"Beauty confronts us with the requirement that we place ourselves among...the redeemers, the leaders in the protection of life. Once you have seen the bush on fire, you are not going to get out of the assignment unless you close your eyes to the beauty.... [You] either have to close your eyes or go back to Egypt and set the people free." - Rev. Dr. Rebecca Parker, "Rising to the Challenge of Our Times"

Wednesday, November 15, 2006

plot thickens

This is an issue that's hard to feel until it kicks you or someone you know in the teeth, but since more and more people are being kicked in the teeth, maybe it's not so hard. I'm talking 'bout the health insurance industry, having recently spent 7 - 8 hours in a conference on medical debt. I have a goodly number of elderly clients who are or have been dragged through collections because they couldn't pay their medical bills. Having some kind of insurance is not necessarily always helpful either. I learned about something that hospitals have called a Chargemaster. This is the list of the highest most detached-from-any-reality prices that they have made up for any given procedure. It is different from the actual "Cost" which is the amount the hospital has negotiated with various insurance companies and government safety net programs, the amount the hospital will actually be paid for the procedure. The "charges" have skyrocketed since the 90's with no relationship to anything other than that hospitals figured out they could gouge the government for procedures that are reimbursed at a percentage of the "charge"--for example, wouldn't you rather have 80% of $100,000.00 than 80% of $10,000.00?

California recently passed (takes effect in January) some better protection for consumers including self-paying consumers...the hospital can't charge lower income uninsured people an amount greater than the Medicare, Medi-Cal, or workers' comp rate, along with some brakes on the collections process.

So that's good. But health insurance as a for-profit industry is hurting and / or killing people and small businesses and nonprofits. My nonprofit org has been scrambling to figure out how to deal with yet another 30 - 40% hike in premiums this year. Last year they dealt with it by giving us a $2,500 deductible. One proposal this year is to have us start paying full price for office visits (currently we have a $30 co-pay). Seems like that would really discourage anyone from going in for preventive care. Thanks, I'll just wait until I'm pretty sure that I'm dying. We pay for this?

It is all about profiting at the expense of public health and security, cutting benefits (maternity care is often one of those items on the insurance companies' chopping block) and increasing the revenues. This can't go on. I think Phillip Morris and Wal-Mart have more integrity at this point than the health insurance industry. At least I can make choices about smoking and shopping but I'm just not empowered enough to perform most surgeries at home. Maybe creative solutions are out there and we're not as helpless as it feels like we are. I don't know where the breaking point will be, maybe campaign financing reforms will have to happen first, but I tell you this is the next big revolution that has to happen.

Also, I think that there is a scene in my novel in which some people appear to set themselves on fire in front of the brand X insurance corporate headquarters. Not really a solution (other than they no longer have to pay premiums and it takes care of any preexisting conditions they may have had), but sort of cathartic to think about. Especially since not a whole lot has been happening in the novel in terms of a storyline.

1 comment:

Allie said...

jnI think, relatively, we have REALLY GOOD health insurance, which is kind of sad (because I don't think it's all that great most of the time).

We have "catastrophic" maternity coverage- which means it only kicks in after we have paid $5000, which is just a little more than the typical costs of having a baby. We signed up for aflac, and for $62 a month some of the costs will be covered (about half probably).

We currently can go to the instacare clinic which is only a $25 copay, but a few years ago when J smashed his finger in the door, we worried about where to go. The emergency room would have been over $100. We finally took him to instacare, but had to pay $50 before they would even write his name down to be seen (since our insurance didn't cover instacare).

People should not have to worry about how to pay when their child (or they themselves) is possibly seriously injured.

I hear they are opening health clinics inside of some big box stores. That will solve all our problems!