NY Times Reports Health Insurers are Flush With Cash as Health Care Consumers Put Off Care
The NY Times reported that people are putting off care, resulting in decreased hospital stays and fewer procedures (http://www.nytimes.com/2011/05/14/business/14health.html?_r=1&ref=health), yet they continue to jack up our rates saving for the rainy day when everyone decides to finally use them.
If you are like me, you probably have seen higher bills for health insurance every year, even if their costs to insure you are dropping. This is what is happening today. They contend this is money being set aside for when people use their benefits. The problem I have as a health care provider is that over the past 6 years or so, our reimbursements have dropped by as much as 40% at the hands of some carriers. I am of course not the only one, and other carriers have not increased what we earn per service in at least 10 years, while costs have continue to go up.
The large health care institutions continue to charge unbelievable fees for services (recently, a family member had a sleep study for which they charged us $4300, leaving me with a bill for $1700. The four hour test which includes my son sleeping with electrodes and then waking up could not possibly cost anywhere near that to perform, being that they do a number of these at a time with one tech. Where is the value? Could this be part of the problem;Fees are out of control? Why is it that an EKG that is normally done in your doctors office in network is paid at $80 and out of network billed for $640 according to one doctor I recently spoke with. How is the health care consumer supposed to make sense of this?
The is one other reason I think that services are beginning to drop; people are beginning to question weather we need all this stuff, these medications, these procedures. If my son for instance had sleep apnea according to the sleep study (he did not), they then sell you a Cpap which provides oxygen with a funky looking mask while you sleep. Doctors believe that use of this via studies will prevent congestive heart failure. Many people who purchase this C-pap never use it, lost weight and never have a problem. Was this $8k solution for both the test and the gizmo really worth the price, to both you and your insurer if its benefits are of dubious value and many people with apnea still live into their late 70’s and 80’s. Why don’t insurers look into why procedures like this cost so much and work toward value in their plans? In reality, the insurers only care about making money and we come second, both as the public and as the providers who perform the work. The problem is that there are so many services we have been convinced we need, with little health value, that we fight when they try to take it away from us.
Currently, they are making us share the cost, something we are powerless as individuals to contain. They raise our cost, we begin to reevaluate the need. In the end, we are likely to find out that we did not need nearly all the stuff the medical system said we did and eventually, we will find out that we did not need all the medical stuff nearly as much as we have been convinced we did. Where does that leave us? We pay more, the big institutions will be forced over time to compete more and as a side note, your insurer become quite wealthy because they pay even less.
What to do
All health care services must be questioned for their worth, especially, with some of the high costs we are being forced to pay for these services. We need to become better health care consumers as well, and reject health care services that seem dubious (recently, it was reported there are too many colonoscopies being done on older seniors who are at risk with the procedures and for whom it has little or no benefit). Lastly, I think it is time we seriously consider a single payer system. I know, I know, those who want smaller government say this is too much, but the fact is, doctors costs would drop markedly with less paperwork and confusion, some doctors, mainly generalists will see more income while specialists such as surgeons will likely get a haircut and our overall costs should drop. Health insurance, like it or not is a tax. I would rather pay that tax and get my dollars worth. Right now, health insurance is about the insurance company making money, rather than the patient getting the care they need, and the patients are cutting back as they harbor more of the cost. Higher insurance premium with lower payouts is fair for insurers, not the insured. A single payer system would remedy this and we need to weed out health care services of dubious value.