Insurance Hardly Makes a Difference

By Cameron Ross

Medical insurance is vital for families and the concept seems to make a lot of sense. Pay a certain amount of money every month to a health insurance company and when you require medical attention the insurance company will cover the cost(s). In theory the insurance will pay off in case of an emergency where the cost(s) may be astronomical but how often does that really happen? There are many angles from which one can verbally or legally attack insurance companies.

For a middle class male with a steady job and state or county insurance, they will pay over $1 thousand per month and in exchange, they have medical service at county hospitals and any practices that except the company on the card of insurance carriers. When an individual goes to the doctor for an examination they have a charge called a "co-pay", which is usually anywhere from $5-$15 depending on the location. From there, the patient will be lucky to even see a doctor because nurse practitioners are considered capable of handling the same duties at many practices.

Recently, Bonnie Jeffries, 67, of Stockton was hospitalized after suffering stroke. Jeffries also has diabetes. She has paid into Medi-Cal insurance her entire life since she began working in her early twenties. While recovering at the hospital, Jeffries fell when her walker got caught on a floor mat and caused her to lose her balance. The insurance covered the costs to tend to her bumps and bruises but will not cover the costs of placing her in a recovery center or a convalescent home. The insurance agent told Jeffries she must sell all her possessions and basically spend all of her own money on medical costs before Medi-Cal will begin to pay for such expenses.

If the objective of an insurance company is to pay for the customers' medical costs then why do they go to extreme measures to avoid it like an obligation? A business model is understandable and the idea is to profit but when the situation is analyzed it seems like an outright "rip-off." Restaurants do not avoid feeding customers. Barbershops do not avoid cutting hair. Insurance companies seem to be profitable, especially when so many people pay every month and rarely cost an amount to their insurance that equals what they pay over time.

There are frauds out there and it is understandable that the companies want to avoid being swindled but they have people hired precisely for such investigations yet other people suffer. Doctors seem to be timid to believe something is wrong with a patient because running tests costs a lot and negative results mean wasted money from the views of the insurance companies. A man with a bulging disc in his back that doesn't know the source of his pain may go in for a check-up and be told he is fine and to try physical therapy. He asks for an MRI but is told that is not necessary. After trying physical therapy his back condition worsens and he returns to the doctor and is told to stop exercising. His friend in medical school is an eager product of the science, not yet manipulated by the business side of being a doctor and tells him one of his vertebrae may be protruding. When the pain continues he returns yet again, demanding an X-ray or MRI. After his demands are granted, it is discovered that he has a bulging disc. The discovery is not from work of vigilant doctors but rather a persistent patient.

The insurance companies hold money over peoples' heads as a method of control. They intimidate in order to collect as much insurance payments as possible but then do everything possible to avoid keeping the promise of paying for medical expenses. In society it has become a joke in the sense that medical insurance is constantly ridiculed.

In countries with socialized medicine, all health care is covered for the people. Italy, Sweden, Canada, the list of countries with such healthcare continues while the U.S. continues to experience problems in this field. Taxes are paid in exchange for services and privileges. Citizens are supposed to get their money's worth out of their taxes but it doesn't seem to be the case. Health is always considered to be the most important quality of life. There is a cliché for when people are down that goes "At least you still have your health." Taxes could merge with the purpose of insurance and people could all be cared for equally. It works in other countries. This would mean higher taxes of course but maybe it would be worth it to everyone... we would probably never find out because the wealthy seem to run the country. Insurance companies are very wealthy. The U.S. is said to be a proud democracy. One may look at the country and see more similarities to capitalism but it is very difficult to make an unbiased observation.