03 April 2009

Health Coverage: Broken

Problems with health care in the US are exemplified by three articles in The New York Times this week.

If you have a "pre-existing condition" -- which includes pregnancy (!), good luck in getting health insurance. Melissa Klettke bought an individual policy last year rather than paying higher premiums for an employer-sponsored policy. Three weeks later, she developed symptoms that led her doctors to suspect multiple sclerosis, and the insurer dropped her policy, claiming a bout of vertigo a year before proved she had a pre-existing condition. She's paid thousands of dollars for tests (and it turns out she doesn't have MS) and the insurance company isn't playing.

If you get insured through Medicare, good luck in finding a doctor to give you a check-up. Barbara Plumb's gynecologist decided to opt out of Medicare, and her primary care doctor doesn't know of any gynecologists who still accept Medicare insurance: the reimbursements are too low and the paperwork too onerous.

In the midst of coverage gaps like these, over a trillion dollars a years is wasted in our health care system each year because of unneeded tests and procedures done solely in an attempt to protect doctors from lawsuits in case something goes wrong.

Our system of paying for health care is broken. The health insurers want you to think that health care reform will lead to a decline in the quality of health care. Nope. But it will lead to a decrease in the profitability of health insurance.

I said it last week, and I'll say it again: when folks make money off of others' illness, it's just wrong.