I think most of us are really hoping that our life insurance does not get used this year. We also hope that we don’t have to use our auto insurance and our home owners insurance.
However, when it comes to our health insurance, I think many of us want to be able to use it.
We want to use it for our doctor visits, blood labs, etc. I get it, we pay a lot for our premiums, we want to get our money back. I think most people feel they are buying a health plan not insurance.
The problem is that when you use your insurance, it is a claim and insurance companies are really good at passing the cost back on to you. The more claims we make, the more of a risk you are.
Every time you put a claim against your auto insurance, you pretty much expect it will go up. The same is true for all other insurances.
Health insurance is a little different in that they seem to raise the premiums on everyone when people are putting in claims.
For decades now, Americans have been arguing about who should pay for healthcare. Should it be self pay, insurance based or government funded. The argument goes on and on. There are good and bad points on all sides.
Currently what we have in America is insurance based health care with most of us now having high deductibles and unfortunately high premiums.
Just a few years ago many people had small co-pays with very low premiums. For some, their employer paid the premiums for them. Life was great! Not so much today.
It truly is a health care crisis but what is the solution. The most obvious one is stay as healthy as you possibly can. Life happens though and we are living in a fallen world where sickness and disease exist.
There probably isn’t a day goes by in our office where a person calls us and their first question is, “Do you take my insurance?”.
It is a good question. What they are asking is if I come to see you will I go home and then get a giant bill in the mail that I wasn’t expecting.
I do have to say that I don’t think it should be the first question. I think the first question should be “Can you help me and are you good at what you do?” but with the price of healthcare and the lack of transparency of pricing, it is a good question.
Just think about your last visit to the doctor. Did you ask them what the visit is going to cost?
I did this recently. I needed to get a scope of my esophagus. I phoned the doctor’s office and asked them what they charged. The person I spoke to was very reluctant to tell me.
“What if we have to do more than just the scope when we are in there? That will cost more.” She made a great point. I mean they are not going to wake me up and tell me “It looks like it is going to cost more, should we proceed?”
I told her just tell me what it would cost if everything goes just as planned. I was quoted the amount and then a couple of months later received a bill that was three times higher than what she quoted. I was not happy, everything went as planned, why is it costing more!
It turned out that they made a mistake and billed me what the insurance price was instead of the cash price that I agreed to pay.
I was happy that it was a mistake!
Of course this adds even more confusion. There are insurance prices, cash prices, insurance company reductions and insurance fee structures.
Talk about confusing!
At our office, we have decided to not take insurance. This is not as easy decision for us as we understand people want to use their insurance.
Below, I have listed what I feel are the reasons people want to use their insurance and the reasons that we feel that utilizing your insurance is not the best choice for all healthcare.
Reason to use insurance
– You are paying high premiums, you should get to use it
– Healthcare is expensive, spend a few nights in a hospital and you will find out how easy it is to meet your high deductible
– Doctors, hospitals and clinics that take insurance had to be vetted by the insurance company so they must be high quality
– Typically insurance based doctors, clinics, and hospitals utilize the latest and best technology
– The insurance company could protect you from unnecessary bills and treatments that don’t have effectiveness
– Insurance pays for a lot of tests that are early detection such as colonoscopies, routine physicals, mammograms, etc. with no out of pocket to the patient
Reason to not use insurance
– Insurance companies utilize protocols which eliminates individual care. For ten people who have a health issue, there will usually be ten very different approaches to helping them get better.
– Insurance protocols typically do not take natural approaches to care first
– Insurance companies have fee agreements that make it so reimbursement rates are low. In order to recover that money, clinics and hospitals try to see more people in shorter time
– You can feel like you are nothing more than a number due to those shorter visit times
– Every time insurance is used, premiums go up
– Insurance companies utilize studies that are pharmacuetical based to create their protocols
– Hospitals and insurance companies have higher fees because insurance companies can take many days to pay and many times can deny care for multiple reasons, slowing down reimbursement. This can end up costing you a lot of money with the high deductibles that many people have
– Insurance based healthcare and most insurance for that matter is utilized for crisis/acute situations
– Insurance companies pay for what they call prevention such as colonoscopies, mammograms, physicals etc. but won’t pay for things that can prevent such as supplements, good nutrition, etc.
– Insurance companies list modalities that don’t have double blinded controlled studies as experimental and typically deny the care. The problem is many natural approaches to care have too many variables to fit into those types of studies so they are not performed plus there is very little funding for natural care. Who will pay for a study that shows a gluten free diet helps with hypothyroidism?
These are just some examples of the benefits and the drawbacks of insurance. We are always trying to serve our patients We would love to hear your thoughts. Please comment.
