Insurance companies, along with pharmaceutical companies, receive large profits each year by basically denying countless Americans coverage or cheaper health care options. Many Americans don’t have health insurance and choose not to go to the doctor because of the expense.
During my childhood I can only think of one time I had to go to the hospital. My mother always told me, “Unless you are dying, I am not taking you to the doctor!”. This very rare trip to the hospital was for my tonsil removal surgery. My tonsils were so large that they protruded far into my throat causing me to choke on food. Obviously, this was affecting my daily life, so my mother decided to schedule the $3,000 to $4,000 surgery.
All of it was covered by my mother’s health insurance at that time. You may be saying to yourself: “You had your whole surgery covered, what is the issue with health care/insurance?” Luckily, my mother was poor enough to be able to receive a Minnesota health insurance called UCare. UCare covered the. entire costs because we were unable to pay for such an expensive surgery.
This scenario is a superb example of how great of a service health insurance companies can offer to the American people. But insurance companies are much more of a ‘business’ than a service. In my opinion, if one is paying a monthly bill to cover health care costs, the company should not be able to deny payment for any reason. A tactic for insurance companies to gain more revenue and decrease costumer coverage is provided by the Verden Report (2007):
Insurance Companies Decrease Their Medical Cost Ratio:
Medical Cost Ratio (MCR) is the percentage of costumer insurance premiums that are spent for health services. According to this report, UnitedHealth Group in 2007 had received $16,984,000,000 in three quarters. In their first quarter for 2007 they had a 82.7% MCR. They spent almost 83% of their premiums on health services received by their costumers. But this is when things get interesting—they only spent 79.5% of their total premiums during their 3rd quarter. This 3.2% percentage change may not seem like a lot, but it saved the company more than a half billion dollars! This money could have been spent to pay for life saving operations, medications, and other services.
The Verden Report has many more elements regarding the “Cost versus Profit” of health insurance companies. I highly suggest you check it out; it is a very eye-opening read!
What I Think Must Change
In my opinion, the biggest things that need to change to make our health system more convenient, affordable, and run by ethics is:
Provide a health care plan for people who can’t afford insurance company premiums (the government health care plan, for example). Insurance companies have to provide a service to the American people, and operate more as a non-profit company than a mega-money-maker.
In retrospect, my family was lucky to be poor enough for a government provided health care plan where we had to pay very little out of pocket for our health services. On the other hand, wealthier Americans have to purchase high priced insurance and hope that some of their medical bills will be covered.
Should we really be paying top dollar for a service that we hope will help us when we need them the most?