The rich don't worry about paying their medical bills. The poor rely on Medicaid. But the middle class is in big trouble. For about fifteen years, health insurance coverage through companies and privately purchased has eroded coverage and flooded the market with distraction. From wellness credits to high deductible plans, we're watching price competition. But look at the largest insurers' websites. From "high risk" insureds to those with preexisting conditions, the websites promise quotes and coverage. And as part of that middle group, I am sorry to say that I no longer care about the endless debate about getting "some sort" of coverage for the uninsured.
The uninsured remain the pet cause of politicians who boldly claim they are addressing the health care crisis. Unfortunately, the "crisis" is that even those with insurance are choked by medical bills in the event of poor health (you know, that situation where you are left struggling for your life and to pay your bills in the event you need more than the check up that is "included" in your coverage). Health insurance reform requires changes in the availability, affordability and access to medical care in the event of illness--period. If you doubt this, add up all your included "screenings" and check-ups for which you pay nothing or a small co-pay. Really add them up, go shopping. Call the "best" doctor and ask how much your out-of-pocket cost would be for a complete exam and then compare it to what you pay for health insurance. Chances are, the cost of all your screenings--RETAIL-- wouldn't add up to a fraction of your premium costs. It is the coverage of pre-existing conditions, high-risk individuals, those who have been stricken with a medical event that creates the need for health insurance, not the need for a physical or a screening. The costs of physicals and screenings is affordable without health insurance. It is the cost of medical care and treatment that is expensive.
For decades the conversation about health care has directed itself towards the uninsured--it is time to redirect it to the tougher situation, the fact that many with insurance are still up a creek in the case of a medical event and that even if they survive that, the next time they try to get benefits they're in trouble.
The politicians need to get some boots on the ground wisdom. Health care reform has to start from the middle. Don't cover anyone's screenings or checkups. But don't keep chipping away at the very things that insurance was designed to cover--the costs of medical care when medical care and treatment is what is required.
