2012-06-29 / Columnists

Health & Harmony

Health Insurance? Think Again
Commentary By Dr. Nancy Gahles, DC, CCH

My understanding of health is a state in which one is free of symptoms, enlivened and all parts of the organism are operating in admirable, harmonious, vital operation, as regards both feelings and function, so that our indwelling, rational spirit can freely avail itself of this living, healthy instrument for the higher purposes of our existence.

In our culture we are tasked with, and now, perhaps mandated, to buy an insurance policy. According to Merriam-Webster dictionary, the first definition of insurance is “coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril.” The second definition is, “a means of guaranteeing protection or safety.”

Where is the “health” part? How did insurance companies come to dominate, control and fix the prices for doctor’s visits? How is the insurance company protecting us or, more ludicrous, guaranteeing our safety?

It appears to me that the insurance companies have run amok of their duty to indemnify against loss only and have taken it upon themselves to call the shots of the healthcare industry to the detriment of you and me, the consumer of healthcare. Witness the fact that there is NO cap on rising insurance premiums. The Affordable Care Act, better known as ObamaCare, doesn’t have any provisions for stopping the madness of ever increasing premiums. I continue to pay more and get less. Do you see that? Are you paying more for your insurance premium and getting fewer number of office visits, higher copay, fewer procedures paid for? Why are the insurance companies in charge of telling your doctor and you what services you can and cannot receive? How is this guaranteeing against loss by a specified peril or protecting us?

Let me give you an example. I am a small business owner. I have one employee who provides her own coverage. My policy is close to $1,000 per month with a $2500 deductible. This is the least expensive policy I could get. It is terrible “coverage.” It is an HMO. There were no primary care docs in our neighborhood who would even take it. Fortunately, I have invested in “real” healthcare for myself and my family and am proud to say that with the exception of my son breaking his arm over 10 years ago, we have never used our ‘insurance.” I continue to pay monthly out of fear because I am completely aware of the price gouging and lack of transparency of pricing that occurs when you have an accident. I have seen families come to ruination in cases like this. That said, I received a notice from my carrier this week notifying me of an estimated price increase in my premium for 2013. The usual increase is from 16-18 percent annually. Do you know of any other company that increases your premiums or services by that amount each and every year and continues to provide lower quality and quantity services? Insurance companies lower my fee for service on an annual basis by approximately 20 percent.

Allow me to start a new paragraph as I tell you what my estimated increase will be. Ready? 46.5 percent. Let me repeat that. 46.5 percent.

Now, in all highly questionable fairness, they are giving me the opportunity to provide comments to the Department of Financial Services about this. Let me also tell you that this same insurance company is one that I, as a chiropractor, am a provider for. This company is one that pays me $10 per visit and the patient pays $40 co-pay. AND they can only have a few specified number of visits per condition. NO health care. They only pay for pain and sickness. Where is it that they are protecting us again? Now, if you pay a higher co-pay, that is, $50, the insurance company pays me.... ZERO! That means that you pay a premium to have visits to your chiropractor paid for but you pay the whole bill for that also. How is that a “co”-insurance? Can you say SCAM?

The reason that I write about this now is that the time IS now. If not now,

when? When are we going to speak up and stop this madness? It is an election year. Now is the time to contact your representatives and tell them what is happening to you. As a small business person, I will not be able to sustain a 46.5 percent increase in premiums. I will have to drop it and hope for the best. I will have to protect myself and my family with natural healthcare, proper diet, exercise and meaningful lifestyle adjustments. I will have to join the ranks of the uninsured should an adverse event take place. This is exactly what drives up the cost of premiums. We have been put in an untenable situation. The costs of “alleged” insurance is driving small businesses out of business. So much for encouraging an entrepreneurial spirit. So much for driving the economy with job creation. Oh, by the way, a larger group with the same insurance as mine is getting 16 percent increase. Stick it to small business people. Great plan! I need insurance to protect me against this peril of loss!

In conclusion, I would like to say, does anybody care or have they really dumbed us all down into blind submission? I will send my comments on this outrageous increase but will there be any others who have the courage to stand up and make a difference?

May The Blessings Be!

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