A mother was in the office the other day, and her child was covered by a certain for-profit, commercial insurance...not to name names, but the company rhymes with "You lie, Ted."
Last year her co-pay on office visits was $20. As of Jan. 1 it rose to $40. She was not happy about this.
I wouldn't be pleased either. And I will go out on a limb and guess that her premium did not decrease. So this health insurance company gets the family to pay $20 more per office visit, and they get to pay $20 less.
That is an awesome way to make a profit: shift the cost to someone else!
Too bad I can't figure out a way to do that (legally, that is).
This same insurance company (whose letters can also be rearranged to form the phrase, "DIE, NUT") announced last year that it would finally start paying for both a sick visit and a check-up on the same day. Previously, it would only pay one or the other. Now most check-ups are pretty straightforward, and minor issues are expected: the baby has some cradle cap, my teenager has a little sniffle today. But every once in a while they present with something more complicated: a wheezing infant, a preschooler with bad behavior problems. If the insurance company won't cover both on the same day, I tell the parent: we can address the problem or do the check-up, but not both. (Expecting a doctor to do otherwise is like taking in your car for a tune-up, finding that your brakes are shot, and expecting the mechanic to fix the brakes for free, since "it's all part of the tune-up.")
Well, this nameless insurance company now says that due to computer issues, it won't start paying for both a check-up and sick visit on the same day until, oh, December 2007.
(Warning: sarcasm ahead.)
Dang, that must be a wicked bad computer problem. They must be getting some serious l33t hacker dudez to crack that code. Maybe they're asking both Steve Jobs and Bill Gates to work together on this one. I mean, how in the world would you program a change in a reimbursement rule? They must be outsourcing that one to, heck, every computer programmer in Bangalore and Boston combined. I hope they're at least consulting with MIT.
"Computer issues?" Really, couldn't they at least think of a better excuse? Though I admit it does sound better than saying, "we delayed the implementation to continue diverting money from the premiums to our shareholders."
I don't want to paint all health insurance companies with the same putrid brush, but as a doctor (or, as they say, a "health care provider,") I think the average person doesn't realize that these companies are first and foremost in the business of making money for their shareholders. If they can provide health coverage along the way, great, but they aren't in this for their health. Nor for yours.