The debate over how to fix our country's broken health care system can get pretty darn abstract and complex. But last night my wife and I had a hands-on experience of what's wrong with private medical insurance.
After Regence's 40% premium increase on our individual plan over the past two years, we decided to look for a way to get more health care bang for our bucks.
Laurel has a friend, Christy, who is an insurance agent. She said we should look into changing from Blue Selections Plus to Blue Selections Premier, and consider altering our deductible.
First, though, it was necessary to make a big pot of coffee, pray to the health insurance gods, and hope that a mixture of caffeine and supernatural guidance would enable us to decipher the differences between Plus and Premier.
Remember: we were exploring private sector options, not the Obama "socialized medicine" that right-wingers are claiming will ruin the world's best health care system.
Well, after a few hours of trying to navigate Regence's private sector maze, we were damn ready to embrace anything other than the insurance we have now -- if that turns out to be a public plan such as the one members of Congress have, great.
If someone wants to call it socialized medicine, go right ahead. It can't be worse than the horribly confusing and unfair health insurance system we have now.
I worked for ten years in health services research and planning. Laurel was a psychotherapist in private practice for about the same length of time. We know a lot about health insurance.
And we both were scratching our heads last night, trying to weigh the pros and cons of deductibles, copays, annual limits on coverage for certain services, annual coinsurance maximums, plus other arcane (yet important) factors that must confuse most other people even more than they did us.
I kept thinking...
"Come on! Why can't this country simply have an insurance plan that meets the needs of almost everybody? Like how the postal service operates. It does a fine job delivering our mail. And it's a government program. If I want extra service, I can head to Federal Express. But by and large the USPS provides a great product -- for everybody."
After phoning Christy and getting some advice on the best deductible for us, we decided that it made sense to switch to the Premier $2,500 deductible plan, from our current Plus $1,000 deductible.
OK. Optimistic me actually thought that maybe I could just call Regence, talk to someone, and have our contract easily changed from Plus to Premier.
As if anything is easy with health insurance these days. Which reminds me: the Regence web site, for some utterly understandable reason, doesn't include "plethora of inefficient private plans" among its reasons for rising health care costs.
A 2005 Science Daily story says:
I can believe it, given how much time we spent last night filling out an application for a Premier contract. Because even though we've been Regence customers for many years, I was told that switching to a different plan entailed applying for coverage just as someone new would have to.
I didn't think the online form would be fun to complete. However, I had no idea that it would be as time-consuming and frustrating as it was.
Whoever designed this monstrosity of a questionnaire probably never filled it out himself or herself. If he or she had, the ridiculousness of asking the same question over and over in different ways would have been obvious.
Yes, one of us had moderately high cholesterol at one point (me). I dutifully check that health problem as I move down a lengthy list of diagnoses, symptoms, and such we've experienced the past five years that Regence wants to know about.
Then the form demands more details. I explain that I was prescribed a low dose statin and my cholesterol is much lower now. Regence wants to know the name, address, and phone number of the doctor who wrote the prescription. I provide it.
Later, after Laurel and I have been working on completing the application for 90 minutes or so, page 967 (roughly speaking) of the form asks for a list of prescription drugs we're currently taking.
"We already told about those in the problem areas," Laurel said. No matter. The online application must be obeyed. We spend more time re-typing in the same info we'd already provided. Now I understand how staff in doctor's offices and hospital billing must feel:
Wanting to strangle the private health insurance bureaucrats who come between patients and their health care providers.
I can't understand how the conservative blowhards I hear on talk radio/TV manage to say, "Americans don't want the government interfering with their current health insurance coverage."
Yes we do! Please, please, government! Step in and interfere!
Just save me from ever having to fill out another private health insurance contract application like the one we worked on last night. It was insane, because the clear purpose behind most of the questions was to learn whether we -- gasp! -- might have some health problems.
Gosh, Regence, you got us.
You're right. Laurel and I want health insurance because we're not always healthy. I know that you and other health insurance providers would prefer that your customers never got any medical care, because then you'd make more money.
And there are plenty of horror stories about people being denied coverage by private insurers because they failed to dot some "i" or cross some "t" on a form. So we did our best to be as complete and accurate as possible in filling out the damnably long and complex Premier contract application.
Throughout the process, though, I was struck by how absurd the whole notion was of grilling us about the health problems we have so some Regence employee can decide whether we have too great a need for health insurance.
Then Regence could deny an application for health insurance, because the applicants need health care. Um, don't people need a way of paying for health care because they have health problems?
There's something desperately screwed-up with American medical care. That came home to us last night, even though we already knew it.
Expecting private health insurance plans to be the centerpiece of reforms, given that they are a huge part of the problem, isn't reasonable. This country needs a public option. Bad!
For all their paeans to the power of private enterprise, we know that private insurers simply can't compete with the government, because they offer an inferior service at higher prices. We know this because of the example of Medicare, which operates more efficiently than private insurance (Medicare spends only around 2 percent of its costs on overhead, a fraction of what private plans do) and gets higher satisfaction ratings.
Oh, I can believe it. After suffering through the Regence Premier application form last night, I can sure believe it.