-based health insurance is an antiquated practice from the industrial revolution and insurance cost and responsibility needs to fall back onto the consumer/employee. (I say non-union because the companies we service that have unions are still managing to arrange for full coverage for their employees.)
This is certainly cutting down on emergency room visits and doctor visits, but it also means that a large number of people will pay into their insurance plan this year but will never see anything paid out as they pay on the deductible through their savings plan or out of their own pocket. Employer funds will stay in the bank unless someone beats you into a coma. Even then, your insurance has a limit. As my company likes to say, "A low lifetime maximum benefit is better than no benefit at all." (Yeah, that is funny, but they printed it in a training manual)
The problem with consumerism insurance is that providers are still charging on the old system in that a contracted provider charges $1,000 for something because they know, as a contracted provider, they will receive $250 in the end. If we, as consumers, are also charged that $1,000 and are not given the same final price of $250, things will get ugly. That is an exaggeration but a $32 bandage does add up. Just being with your insurance company will give you an advantage with those contracted providers, but not everything is contracted so I only used the above example to showcase the disparity in prices charged and expected so that when you choose or must use a non-contracted provider -- who still charges the same as his/her peers -- it suddenly becomes a situation where you might have to choose between food and shelter or healthcare. I am sure a lot of people do that now, but I believe this system will make it more widespread.
I wish I could say that this personal responsibility plan is backed up by wellness benefits (preventive care), but I do not see that happening in the insurance plans that are created. Not in a significant way. But the company nurse does try to call me at home a lot to see if I am eating right. Seriously, I want to slap the person that thought up that brainchild. (I did end up changing my phone number on my plan to the company weather emergency line. Those home phone calls were becoming stressful and prozac isn't covered.)
This is just one direction that is being pushed and may not end up being the resolution to America's healthcare problem. But when I read that a Wal-mart executive was brought on board to brainstorm a solution at the national level, my pessimistic side kicked in. Its still a long, hard road to something workable.
I do not believe that employer-based insurance is antiquated. I am on mandatory overtime for months (almost a year), none of the office windows open, the carpets are never vacuumed, the equipment is old and not paticularly healthy as far as posture and ease of motion, the drive to and from work is very dangerous in the winter, and I am surrounded by people who have germ-carrying shorties at home. If I wasn't at work, I would be SO much healthier. <grins> Admittedly this is not what it once was: 18-hour days, locked exit doors, no heat and/or a/c, fires, lamplight and being surrounded by toxic materials. But I am still having trouble with the idea that employers should not be involved with providing decent working conditions, fair pay, and health insurance. Health insurance included as everything stands right now. I am open to new ideas and would vote for a better solution. But I do not see a cost of healthcare pay increase coming down the line with "pay your own doctor bills."
It would be interesting to find out the reason this country does not go with the healthcare models of other countries that seem to be making it work. I can only imagine that it is because of money.
Best wishes,
Christine
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