I’ve learned some interesting things about health insurance. As a healthcare provider and a patient, I’ve seen both sides of the tyranny of our healthcare system. When you go to see your doctor, the doctor bills insurance, if you have it. The billing is done through a bunch of codes called ICD-9s. The doctor won’t get paid unless the proper codes are used, so it’s a kind of game. However, you, the patient never win this game. Let’s say that last year you went to the doctor for hypertension, neck pain, a bout of diverticulitis and high cholesterol. Let’s say you were diligent and changed your diet, started exercising and lost weight—and now are free of any of those conditions. Think you’ll ever be able to get insurance again? Think again. Yes, maybe somebody will carry you, but your premium will be punitive—because you are a branded sick person by virtue of the ICD-9 codes attached to you like antibodies. Health insurance companies don’t care if you get well and they don’t believe there’s a cure for anything. Once you are associated with a disease state you will always be associated with that disease state. Now you suffer the indignity of having overcome a few health problems through your own discipline and perseverance, only to have your premium skyrocket, or, worse, to have your insurance cancelled. Meanwhile, if you are lucky enough to have insurance, you’re being taxed for all the patients who don’t choose to get better, who don’t lose weight, stop smoking or make an effort to eat right. So, we’ve invented a system where you come out better if you’re an overweight, sedentary, diabetic smoker than if you’re a Pritikin, South Beach, Scarsdale dieting marathon running health nut. Think the new Affordable Care Act will help? I doubt it. Anything the government in cahoots with insurers comes up with is bound to be bad news for everyone. While we bankrupt our nation with healthcare costs, other countries, such as England, Canada, Japan, Germany and France, maintain much better systems at much lower cost. Every time I put in an ICD-9 code for a patient I know I am putting another nail into the coffin of my own integrity and the patient’s bank account. Maybe the answer is that free enterprise doesn’t really belong in the sphere of health or medicine. I guess I’m naive, because nowadays churches, hospitals, doctors, charities have all retooled for maximum benefit to the institutions themselves and little benefit to the recipients. Many years ago, when I was a volunteer EMT on a small town ambulance squad, I remember a patient I transported to the hospital rewarded me after his recovery with a carved wood figure he had whittled. I think that was the last time I truly felt legitimate and authentic accepting a fee as a healthcare provider.
Posted on: Thu, 13 Jun 2013 22:45:49 +0000
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