How much control do you have over your healthcare?
Now, many of us have limited control over our health, but we should at least have control over our healthcare, right? I don’t know what the answer is, but it can’t be this.
I read this morning about a plan by a local health insurer to reimburse patients for choosing cheaper care. 
Well, that’s the basic idea, anyway. If my doctor sends me for an MRI at site X and instead I go to the cheaper site Y, then I’ll get $10-75 from my health insurer.
This troubles me in many ways. To keep myself from rambling, here’s a quick bullet list:
- Will the care be comparable? Or will patients lose out?
- People suffering financially may put their money ahead of their health. I admit that this is their choice, but is it really a choice? After all, premiums won’t be cut, so this is their only chance for relief.
- This may make it harder for doctors to coordinate care. When I get a test done now, all doctors in that hospital system see the results. If I get a test done elsewhere, I’d have to get the results sent to all of my doctors, which is unlikely to happen, so the burden would be on me to bring the results of all tests with me to all appointments.
- There are already health plans that only allow patients to be seen by cheaper doctors at cheaper facilities. How much farther will this cost-cutting expand? I don’t get to choose my health plan – my employer does. If they choose one of these, I might have to change all of my doctors, and it has taken me years to build up a medical team I trust.
- If cutting costs is so important, why doesn’t the health insurer cap reimbursement payments? Wouldn’t that make more sense? Why reimburse one site more than another?
Really, what upsets me is the direction of healthcare changes. Health insurers and politicians are floundering to find a way to save money and stop the skyrocketing costs to patients and employers. There is talk of a single payer system in my state. While I love the idea theoretically, I have seen the way it has been put into practice in other countries, and I don’t trust it. Really, do I want anyone involved in my government to decide if it’s cost-effective for me to take a certain medication or have a certain test? No! I trust them even less than I trust health insurers – I guess I trust the devil I know more than the devil I suspect. If my health insurer chooses not to cover the cost of something, I can appeal within the insurance company and also to a state board. If the state were in charge, who would I be able to appeal to? Costs are too high. People can’t afford care. Those of us that can afford it, often pay so much that we must cut back on other things (like ever being able to afford to retire.) This just isn’t working.
We need a solution. So many of us are desperate for a solution. If only I had any idea whatsoever what it might be.
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Chronic Rants 