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COVID-19 is a pathogen but it’s also a diagnostic test being run on America’s health insurance system. The results are coming in and they aren’t good. We need immediate, emergency #insurancereform. For example, covid will give millions of healthy people a taste of...
the fact insurance companies fundamentally believe that you won’t stay healthy unless they threaten you with high costs if you get sick & seek treatment. It’s called “skin in the game”. That’s what your deductible & copays are. So the premise is that those who might...
...struggle to afford a $1500 hospital charge will socially distance more effectively to not catch covid. Of course, those are also the same people who sometimes can’t afford to stay home. Maybe they work at a nursing home & have vulnerable people depending on them. No matter...
...insurance doesn’t care. Nor does it care that skin-in-the-game, both deductible and copayments (together, out of pocket costs), don’t so much deter people from getting sick but from seeking appropriate care. So they won’t go in for covid testing b/c they might get a bill...
...and then suffer longer and spread the virus. imagine what happens when we do develop treatments for covid that logically work best when you start them early. Those threatened with high out of pocket costs won’t come in at the first sign of distress...
...but will wait a longer to see if they get better on their own, and then will come in when they can’t stand it anymore. The treatments might then not be as effective. Covid is just showing everyone what some have long known: how insurance plans, including a Medicare, nudge...
...patients with many diseases into not seeking or sticking with appropriate care. People don’t go to the doctor to avoid a bill, don’t get a generic glaucoma eye drop that could save their vision, & then go blind. That ends up being a higher cost to society, and heartbreaking...
...for the person now blind & their family & friends. You might think insurance just wants to be sure that you are taking only medicines you really need, so they want to see you pay something for that drug. But consider that insurance plans routinely review treatments...
...by requiring that your doctor get “prior authorization” from your insurance before letting you get a particular procedure or drug. And yet, even after authorizing it, the insurance plan tries to discourage you from getting it by charging you out of pocket costs.
Now maybe you can pay, so really insurance just saved itself a bunch of money. Or maybe you get the procedure & then can’t pay, in which case either the hospital eats the costs and has to make up for it by charging more elsewhere (even hospitals have to balance budgets), but...
...then the debt hangs over you, ruins your credit, and maybe even drives you into bankruptcy. Or finally, maybe you skip the treatment that your own insurance said was appropriate in the first place. So what the hell is wrong with America!?
Why can’t we accept that whether insurance actually is insurance is based on whether it makes appropriate healthcare affordable. If it doesn’t, it’s not insurance. It’s just false advertisement. Congress must fix this. As far as the relationship between insurance and...
...drugs, I’ve written a book about how to make drugs affordable to all Americans and ensure that America gets value for them. It calls for both insurance reforms & righting the wrongs in the drug industry (of which I’m an insider, so I give a tour). http://www.thegreatamericandrugdeal.com
Anyone who wants references and details to back up what I’ve just told you about insurance will find a lot of material in my book. I’ve also written articles on the same subject. https://medium.com/the-biotech-social-contract
Anyone who has had to grapple with getting their medical bills paid won’t be surprised by how America’s insurance system is treating people coming in for Covid-related care.
But now everyone who is otherwise healthy might find themselves feeling sick at what our system is doing. Here’s just one story. https://www.nytimes.com/2020/03/30/opinion/coronavirus-test-cost-bill.html
A few are stepping up to do the logical thing and waive covid-related out of pocket costs. All plans must. And then all need to do the same for all medical conditions. What’s right for COVID is right for cancer, diabetes, Parkinson’s, heart failure, etc. https://www.npr.org/sections/health-shots/2020/03/30/824075753/good-news-with-caveats-some-insurers-waive-costs-to-patients-for-covid-19-treatm
