A "Dear John" letter to UnitedHealth and other (private) insurance companies......4 reasons given
An Equal Shot
Dump Your Health Insurer
Forbes.com
May 18, 2009
I'm just not that into U...nited Healthcare. We've been together for years--but my employer really forced us into the relationship and most of the time I feel vaguely taken advantage of. Isn't it strange that, in our multi-year relationship, United hasn't once picked up a check? I'd leave United if something better were to come along.
Hopefully, though, President Obama will play matchmaker. He wants to offer people like me a public health insurance option. I'm ready to flirt with the idea, but the private health insurance industry doesn't want me straying. Karen Ignani, head of the trade group America's Health Insurance Plans, would oppose letting me play the field. Private health insurers can meet our needs, she argues. But she's never asked about my wants.
Here's a problem: I've been insured for years and, despite paying premiums twice a month, I've also had to pay all of my medical bills with my own money. That's because I have catastrophic coverage combined with a health savings account that covers most (but not all) of the high deductible. Thankfully, I haven't had to deal with any catastrophes.
It's odd to me that I pay for health insurance but also pay to see a doctor for any visit other than my annual physical--even though it's the kind of preventative care that saves my insurance company money in the long run. But that's how our relationship works.
Not only do I pay for everything, I'm stuck with all the paperwork. I get blood work done and wind up getting billed by a lab I've never heard of. So my insurer pays no bills and refuses to clean up after itself. The insurance company doesn't care, because I have nowhere else to go.
If I decline my employer's coverage, I won't be able to afford to buy insurance on my own. United is only singled out here because it's the insurer I have now. Complaints about
I'm one of many who would at least give a public plan a try--and the industry really has no good argument against giving me the choice.
Opponents say that a public plan will mean higher taxes. But if I don't have to pay insurance premiums, do I care if I pay a little more in taxes? There's even a good chance that the taxes I pay to the government will be lower than the premiums I pay now. Taxes or premiums, the difference is only semantic.
Also, it seems to be easier for private insurers to raise rates annually than it is for the government to raise taxes. Beyond that, when I pay premiums, I get no say in how the money is used--it could be given to shareholders as a dividend or used to fund executive perks. If bureaucrats try to live large off the public plan, we can at least expose them and get rid of them.
Some warn that the government will ration care, indiscriminately providing treatment to some patients and not to others. But insurance companies and health maintenance organization already ration care, and they'll ration it even more strictly if the industry tries to keep its promise to save $2 trillion in costs over the next decade.
One example is that health insurers can override the dictates of a practicing physician by refusing to pay for a prescribed treatment, whether or not the patient and doctor think it's necessary. My fiancée had a prescribed physical therapy regimen her insurance company rejected. Doctor said go; insurance said no. There's no recourse but a lengthy appeals process that's inappropriate when someone is trying to get an injury treated. See? Rationing already exists.
One irony of high-deductible plans like mine is that the insurer has an interest in denying coverage--even when the patient will be the one paying. The insurer doesn't ever want the deductible breached, because that's when they start paying. That's rationing too.
Opponents of the public plan claim, finally, that the government will crowd private insurers out of the market. If people like their insurance companies, this should be impossible. Nobody will sign up for a government plan that costs more than what they're paying now or one that is stingier with services. The government plan will only crowd out private insurers if the government plan is cheaper and more generous.
If, my dear United Healthcare, the government plan stinks, or you can make me a better offer, I'll come back to you. It's not that I hate you, private health insurance. I just think we need some space. And if I want to see someone else, I hope you'll be mature enough not to try to stand in the way.
Michael Maiello is the editor of Markets and Intelligent Investing at Forbes. His weekly column, An Equal Shot, runs Mondays.
posted by Kathie Bracy at 4:53 PM
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