Tuesday, December 8, 2009

Health Care Reform – Why Bother?

By Howard Stanten, Owner of The Met Coffee House and Mount Washington Valley Physical Therapist

As a small business owner in New Hampshire and a physical therapist by trade, I view the recent debate over health care reform from two different angles depending on where I’m sitting at the time.

 

 

 

 

From my small business seat, I want to provide health insurance for my family and my employees, but the value just isn’t there.  Furthermore, trying to figure which types of policies cover which medical services for what co-pay and what deductible is, for me, about as easy as trying to figure out quantum mechanics.  Throw a pre-existing condition that requires yearly diagnostic work and lab tests into the equation and forget it.  The ability to fully understand or even come close to understanding what you are buying before you buy it never materializes.  What I do understand is that policies that cost around $300 per month for a middle aged married couple don’t cover much until you reach around a $2,500 deductible.  A healthy single younger person may pay about $150-200 per month for coverage with the same deductible.  More on this later.

From my health care provider seat, I see first hand how our present system tries to reward the right things like quality of care and efficiency but often falls short of the mark.  Health care institutions operate in the competitive free market.  As such, they must make strategic decisions based on the principles of any business operating in the free market.  If they don’t, they won’t survive.  Operating within such a milieu, health care institutions must make decisions, at times, that prioritize their bottom line.  Don’t believe it.  Ask a Medicaid patient how much choice they have when it comes to highly specialized care or extended rehab services. 

So, health insurance is cost prohibitive for most individuals and small businesses and impossible to understand.  Health care delivery is driven by a bottom-line motive that, by definition, cannot always be looking out for what is in the patient’s best interest.  The folks that are covered by a decent employer based plan that doesn’t bankrupt them (I include myself in this group as I am gratefully covered under my wife’s policy) are hesitant to welcome any change for fear that they will lose their beneficial position.  No wonder we’ve tried and failed for a quarter century in this country to deliver substantive health care reform. 

But wait.  When I’ve asked my employees if they would participate in a small business group health insurance plan if I paid half of their premium, they say, “No. Why bother? I don’t need health insurance.  I’m not sick. And, if I do get really sick, I can always go the emergency room and get treated for free.” 

Writing often brings great insight to the writer. It’s the nature of the process.  I feel much better now. I can stop watching Harry Reid and John McCain debate health care reform.  I can stop trying to figure out some way to provide health insurance for my employees.  Why bother.  After all, health care is free.

 

 

Tags: Citizens Health Intiative, emergency room, group health insurance, Health Care Reform, health coverage, health Insurance, small business

This entry was posted on Tuesday, December 8th, 2009 at 9:43 pm and is filed under Health Reform. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.