My last two blogs (Part 1 and Part 2) highlighted two of the ways the quality and effectiveness of your healthcare get compromised… by the profit-driven nature of our current hospital systems and the greed and corruption of the pharmaceutical industry. The third thing that interferes with your healthcare, a third leg of the profit-centric problem, is the insurance industry.
Back in the old days, you entered into a relationship with your doctor. You would see them for regular physicals, illnesses, or injuries. They provided a service, you made payment to them, and it worked beautifully. Nowadays, there is another component to this relationship… the insurance company. This relationship involves you paying a premium each month, and in turn, the insurance company agrees to share some of the costs of the services you require. You have a deductible, which is the amount you must pay before the insurance company pays for anything. You also sometimes have a co-pay, which is a set amount you pay toward each service or procedure or per visit.
The problem with the relationship with you and the insurance company is that it is not based on a mutually caring and concerned nature. The insurance company, like the hospital systems and pharmaceutical companies, are profit-driven. Their primary goal is not to ensure that you get the best care possible or remain as healthy as possible. Their goal is to make as much money as possible. They achieve this in two ways… by charging you more for the insurance plans (higher premiums, higher deductibles, and higher co-pays) and by paying less towards your medical expenses.
Anyone reading this has felt the sting of paying more for their health insurance. The cost has skyrocketed. And I am certain you have also had services that your doctor ordered or recommended get denied by the insurance company.
People often make the mistake of thinking that the insurance company knows what you need. They think if a procedure, test, or treatment gets denied or is not covered by your policy, then it wasn’t necessary. In reality, the doctors’ hands are often tied, because they may strongly want you to get a procedure, test, or treatment, but someone at the insurance company denies it–not because it is not necessary or helpful for you, but because the insurance company does not want to shell out the money to cover that procedure, test, or treatment.
Don’t be fooled. The insurance company is not concerned about your health or well-being. You are a revenue stream for them. And they make more money by paying for less, therefore will deny any service possible.
Instead of looking at health insurance like a key component to your wellness plan, and thinking that the better your insurance, the healthier you will be (which is false!), think of it like you do all other forms of insurance. You expect your car insurance to pay when there is an accident. You do not expect them to pay for oil changes, tire rotations, or tune-ups. You expect your home insurance to pay when there is a fire, flooding, or other disasters. You do not expect them to pay for gutter cleanings, power washing your driveway, or staining your deck. Health insurance is really no different. They are there to help out in a crisis. They are not there to pay for the things that keep you well.
In sum, don’t be fooled into the idea that health insurance companies care about you, are there to pay for everything you need, or have your best interest in mind. They are in business to make money.
We need hospitals, we need medicines, and health insurance has become a necessity. We would be in big trouble without these. But you MUST be aware of how these entities interfere with you expressing optimal health and wellness. Understanding their role in your navigation of your healthcare throughout your life will keep you safer, less frustrated, and more aware. Utilizing them is necessary… relying on them can be catastrophic. Do not be naïve when it comes to your healthcare and those that are involved with it. Our healthcare is severely broken right now, which is driving the cost of services up, raising the rates of your insurance, and putting more emphasis on expensive and dangerous drug therapies. The greatest investment you can make in your healthcare is the lifestyle choices you make. What you eat, how much you move, the quality of your sleep, and how you manage your stress are under your direct control, and can be managed without hospitals, pharmaceuticals, or health insurance companies controlling it.
