Monday, October 01, 2007

America Is Too Insulated on Health Costs

America Is Too Insulated on Health Costs

When I was working and had group medical and dental insurance, I was mainly interested in what my co-pay was and whether I had any sort of deductible. For the most part, I could obtain any prescription or see any doctor for a maximum of thirty dollars for a month's supply of medicine or an office visit.

A few years ago, I lost my job at the end off the month and the employer cancelled me from the plan for the next month before I was able to obtain COBRA insurance. I went to the pharmacy where I was informed that my insurance was cancelled and that I had to pay full price of more than $200 for the one month supply of one drug. That was a rude awakening at my pharmacy.

Now I have individual health coverage where I have a 50% plan for prescriptions. It seems that the bulk of the drugs are priced from $100 to $200 per month of which I pay slightly less and for others slightly more than $100 for a one month's supply. It adds up quickly. Thank God for generics. Thank God, for Walmart $4.00 generic prescription 30 day refills.

I was concerned that my family doctor and the specialist I see were not getting enough money from the health insurer. It appears that my primary care doctor receives $200 for an office visit. My office visits are on the longer side because I have some problems recently. The specialist does not get that much for office visits which are short, but makes up for it in many tests each year. Another specialist I saw to get a colonoscopy took the $30 co-pay from me and billed the insurance company more than $700 for the initial office visit. I know they do not always get the full amount that they bill, but I thought that was high. I think the doctors are well paid.

I think my specialists may have million dollar practices. I had surgery around 15 years ago and I am sure he had a million dollar practice back then, too.

I was in the dark on doctor fees and insurance payments to them for many years. Many years ago, my health insurance was something like 80% of fee paid after $500 deductible. I was younger and healthier then so I did not have many visits. I think most office visits were $15 or $20 each back then and an initial visit with a specialist might be $50 or $75. I do not know how often I would see my primary care doctor for $200 each visit and I would have a serious problem coughing up more than $730 for an initial specialist office visit. Now I know why some people go overseas to have medical procedures accomplished.

I want to be prudent with my health and obtain what I need at a fair price. I think that insurance premiums are too high and the 50% cost of drugs is cruel. I am surprised at the high reimbursement to doctors there is with all of the complaining they have been doing for so long. I am confused by the closing of some hospitals in my area while others are being added to. I am shocked that the pharmacists have a loaded cost of more than $100,000 per year
for a basic 40 hour workweek. I am shocked with forecasted shortages of staff for all healthcare job types during the next few years. I am shocked that the biggest growing expense in healthcare is administration rather than direct care. I am surprised that one insurance executive earned more than a billion dollars worth of stock while his customers depend of his company to provide them healthcare. There are far too many executives earning more than one million dollars per year each providing administrative services.

I think healthcare is in critical shape in America and requires intensive care in order for Americans to survive now and in the future. Too many Americans do not have health insurance let alone good health insurance. There are too many Americans that go to bed hungry in America. Drugs cost too much money. All administrative expense should be cut in half. If America is going to be short handed, then why not provide the additional seats for nurses, doctors, technicians, and pharmacists and fill them with willing and eager students? Let's elliminate some of the insurance company loopholes like pre-existing condition and others. Let's provide better health care education for all and model good eating and exercise in all of our schools. Lets influence health issues such as smoking, over-eating, diabetes, exercise, and others in positive ways. Let's find practical ways to reduce administration costs like reducing coding to one scheme instead of several.

America is the only country in the industrial world that does not guarantee healthcare for all of its citizens which is an insult to the rank and file Americans. It is high time for this to be corrected.