I received my "2011 Annual Notice of Changes/Evidence of Coverage" for my health insurance the other day. It is a 247 page document. Of course, that's only half the book. The other half is attachments; hundreds of pages of them. The entire document is written as to be unintelligible. I would have to pay an attorney to tell me what's in there.
Can anyone tell me what an "Abdominal Aortic Aneurysm Screening" is? Am I supposed to know this? I have no idea what it is. I guess I'm supposed to understand it because the insurance company tells me to read the book. But, hardly any of it matters because of the phrase "usual and customary." If the insurance company doesn't like it, it doesn't matter what it is, they'll refuse to pay for it.
My doctor doesn't like the health care system any more than I do. While the insurance company raises my premiums, they lower his payments. The doctor is forced to accept health insurance company discounts because if he doesn't, he'll go broke treating people who can't pay. The health insurance industry works best when there are a lot of uninsured people.
To make up for these discounts, my doctor runs more patients through his office per hour than he'd like. The doctor would like to spend a little time with me, get to know me, but he can't. The exam rooms must turn over quickly. You're in and you're out. Nurses do the actual work so the doctor can meet his quota of patients per hour. No offense, doc, but isn't there anyone in the office who can draw blood without sticking me eight times?
For health insurance companies to make windfall profits, they must charge people high premiums, pay doctors low fees and make sure they enroll healthy people who don't need medical care. They don't insure pre-existing conditions, have long waiting periods to make sure you're healthy, have large deductibles, hefty co-pays, mandatory payment caps and so on. The health insurance industry is a scam.
To protect themselves, health insurance companies must game the system. They spend billions of dollars lobbying Congress, giving political contributions, funding political action committees and billions more in advertising, sales and public relations. Instead of that money going into care, it goes into protecting the jobs of paper pushers who do nothing to treat people. I knew a guy who was vice president of a large health insurance firm; his kid played on my baseball team. The family was filthy rich. Multiply that by all the health insurance executives around the country. You talk about Wall Street profits? Health insurance executives are making big bucks.
The best health care system would be to give every citizen in the United States a single payer Medicare system that covers everyone, cradle to grave. You and your doctor make the decisions; everything is covered. The system does not have to make a profit and our elected representatives manage the system. Citizens pay into the system through taxes, but would pay far less than they do now because the system is not for profit.
Republicans call this socialism. But, what the G.O.P. is actually doing is protecting a health insurance industry that pays big bucks to Republican candidates. I don't care what it's called; call it anything you want. If we eliminate the for-profit middleman - the health insurance company, with all its inefficiencies and wasteful spending, and replace it with a non-profit Medicare style system, we will get better coverage at lower cost.
People are a nation's greatest natural resource. If we are going to invest in anything, it should be ourselves. We should invest in every single person, not just those who can afford health care. We should stand up to Republicans who protect the windfall profits of insurance companies, take control of our health care away from insurance companies and put it in the hands of ourselves.
And, that is a view from Missouri.
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