HEALTHCARE REFORM PART 2

As we continue this discussion on healthcare reform, I will admit that this blog will probably develop more questions than answers but we will see.

On part 1, I informed you of all the changes that are taking place January 2011 with health insurance.  Now it is time for me to tell you what insurance companies are doing to offset this cost.  If you think they are just going to count it as a loss, you got another thing coming.  I have to make two points before I begin:

1) There are thousands of different insurance plans out there and I cannot know how each and every plan will make changes but I can safely assume that since I and my wife’s have changed, others will as well.  For this blog, I will be discussing the changes in me and my wife’s insurance plans.

2) Don’t look at this blog as a “See, this is why I hate insurance companies because all they think about is themselves”.  You have to understand that you can’t get mad at people trying to make money.  That’s what businesses do and I’m sorry but how many people can honestly say that if they owned a company and the federal government was making decisions as to how you spend your company’s money, you wouldn’t be upset or try to find ways to cut costs.  I think the majority of us would.  Now let’s begin:

First, last year my co pay (the amount of money you pay up front to be seen by a medical professional) for office visits was $20.  That has since been increased to $30.  It seems stupid, however, that the name of the plan is called the “choice 20 plan”.  It ain’t 20 bucks no more.  Ten dollars may not seem like much but if you factor in the thousands of people employed here, that will make a significant boost in revenue.  The co pay to see a specialist has also gone up from $40 to $45.  They might as well change the name from the “choice 20 plan” to the “Choice to give me more money plan”.  I told you, they aren’t eating the costs…………..    

Another important fact that insurance companies have figured out is that a lot of people in America do not have primary care physicians.  Most people go to the Emergency Room for primary care.  This is the reason why ER co pays are so high.  Mine used to be $150 already and next year they are increasing it to $200.  So, now if I am really sick, I have to pay $200 and sit in the ER for hours behind a kid with a cold, a man with arthritis, and a lady waiting for a pregnancy test.  I know women who will sit in the ER for 4-5 hours just to get a pregnancy test.  Really?  You don’t have a dollar to buy one yourself?  What’s interesting is that all three of those problems can just as easily be treated at a doctor’s office for a lot less money.  To be honest, the EPT over the counter is probably better than what we use in my office anyway but y’all want confirmation and we want the $25 we can bill for the test so it’s a win-win I guess (yes, a urine pregnancy test in a doctor’s office will be on average $25.  Just pee on a stick at your house, call your future baby daddy and tell him you keeping it.  It saves money).  Emergency Room visits cost both the employee and the employer/insurance company a lot of money.  The only difference is that the insurance company/employer can raise their rates, deductibles (amount of money you have to pay before the insurance starts covering the bill), and co pays to cover their costs.  So guess who gets stuck?  The employee.  The best way to combat this is to have more people get established with primary care physicians that way if an “emergency” happens between 8-5, they can be seen by someone who is familiar with them and can provide the best care for them.

I’m just getting started, wait until I give you part 3, It’s mind boggling………………….