When it comes to a significant drawback of our health insurance coverage difficulties we, each individual are partially to blame. Without a reconsideration of our own values the problem will persist and worsen.
Insurance was designed to help cover the costs of needed healthcare. So what went wrong?
First, costs rose so that the cost of needed healthcare became a larger cost to insurance companies providing coverage. Insurance companies raised rates to try to preserve their profits in the face of rising costs. As rates rose there was a backlash of employers and others paying for health insurance regarding the raise in insurance rates.
What we did wrong at this juncture was that those of us whose employers contributed or paid in full for our insurance coverage were largely oblivious to the increased costs of health insurance and those of us paying for our own insurance coverage were satisfied with what we could find as individuals purchasing health insurance.
No pressure was put on the healthcare industry or on government to address the rise in healthcare costs. This problem remains. Without cost controls health insurers will have to continue to preserve profits by providing less coverage and more expensive coverage.
Next insurance companies began breaking down types of coverage and putting limits on coverage in order to preserve their profits. What we did wrong at this juncture was we bought in. Individuals across the nation started examining each other and adopting the view that they didn't want to pay for another person's illness that might be traced to smoking or traced to pregnancy or traced to chronic illnesses.
We began seeing one another as the cause for our increased health insurance rates still failing to examine the lack of limits on what we could be charged by healthcare providers.
Once we as a society had been broken down into more expensive groups and less expensive groups, the groups solidified their separateness by organizing to fight for their interests from health insurers.
Instead of focusing on the original need and concept of health insurance that would charge everyone premiums to cover the cost of needed healthcare for some and balance that out with the reduced or negligible costs of healthcare for others and demanding limits on increases in costs for healthcare, individuals gave up their power of being part of the larger group of citizens and started believing they could do better by throwing their sicker counterparts under the bus.
Then insurance companies reinforced the new vision of citizens that they were better off as healthy individuals ignoring the plight of their sicker neighbors by providing "perks" that were an insurer's dream, the preventive exam, that affordable and finite, known expense that actually is not insurance in terms of helping to pay for needed healthcare since preventive exams do not indicate poor health nor do they involve unknown expenses.
Insurers threw in "preventive" and further limited treatment coverage, eroding the very concept of health insurance itself.
Suddenly getting a checkup for free or for a small co-payment dazzled the healthy so that they didn't pay attention to the fact that fewer treatments for illness and lower percentages of the costs of those treatments were covered by insurers.
So is there a war on women? No more than the war on smokers, the war on the obese, the war on those with mental illness, the war on those with chronic disease, the war on those with genetic disease or the countless other factions that we allowed to form because at every juncture we forgot what health insurance was supposed to do and we forgot that controlling costs of healthcare services was a crucial part of the formula. All these distinctions omit other groups such as motorcycle riders, those who drink too much,those who play football or ski.
Certainly they too will come under the microscope at some point in time if we don't reassess what we expect from our healthcare providers in terms of reasonable costs and from our health insurers in terms of helping to pay for needed medical expenses.
It looks like a "war" on women but in fact it's still about money. In fact the higher rates charged to women are based on the same statistical analysis that weeded out smokers, the obese, those with chronic diseases, cancer survivors, those with high blood pressure as the "THEM" before the current "war."
So where can cost controls come in? Three simple steps follow: Insurers themselves should prevent insurance claim fraud. We are paying for their failure to monitor their payments for fraudulent claims amounting according to some estimates into the billions of dollars a year. Insurers themselves should adopt better standards for negotiating fee payments to healthcare providers in order to prevent continued healthcare cost increases. Insurers should stop paying for items that have finite costs such as a checkup. And third insurers should require that none of the dollars paid in premiums by their members should be used for anything but medical costs of care for their members including fees charged by hospitals for research or for treating the uninsured.
Until citizens redefine themselves as "WE" in the healthcare, health insurance environment of today there remains no incentive for insurance companies, governments or healthcare providers to modify current trends.
