Or what’s a health insurance company for?

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Sunday, March 21 saw the passage of a bill almost a century in the making.

Ever since the costs of health care began to exceed the ability of the majority of Americans to be able to pay for it, in the 1920s according to author Jonathan Cohn, we have been dealing with health insurance companies when we get seriously sick or injured.  It wasn’t long before the costs of health insurance also outstripped the ability of many Americans to pay for it, leading to many attempts to rectify that situation by Presidents Roosevelt and Truman, Senator Ted Kennedy and most recently first lady Hillary Clinton.  Each was followed by attempts to stop any form of government involvement in the health care debacle.  And it was stopped.  Until this week, under President Obama.

In the debate that shadowed most of the 20th century, and will continue into the 21st despite the historic passage, I feel that there is a little detail that has gotten lost in the polarization of the issue.

That something is, why health insurance exists.

Health insurance exists because we all need it.  Simple as that.  If we could pay out-of-pocket for multiple doctor visits, various diagnostic tests, associated prescriptions, and technological marvels like CT or MRI scans, we would.  We are honest, responsible people.  If we could avoid these when we weren’t able to pay for them, we would.  But the nature of health (and illness) is that it won’t wait until you’ve saved the necessary thousands to millions that one can incur.

One of the buzzwords in the debate is “personal responsibility.”  It is a very good thing to be personally responsible for yourself, your actions, and your financial obligations.  That’s why having health insurance is the responsible thing to do.

In the 1920s, as mentioned above, health care technology had improved to the point where, while it saved many lives and cured many illnesses, the average American could no longer pay out-of-pocket(see article).  This led to the rise of non-profit health insurance cooperatives, and eventually for-profit health insurance companies.  If you pay a monthly amount, the company will pay for the costs you incur if you get sick or injured.

This is a fee-for-service arrangement, not a charity.  The company has told you that it will pay for your medical costs, and your responsibility is a monthly fee, and certain percentages of the costs.  Paying a monthly fee to avoid bankruptcy for yourself and your family is the responsible thing to do, in a society where any illness but the common cold can cost a small fortune to diagnose and treat.

Now lets talk about “corporate responsibility.”  Many health insurance companies are not providing the service they promised when you paid them a fee.  True, technically they are not breaking their contracts.  In practice, however, after they say they will pay and they begin to collect the fee, they are exceptionally good at finding ways not to pay when you get sick.  It is well documented that health insurance companies revoke coverage for people who become seriously ill and have hospital bills that the company had agreed would be paid (example here). Many also use any mistake in the health provider’s billing to deny payment (making you ultimately responsible for the amount the insurance company had agreed to pay) (see sickthebook.com).

If we want to continue entrusting our health to health insurance companies, lets at least make sure they are doing what they advertise and say they are doing:  supporting our ability to access needed health care without losing everything.

Next:  Me, myself, and my health:  Poster child for health insurance reform

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