Health Insurance - the good, the bad and the ugly

In the US, healthcare is not a inalienable right. Many of you have health insurance either through employment or by paying yourself. Others are not so fortunate and do not have any coverage.

Healthcare insurance is viewed very differently from other types of insurance. Most people have auto insurance but don't expect that it will cover basic tuneups and preventive care so car owners take it upon themselves to get the oil changed, check the tire pressure, etc. Many view their health insurance as where their efforts to health begin and end. A healthy lifestyle is your best insurance but takes effort and responsibility.

So what are the pros and cons to health insurance?

Patients Perspective
Pros

• Peace of mind - just knowing that coverage is in place can be of comfort.
• You are more likely to seek medical care when you need it.
• If you are unlucky enough to incur large medical bills it may keep you from financial difficulty. Conversely - you are getting your money's worth

Cons

• It is not universal - having healthy neighbors makes you more healthy too,
• Those that cannot afford it generally do not seek medical attention when they need it.
• Insurance companies are purely profit driven and not an advocate for your health. They are in the business of denying benefits to increase profits. Insurance companies are making record profits and it is draining the pockets of America.
• They do not cover preventive medicine
• Actuaries are making health care decisions for you, not you, and not your doctor.
• Expense - many people cannot afford insurance and rely on the ER for their care; especially if you are healthy it can seem like money down the drain
• There is no incentive/reward for leading a healthy lifestyle
• Some things are not covered that you may want - massage, chiropractic...sometimes even naturopaths
• Deductible can make having insurance seem a waste of money

Physicians Perspective
Pros

• Increases the number of patients I see - those with healthcare are more likely to seek care

Cons

• As physicians we have an ethical and moral directive to help people in need. We also need to eat, pay our staff and student loans. I would love to provide healthcare to the best of my ability and not have to worry about whether someone has coverage or if I will be paid.
• Insurance companies are more likely to pay for a limb amputation than preventative medical treatment. Those without coverage don't even get that.
• Naturopathic treatments are more cost effective and yet there is no recognition of this.
• Massive amounts of paperwork.
• You are at the mercy of the actuaries.
• Time and money spent on following up on declined reimbursements
• You must agree to accept whatever the insurance company decides your services are worth
• Some appropriate treatments and diagnostic tests are not covered
• Practitioners must agree to charge the same amount for cash payers
• It is really a game and naturopaths do not really fit into the insurance model because we spend more time with patients
• They may only cover a certain amount of visits even though the patient would benefit from continued care
• Drives up the costs of healthcare - our healthcare is the most expensive in the world but not the best
• Many patients see insurance as their healthcare and don't accept their own responsibility making them difficult patients

Alternatives
For those that take an active roll in their health and lead a healthy lifestyle, a high deductible, low cost catastrophic insurance plan plus a health savings account for general health care might be a good alternative. This will save money overall if you remain healthy yet still provide coverage for emergent events. Perhaps we will see universal healthcare with the new US Government administration?

Further food for thought

• Michael Moore's film 'Sicko' - examines the state of healthcare in the US and gives glimpses of the national systems that other countries have in place
• Fast Food Nation - a humorous film that examines what happens when we feed ourselves with fast food. Changing diet to whole foods is great and tasty insurance.