Wednesday, July 01, 2009

There's No Health Care Choice Now!

In the continuing drama that is health care reform, President Obama will be holding a town hall meeting at the White House today. I hope he will be pushing for a public option in any health reform legislation that goes to Congress, in order to give Americans a real choice regarding health care, because even with the plurality of companies offering health insurance, the insurance companies, being insufficiently regulated, offer what they want, IF they want, at whatever price they want, to whomever they want.

One consequence of this one-sided market is that some companies offer, in addition to ostensibly real insurance policies, offer "limited benefit" policies, which can leave policyholders worse off than before, as chronicled in today's New York Times article, "Insured, but Bankrupted by Health Crises."

Now, there's more than one way to underinsure, and some of them involve leaving patients with fewer choices, as I found out the hard way years ago. Yes, like the couple in the article, I was covered by my employer's insurer, which happened to be Aetna. I assumed that it was regular medical coverage, so I blithely went to a highly recommended doctor at a nearby clinic near Wisconsin and Western Avenues in DC.

When I provided my insurance card, I was told that I was not covered. How could that be, I asked. I was then told that my type of coverage, I could only be treated by a doctor in my jurisdiction, MD, not in nearby areas like DC, not even at clinics which were almost directly on the MD-DC boundary like this one. Huh? Most of my co-workers also lived in Maryland (they were the ones who recommended this excellent physician), and were covered. I found out that the most recent hires (me and two others) were covered under a slightly different, more restrictive coverage plan than more senior employees at this small consulting company. Ick.

So, I sucked it up and paid for the office visit out of pocket. Thankfully, no tests were needed, or I would have been up the creek. Thus, in practice, I was underinsured. Of course, no one was told this at orientation--it's likely that the HR manager was not fully aware of the consequence of the change in policy. Nonetheless, that such a restrictive health insurance policy change was even implemented speaks to the squeeze that small businesses are placed in regarding insurance premiums, as they pay high prices for coverage because they are not in large coverage pools.

Oh please--as it is, the American public doesn't have health care choice--you are covered by an insurer your employer chooses, by a policy chosen by your employer, etc.--IF your employers offers health insurance, and even that's only if you don't have a dastardly "pre-existing condition." Anytime one of these Republican talking heads screeches that a universal health care plan would reduce patient choice, ask if the coverage of their Congressional representative is restrictive.

Members of Congress who refuse to vote for a true public option (not some watered-down state cooperatives) in the reform plan should be seen as backstabbers.

Unfortunately, one prime reason that Congressmen and women (and anyone else, for that matter) become backstabbers is the love of...

No comments: