On November 29, the Washington Post carried an article by Ceci Connolly headlined, "US NOT GETTING WHAT WE PAY FOR." With the rage of an old timer yelling at the television set, I read that the US spends too much on health care that doesn't achieve results in terms of life expectancy. First off, is this really newsworthy? You can search these blogs and find comments about life expectancy that were considered long before the article of November 29. But onto the comments quoted on how to fix things by insurance executive Reed Tuckson, executive vice president at United Health Group. Here's his suggestion: "SHIFT LARGE SUMS INTO PREVENTION AND WELLNESS."
Okay, let's try again. Health INSURANCE is supposed to cover the RISK of needing money to pay for needed medical care. SHIFTING MONEY AWAY from paying for medical treatment into the fluff of prevention and wellness, FINITE costs including lifestyle management and routine checkups IS NOT INSURANCE!!!
Insurance companies are insuring less and lecturing more and guess what...PREMIUMS HAVE NOT GONE DOWN! Until we insist that insurance companies first and foremost cover the RISK of treating illness, we are sunk.
Utilization rates reflect the percentage of each premium dollar used in the medical care of a given individual. Today we are at about 43%. 43 cents of each dollar is used to pay for medical care and it is actually less because those numbers include the cost of doctors overprescribing tests as part of their attempts to cover their butts, better known as defensive medicine (search this website for the AHIP report, an insurance industry report on where our premium dollars go). Even with this minimal amount of our premium dollars actually going to what we think we're paying for, the insurers will try to squeeze out more money through higher premiums and less coverage of risk.
Prevention is great, but the coverage of Prevention INSTEAD OF the coverage of risk is a dangerous scam of the US population. Go get that mammogram, it's covered. Treatment for breast cancer? Not so much.
Another suggestion included in this article is to have YOU, the consumer, be part of a process that uses information that "evaluates various drugs, devices and treatments and publicizes which work best and at what cost ...[so that] patients and doctors could make more rational decisions". The IS IT WORTH IT scenario. Well, since we're having the discussion, health insurance is NOT WORTH IT if you need two or three policies at extreme prices JUST IN CASE you get sick. Physicians who don't fight insurance companies on behalf of patients who need a certain treatment ARE NOT WORTH IT. Insurance company execs earning millions and investing in financial products that leave them susceptible to stock market fluctuations so that they then have to take money from the federal government or charge more to consumers are NOT WORTH IT.
These articles and others of their ilk are WORSE THAN NO REPORTING AT ALL because they perpetuate the myth that spending on prevention REPLACES the need for a financial product that will cover our risk of expense for needed medical care. If INSURERS don't insure, let them start an online educational service and charge accordingly instead of scamming the American people.
