Mike the Mad Biologist

COBRA and Health Insurance Versus Healthcare

First of all, thank you to everyone who commented on my post about COBRA. One of the odd things about the situation was that I was screwed by the calendar: had I switched jobs during a calendar month, I wouldn’t have to have picked up my own health insurance. This doesn’t alleviate other inefficiencies, such as everyone wasting their time (and salary money) re-registering me for the exact same health insurance. Which brings me to a point that needs to be raised, even if it is obvious:

There is a difference between health insurance and healthcare.

Granted, even Yogi Berra probably wouldn’t have said something this obvious. What lead me to blunder into the obvious was having to decide which health insurance plan to choose at my new job. I had a total of seven different health insurance plans to choose from, three of which were HMOs. The HMOs were the most interesting: the most expensive was $173/month (for an individual), and the least was $118/month. As far as I could tell based on the benefits package, the $118/month was the ‘you are legally required in Massachusetts to have health insurance, but if anything happens other than an annual checkup, you’re hosed’ plan. But I could be wrong: maybe someone paying $173 per month is just wasting his or her money. Or maybe we’re both screwed if something bad happens.

The problem is that I have no way to evaluate how good any of these plan are at keeping me healthy, which is what I care about–hence, the above distinction between health insurance and healthcare. It would be nice to see these plans broken down by healthcare outcomes (and death too…) as well as patient satisfaction (granted, these data would have to be subdivided–a twenty-five year old woman isn’t the same as a sixty-five man).

This is one more reason why consumer choice healthcare is a bad idea: we’re essentially gambling with our health. I use the word gambling because none of us have any way to evaluate if the insurance we have picked will provide the healthcare we need if something disastrous (or even mildly annoying) strikes. I have no idea if something bad happens (and there are many kinds of ‘somethings bad’) whether my plan will provide the healthcare I need. Would I have access to the specialists I might require? Which treatments would be covered, and for how long?

Realistically, I can’t determine that. That’s not a choice, it’s Russian Roulette.

Related post: Paul Krugman has another reason why ‘choice-based’ healthcare fails: the big ticket items (e.g., cardiac surgery) aren’t driven by choice, but by necessity.

Comments

  1. #1 CRM-114
    November 13, 2007

    For a fresh perspective, look at where we don’t have insurance at all.

    Instead of food insurance, we have a number of competing grocery stores.

    Instead of water insurance, we have municipal water supplies.

    Instead of electricity insurance, we have monopolies regulated by government.

    There are three hugely different solutions to everyday problems of living, and none of them require gambling.

    If we’d had insurance rackets operating in any of those theaters, we’d all probably be dead by now.

  2. #2 Mark P
    November 13, 2007

    Staying healthy is certainly a good plan, but insurance is really there for catastrophic events. I have commented on some blogs about my own experience with a torn rotator cuff caused by a fall from a ladder – not a long distance, but long enough. The total cost is probably going to approach $50,000 for diagnostics, surgery and physical therapy. Imagine someone who works on ladders for a living, like a carpenter, painter, plumber, or electrician, who might not have insurance, or who might have marginal insurance, and who does not make a lot of money in a year. Without insurance, it would be a life-changing experience. You have to have the surgery to continue to work, but the cost might well be equivalent to your gross annual income. Even with stingy insurance, you might end up owing 20 percent, or $10,000, not a sum to sneeze at. So, staying healthy is a good plan, but I would worry about things you can’t plan for.

  3. #3 Allen
    November 16, 2007

    Hello,
    Your discussion is very nice for difference between health insurance and healthcare. It is very use full. I like to read it. I like to share with you about very good CRM software. It is http://www.leadorganizer.net/ they have very good products for insurance industry.