I may not technically owe my life to the Affordable Care Act but my quality of life is certainly much better. Unfortunately I’m already being told by doctors that I need to get necessary care done this year. It’s all necessary.
Thus I have been watching the U.S. Senate closely for the last few months because they’ve been debating the fate of the ACA. On September 6, the first round of hearings will start in the Senate HELP committee. First up: the state insurance commissioners from five states.
Oklahoma Department of Insurance
Mike Kreidler, OD
Washington State Insurance Commissioner
Julie Mix McPeak
Tennessee Department of Commerce and Insurance
Teresa Miller, JD
Insurance Commissioner Of Pennsylvania
Lori K. Wing-Heier
Alaska Division of Insurance
Alaska actually has the best story so far as I can tell about how to make health care more affordable. How Alaska Got Affordable Insurance Back. Short version is reinsurance which I savaged in this post originally.
I’m glad that I was wrong when I said insurance execs would be testifying because they are peddling a system that may have passed its prime.
The insurance commissioners have expertise that is relevant to this process certainly.
However, I do still believe that insurance is one of the problems we should fix in our health care system, and so I’m hoping the “fix insurance so it doesn’t collapse in 2018” doesn’t become a kick the can down the road until after the 2018 (or help us, the 2020) election for health care system reform more broadly. This issue is directly tied to access, bankruptcy and is a life or death issue for many. And our current system has some fundamental flaws, including health insurance. Now, I’ve been an advocate for a family member treated in the NHS system and I can tell you, even having government health care (“single payer”) does not mean insurance goes away. We were told repeatedly by doctors that we should go to private doctors outside of NHS. But it is not required to have access to care. In the US, unless you need emergency care, or can pay cash, good luck getting care. In the NHS, it’s just a matter of how long you have to wait.
With that new preface, below is my list of the top six reasons I dislike health insurance companies.
1. If insurance companies had any idea how to make health care affordable, they would have done so by now. They clearly don’t have any ideas other than only sign up healthy people and kick them off if they get a major illness.
2. Insurance companies have destroyed health care as we know it. Thanks for making medical billing and reimbursements so effed up that doctors can only make a living by seeing 30 patients per day or performing at least ten procedures per day. Rushed doctors do not improve the quality of care.
3. Thanks for also making medicine now about documentation for insurance purposes. Last time I had physical therapy, I saw a PT in training and he told me he had to stay after work for 1-2 hours to finish up documentation every day. But there was no medical reason. It was just so insurance could be satisfied they were getting their money’s worth.
4. The NYT had an article in the last few days about the success of Minnesota’s exchange due to reinsurance. I’m not going to link to it bc it is infuriating. So the cases where an insured person needs heavy care, the state will reimburse insurance companies for their care so insurance can keep costs low for everyone else.
Hi, that’s the actual purpose of insurance, to spread the risk within a big pool. If your business model is that no one can get sick or you can’t afford their claims, why do we even have insurance?
5. Insurance isn’t known for altruism. Rather, they are known for denying lifesaving treatment, having researchers find any excuse to cut off necessary care, and pre-existing conditions. Yes, pre-existing conditions, the number one thing Americans loathe about health care, is due to insurance companies and their shitty policies.
6. Insurance companies can never be bothered to incentivize prevention and wellness which would, oh that’s right, reduce the cost of claims they pay out. Rather they refuse to pay claims for dubious reasons and then spread the narrative that Americans are needlessly “consuming” health care. Forget going out to the movies, I want to waste a whole day waiting in a doctors office for him/her to spend five minutes going over my symptoms and then prescribe me medicine I don’t need and can’t afford. If I’m lucky, maybe I’ll need surgery because everyone knows surgery is something fun everyone wants to “consume.”
In short, insurance companies are the problem with health care and their suggestions should all go in the circular file.
[Note: Posted edited on Sep. 5, 2017 to reflect the Senate hearings will be with state insurance commissioners, not health insurance executives. Diatribe against insurance companies remains.]