Is the public waking up to the empty promise of universal health insurance?

Let me start by stating again that I am enthusiastically behind the idea of health care for all in the U.S.  I want this to happen.  It will be a good thing.  [I know it will create a mess if we don't reform the health delivery system, but that's another post.]

The problem as I see it is that Washington D.C. is talking not about health care for all but about health insurance mandates for all.  These two may look the same to the public but are fundamentally different.

As I've noted before, having health insurance is no guarantee of getting health care, of being protected from personal bankruptcy if you have a major medical problem.  Having health insurance right now results in limited choice of doctors, rationing dressed up as "pre-existing conditions" and prohibitive deductibles & co-payments, and intolerable waits and delays from insurer administrative denials.

We could do so much better than this.  We deserve better than this.  I won't stand in the way of insurance for all, but I'll only be able to swallow that kool-aid if there is some promise of reigning in the egregious excesses of the insurance industry - stop them from hurting our patients and making it nearly impossible to survive as a primary care doc who cares about quality.

At least the blogosphere seems to be developing a growing awareness of the gulf between health insurance and health care.

Here's a recent piece by Paul Loeb in the Online Journal

But why assume that the insurance companies are our friends? Why appease them at all? It’s not as if they’ve played a helpful role in our current system. Rather, they’ve gamed it in every possible way, leaving our country with the highest health care costs in the world and worst health outcomes of any advanced industrial country.

Here's a pathetic real life story from a front line doc:

I had a girl come in yesterday who was on the schedule as a new patient appointment.  She had purchased an individual policy after she lost her job last fall.  The agent had her convinced what a great deal she was getting; only $108 per month for major medical coverage.  What she didn’t understand was that she had a $3000 annual deductible that had to be paid before this great insurance paid anything and that she had an 18 month preexisting condition clause in the policy.  She was coming for her annual pap and BCP prescription; she had not had a pap in 4 years.  Her co-pay for an office visit was $40 which if her deductible had not been met was not applicable since the whole visit was her responsibility.  Who did she get mad at when confronted with the information and the request for payment by my staff?  Not the agent that sold her the worthless policy, but rather my staff who informed her of the deductible.  My staff was wrong; she had insurance they have to pay.  She was in tears when she left.  My staff had put her on the phone with someone at her insurances customer service department so they could fill her in on what the agent hadn’t bothered to tell her before taking her money.

Everyone is talking about credit card reform  over the ridiculous interest rates etc that are being charged, what about the insurance policies that people are being sold because they have been conditioned to believe they have to have health insurance.  You see ads everyday for these plans that really don’t amount to much.  If the insurance industry isn’t taken out of the mix in the healthcare reform debate, GOD HELP US EVERYONE.

Comments

[Dr. Michele DiLauro]

I have talked more people out of buying this kind of "insurance"! I'd much rather help them out with reducing my rate than see them waste their money on what they think they are getting is nonexistant insurance. Why people are so afraid of the concept of 'socialized' type of medicine as a bare minimum safety net I don't get. To many of US out there without coverage, . Including me!