Posted by: 12stepgolf | August 31, 2009

Health Care Insurance and the Addiction to It

Insurance: in law and economics, is a form of risk management primarily used to hedge against the risk of a contingent loss.  Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of as a guaranteed and known small loss to prevent a large, possibly devastating loss.


We have become a nation addicted to health care usage.
It seems that as long as we are removed from dipping into our own pockets, cash on the line, and pay a share of our own costs we will remain addicted.  The nation suffers from Munchausen syndrome and some of it is by proxy, also.

I have really become confused with the health care debate.  There seems to be a disconnect from my definition of health care (medical insurance coverage) and what the rest of the nation defines is as.

I am not of the believe that health care is a “civil” right.

I did not realize that everyone wants every little thing covered by an outside agency.  They want every single doctor’s appointment covered.  They will also be demanding dental care and eye care covered not long from now, if there is any passage of a universal system put in place (how does 5 trillion sound?).  Everyone wants every aspirin covered along with every visit.  I must have carried my own policy for so long (20 years) that I didn’t realize how many people are not paying their fair share of health care costs.  We love that phrase “their fair share” when we think it doesn’t have anything to do with us.
We have not become consumers of health care, we have become abusers of the system.  The “my insurance will pay for it” removes the individual from any responsibility for the sensibility that should be used in determining what is really a health problem and just a sniffle.  Everyone believes whatever is wrong with them needs medical attention, from a sneeze to a stubbed toe.  Add children to the mix and we have Munchausen by proxy.

I grew up in the day when no one gave health insurance policies much thought.  Everyone had a relationship with a doctor and there was no 3rd party to interfere with that relationship, it was all one on one.  My grandmother was in the hospital with lumbar pneumonia for a good deal of time in the early ’50’s, and I know she had no insurance.  Somehow the talk or wailing about the lack of insurance was never discussed.  The bills got paid.

My first employer did not offer health insurance.  We never gave it a thought.  Eventually there was some coverage offered through a payroll deduction.  The coverage covered catastrophic illness and accidents.  It made sense to purchase said insurance, it was a good deal.  Every employer after that gave the option of a plan that was employee contributions.  I know a little about insurance, had to learn about it when I took my state test to be able to sell life insurance (that was a long time ago).  My how insurance coverage has changed.

As things have evolved and the unions demanded more from the employers, we now have come to these HMOs and PPOs and God only knows how many other monikers are used to describe some of the policies.  The problem still is that there are no employee contributions to any policies any longer.

What we need is to get back to the catastrophic and accident coverage.  That covers all those unforeseen contingencies which insurance was invented for.  Like car insurance to cover those things we don’t expect, not insurance to cover an oil change or tire rotation.  It really is the same thing when you really think about it.

This argument that insurance companies are rationing care currently, is a fallacy. The companies don’t tell you that you cannot have a procedure, you just won’t get it paid for by the company.  You still can have the procedure if you are willing to pay for it. As long as we can pay out of pocket, we are free.  As long as there is no universal system we have the option to go and pay for it ourselves, there is no one that has to not get the procedure if they are willing to pay for it themselves.  Can anyone remember that doctors could not accept a self payer (they would be penalized, fined) under the Clinton system?  That is health care in a classless society (unless you are of the class like politicians).  Has anyone paid for plastic surgery, and tried through making it a corrective procedure to get the insurance company to pay for it?  Did you save and pay for those breast implants yourself?  There are things people are willing to dole their own money out for.  We are not the victims of the insurance companies.  We are victims of the belief that I have no responsibility for my own health care payments.

I bought my present policy in 1988, and it was for only those unforeseen contingencies of catastrophic care and accidents.  I have a large deductible which keeps my premiums down.  This policy is rather old and doesn’t define many of the newer procedures, like the fine needle aspiration I had done when a lump was found on my neck.  My agent worked with the company, and I had the majority of the cost paid for.  It was well worth the deductible to have the chemo for my low grade B cell lymphoma paid for.  The time I drove myself to the emergency room to have a twisted knee was paid for also.  I have to pay for my scripts and any office visits, and you know what there is no need to cry about that.  Sure I am locked into having to have this same policy because of preexisting conditions, but where would I go and what other policy would I want it takes care of me just the way it should.  I am getting exactly what I pay for because it covers those unforeseen contingencies.

The high cost of insurance for those seeking insurance must have something to do with the amount of coverage they want to carry.  Do insurance companies even carry simple catastrophic and accident policies any more are they all Cadillac policies with everything covered?  This is not insurance any longer.  I like to be wordsmith and for the life of me, I cannot come up with a word that describes what we have today, because it sure isn’t insurance that we have.


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