Wednesday, January 16, 2013

Affordable Healthcare OR Affordable Insurance??

Let's propose something thought-provoking with regards to the "Affordable Healthcare Act" for just a moment!

To begin with, this is not a simple "for" or "against" universal healthcare blog, rather it is regarding the "concepts" of what it might mean to have real healthcare coverage.

Please understand, that if there hypothetically were aliens in space watching  humanity, and how we "care" for each other, well..............there would be some frowns. We need a system that ensures better "care" for everyone. Everyone needs to take part in a system that in turn "helps everyone." The great part is that our society is actually at a point where we are at least attempting true "altruism." And this is of course, is a huge leap forward socially speaking. It may not be perfect, however it is a start.

Now, in terms of my focus. Does the proposed plan really affect "healthcare" and thereby the "health" of our American society? We are all faced with having to gain "Health Insurance" whether we really want it or not, this will help to defer the costs among the larger whole of "covered" persons............lower costs, and some potential governmental credits = lower healthcare premiums, right? Yes, this can potentially mean lower Healthcare Premiums, but does that necessarily mean Better or lower Healthcare costs? Therefore, does Healthcare Insurance really necessarily equate to better health? Now, although I believe it a good idea to have insurance particularly for the potential catastrophic situation, we must realize that Health insurance is really "Sickness and Disease Insurance." Although we are finding more plans that will cover more of what they consider to be "preventative" services, lets face it, you can't just go asking for most healthcare services, such as Bone Scan, MRI, etc. without having first been diagnosed with a condition.  Basically, you already have to have a problem in most cases to then be able to treat the "condition." Therefore, most people only go to their Medical Provider when something is already wrong, and this is usually delt with by masking the symptoms ( not necessarily the problem itself) with some sort of Medication. Most people end up at their Medical provider between once and 4 times each year. This is the type of care we are attempting to "make more affordable." Is this really "Healthcare" though? Does this make one more healthy or decrease their risk of further debilitating disorders or even death itself. Interesting that the Cochrane Collaboration (www.cochrane.org) data shows that wellness visits to Medical Providers had almost no effect on the early detection and treatment of most illness nor a reduction in the mortality risk of patients. Now, this doesn't mean that Medical care isn't necessary, however perhaps the "type of care" and "frequency" of visits could be real indicators.

What about further considering the visit frequency to certain providers? First of all, which type pf provider? A Triage and sickness specialist? Or a Correction and wellness specialist? How many people could have avoided that spinal fusion surgery or organ transplant, etc. that was the result of cumulative effects over time? What if a Wellness Specialist were to see a patient potentially 10 times a year, what if more? Would one not agree that with more constant supervision, comes the greater chance of earlier detection and treatment? What if that wellness specialist were actually rendering smaller treatments and tweaks to a patients health along the way? Would those large problems they were to potentially face not now mitigated and potentially kept from getting bigger at all due to more constant small treatment and supervision?

The current way most Americans handle their health is much like getting the oil change on their care only once a year or when it starts to scream and shudder. What if you had a auto protection policy that covered unlimited maintenance, how often would we each take our car in? Some, may try every week, some monthly, some, it would make no difference to because they're going to wait for it to scream catastrophe anyway. Could we argue that the person taking their car in more frequently for check ups and/ or small tweaks is more likely to have their care run better (healthier) and likely last longer with fewer great issues? I think common sense says yes. Therefore, I would infer that our healthcare for our bodies is much like this automobile example. With that, the problem isn't so much making the current model "more affordable," but rather making a model that actually is preventative and effective, more "affordable."

What is more important, making insurance premiums that only allow for the same periodic "sick" care model more affordable, or facilitating a maintenance model for prevention as well as earlier detection more affordable? Again, if we compare this to our automobile model, it may look something like this:
(Example for "non-catastrophic" model of general use and maintenance)
Automobile Insurance Plan Choice 1                                 Automobile Insurance Plan Choice 2
Deductible:                          $500                                           Deductible:                   None
Co Payments per visit:         $20                                             Co Payments per visit:  None
Monthly Premiums:             $400                                            Monthly Premiums:       None
*$600 per month without Governmental assistance
Visit Limit:                           10 per year                                 Visit Limit:                     50 (or unlimited)
                                                                                                                                                         
Total Personal Annual Expense using all visits available:                                               
                                          $5,500                                          Annual Flat Rate:        $4,000

In the above example we would generally find that those "car enthusiasts" would be more likely to take real advantage of a perpetual maintenance program for the car(s) they love, whereas some who don't particularly think much about their car, wouldn't take much thought of this. What about those in the middle though? Those that didn't understand or perhaps didn't know maintenance programs were important much less available and how to understand their use? Well, education is the key, as with all things. No one, can use a tool they have never encountered or been taught how to use! 

At first this seems unrealistic, however do plans like this exist? ABSOLUTELY!!! One only need know what to look for and where to look.

Our cars are important and I would propose that if enough people knew of plans like the ones above, then at the right price to have enough access to car maintenance, more people would certainly take advantage of them. This is the very same with our health. We tend to take advantage of the fact we think we are healthy and don't do much until something is obviously wrong. Kind of like waiting so long you need new tires rather than taking care of them the entire time. Well, we can't get New bodies, nor can we ever repair them, once damaged heavily enough, to the former 100 % functional status.

After all of my analogy to cars here, there seems to be one thing clear with current healthcare reform. The current proposals are reform of pricing of the current sickness model only.  Yes, this can make this type of care more affordable to those without even this, I get it, and yes, this is an important "aspect" of healthcare. However, what about affordable continual access to providers for less than catastrophic care and/ or maintenance?

I would propose the thought of a system of "Affordable" premiums, yes, but also affordable ongoing direct provider access and thereby improved maintenance.

This subject has the potential for great depth and breadth. This particular blog is designed not for that, however to stimulate "thought" on the matter. As well, to stimulate the reader to engage the idea that there are systems out there that actually function much like the proposed examples. That there are systems of maintenance that can often cost less than your health care premiums alone. As always, we welcome your input and questions, and hope that you find this subject thought-provoking and informative.



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