Friday, August 21, 2009

In Defence of Health Insurance Companies

I just got off the phone with my insurance company. I spend a lot of time on the phone with them. Somehow earlier this week there had been a miscommunication between CVS and Blue Cross/Blue Shield of SC, and CVS's computers keep telling them that I’m not insured anymore. It might have something to do with the switch to COBRA, I’m not sure. I’ve called four times this week about it.

I wish I had a dollar for every hour I have spent on the phone with health insurance related matters over the years. A lot of it has centered around my children. With my policy, Blue Cross only includes children over 19 in the family policy if they have proof of being full time students. We have had to provide that proof many many times. Half the time the letters get lost in the bureaucratic haze. It can be a pain.

Not only that but we have had to be very very careful during coverage transitions to understand and play the system right in order not to get stuck in the “pre-existing” condition limbo. I am very glad for laws which guarantee continued coverage during certain kinds of transition, but there is a life fear of being cast out into the “pre-existing” darkness. I feel deeply for people stuck there.

And we would certainly qualify as a family whose financial struggles have had more to do with medical costs than anything else. Some years it has been almost crushing. We’ve helped a lot of doctors make a living over the years. And now, in between careers as I am, medical insurance remains one of the most important things on my mind day to day.

But I want to speak up for the health insurance companies.

First of all in all the years of calling and holding and waiting the customer service people at Kanawha and at Blue Cross have been courteous and helpful. I would think that my family would be an insurance company’s worst nightmare. Nonetheless I have only ever had good service.

Second, my insurance company has helped to keep down health care costs more than my doctors have. Blue Cross is always rejecting the number submitted by the doctors’ offices and hospitals and such. If I were a doctor I don’t think I’d like insurance companies at all.

Third, though we have had more medical expenses than average, we certainly have paid a whole lot less in premiums (well, actually, until recently my employer paid the premiums, but the idea is the same) than has been paid out to us in coverage. Faced with several surgeries (mostly athletic) along the way, baby deliveries, wisdom tooth removals, prescriptions, physical therapy,, braces, contacts, dental costs, plus my recent stuff, well, we’d be out of luck and out of money for sure by now.

Fourth, I am often surprised that the insurance companies cover as much as they do. I do wish that we as a society had some sort of universal basic coverage for everyone, and this reflection is not (yet) addressing the issue of the uninsured. But we as individuals and as people do have high expectation that we should be able to have this and that treatment or procedure or medication and that it shoudl be convered. But do we really have any sort of fundamental right to “covered” medical care? Many of the things our family has paid for, and to which insurance has contributed, well, we could have lived without, suffered without like people have all through history. We simply cannot have the medical care expectations that we do and expect medical expenses not to be significant.

I think that most of us except perhaps the chronically uninsured and under insured have unrealistic expectations. It amazes me that the system can absorb as many of these expectations as it does.

I am grateful for the health insurance we have had. I don’t think health insurance companies are uniquely evil as compared with everybody else, including those of us who are insured. There is plenty of darkness to spread around.

I just don’t see the point in demonizing the insurance companies, doctors, the pharmaceutical companies, lawyers, hospitals, the insured, those that are expensive to care for because of bad habits, or anyone. We’re all in this mess together and most every participant has a mix of good intentions/expectations and bad intentions/expectations, including me, and probably you too.

Each and every one of us who has had the privilege to participate in the benefits of our medical system needs to be willing to carry a portion of the burden in insuring the uninsured. I personally would rather see this shared burden take place through mutual agreement by all concerned. I am open to considering various plans as long as I am given reasonable chance to understand them. I wish Obama would quit demonizing the health insurance companies. I don't think that helps. If we really as a society want to see medical care extended to more people we will all have to pay for it one way or another, so let’s go into the process thinking and knowing that up front. Let’s spread the burden around as evenly as possible without making demons out of the other participants in the system. We will all have to pay a little more or make a little less. It's not very complicated.

That’s what I think.


Brenda Bowers said...

I think that most Americans feel as you do Joel. I know I certainly do. I don't want anyone left out there without being able to get medical care when they need it and if only people would take advantage of what we have most would have medical care. There are 15 million people on welfare who are eligible for Medicaid but are not enrolled.

I quite agree that we expect our insurance companies to take on a lot of costs so we need to understand that we need to pay for these benefits. I do think that it should be left up to the individual just what they want and are willing to pay for however and not the federal government.

As far as the Health Care Reform plans that are floating around congress they are all, IMO, just power grabs for control over our lives. The Republican Committee chaired by Rep. Tom Price has I believe the best idea. Of course it hasn't been allowed to see the light of day! BB

jhs said...

Nice post, Joel. Deep as always.

I think way back in the day they had charity hospitals and such. I'm reading another book about the Depression era in NC and there is talk about how the poor obtained health services back then.

So much has changed.

Inspector Clouseau said...

The short answer to all of this talk about insurance companies is that they are in business to make money. Plain and simple. That we as a society somehow think that they should function to serve our interests is delusional in nature.

Joel said...

Dear Inspector, Yes, they are indeed, as are ALL the other parties in the drama, no matter if "helping" comes before "profession." This includes us the insured - we are wanting not to spend money, which is another way of talking about making it.

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