Do You REALLY Have Health Insurance?
Back in 2010, when the so-called Affordable Care Act first passed, my objections to it were often met with the “car insurance” defense. I argued that the government has no constitutional right to force The People to buy goods or services from private businesses. The liberal answer was always, “Well what about car insurance?”
Now, the car insurance argument was always in response to the question of whether forced insurance was legal. However, it’s the perfect illustration of the difference between real insurance and the overfed monstrosity we currently have.
The “car insurance” argument has 4 flat tires
The way car insurance works is that if you have a wreck, your insurance will pay for repairs. If you hit another car, it will pay for those repairs too. If you get hurt, it will pay for your medical bills up to a certain dollar amount. And if you hurt someone else it will pay for their medical bills.
Now imagine it works like this: You see that you need gas, so you go to the gas station to fill up. You also need your oil checked, and the gas station has a helpful attendant who does this for you. You pump your gas, have the attendant top up your oil, and go in to pay.
If you pay cash, gas is $2 and a quart of oil is $5, but you’re using your car insurance and all you have to pay is a $5 co-pay. So you happily pay your $5 and go on your way.
Then you have a flat. You could change it yourself, but you can have someone else come change it for you under your insurance plan, so you do. Hey, you’re paying for the insurance so you might as well use it, right? Again, you pay a $5 co-pay. Then you notice that your car is looking a bit dingy, so you take it by the car wash on your way home since that’s covered by your insurance too.
It sounds ridiculous — and it is. But this is exactly the type of “health insurance” system we have.
It’s not insurance, it’s a prepaid health plan — and you’re paying through the nose
Of course, you’d never really expect your car insurance to cover mundane things like a quart of oil or a trip through the car wash. Yet this is exactly what we expect health insurance to do. We expect it to cover every single oil change and new pair of wiper blades. We think it should cover tires — whether fixing a flat or buying new ones — and still be able to replace the faulty transmission (a huge and complex mechanical expense).
THIS is how we look at “health insurance.” It’s not our fault, really; we’ve been taught to think of it that way. It began as insurance against catastrophic illnesses and emergencies — a cancer diagnosis or a car crash, for example. And from there it’s grown to encompass everything under the sun. And of course as more and more things are added to the list of billable services, premiums go up.
Here’s the next part of the car insurance scenario: Six weeks after your trip to the gas station you get an itemized statement from your insurer. The station charged $4 per gallon for the gas and $9 for the oil. Why? Because they knew that the insurance company would only pay part of the retail price. Just driving onto their parking lot cost $10 — mainly to cover the hassle of billing your insurance. Having the attendant put your oil in cost $25, and the trip through the car wash cost $31. It’s no wonder your car insurance costs $500 per month.
And the flat tire? It’s not covered because the tire service was out-of-network. You’re stuck paying the $300 bill for that yourself. So you paid a total of $800 for what would have cost you less than $300 if you’d paid out-of-pocket.
This is not “insurance,” it’s a pre-paid maintenance plan. And what we have is not “health insurance,” it’s a prepaid health care — not medical care — plan. That would be fine except for two things: no one is calling it what it really is. And we’re paying double the prices we should be paying for each and every service we use.
As I’ve talked about before, many doctors’ offices, hospitals, and other health services offer a “cash discount” for people who don’t have insurance and who pay up front. The discount is often 50% or more less than what your insurance would pay.
You’re getting ripped off.
Here’s how real health insurance should work — and it’s making a comeback
Good doctors hate insurance. It’s a hassle. It takes time away from their patients. They never know how much, when, or even if they’re going to get paid. And they need a specialist just to do their billing!
A lot of older doctors retired once Obamacare kicked in, rather than being forced to deal with insurance companies. But a growing number are starting what might just be a revolution in the medical world. They’re moving to what’s called the “direct primary care” model.
This is basically a membership program. You pay a monthly fee — which usually runs in the $60-$75 range — and in return you get unlimited access to your doctor. You can have however many office visits you need per month at no extra charge, and you have email, phone, and text access too. All for no co-pay and no extra fee.You also get most in-office services like lab work or X-rays — or setting a broken bone — at cost. DPC programs often offer steep discounts on prescriptions too.
And the best part? DPC doctors see far, far fewer patients than others. Where a conventional office may have a patient base of 6,000 people, a DPC office may have only 600. That means you get some real, quality time with your doctor, which is one of the biggest things missing from the current model of healthcare.
This is what health insurance should look like.
The idea is catching on both with doctors and with patients, and we can only hope that one day it may catch on in other areas like hospitals. In the meantime, a simple Google search of “direct primary care” along with your city or town name will reveal the forward-thinking doctors in your area. If you’re fed up with the current state of non-insurance, direct primary care may be the answer.
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