Universal Health Care

Most developed countries offer a form of universal health care, the only real exception to this is the United States. Today, Barack Obama offered another solution to universal health care for Americans, but will this succeed where others have failed?

Probably not. It is not the responsibility of a government to ensure health care coverage any more than they should guarantee automobile insurance. However, the government can implement guidelines to control health care costs and place the burden on the patient for managing these costs.

The fact is, as a patient you are the only one who knows what is a reasonable expense for any specific procedure. Unfortunately, the patient has no authority to either approve or negotiate the costs incurred rather this is mandated by the insurance company. After visiting a doctor, rather than review a bill the expense is immediately sent to the insurer with the expectation that they will be paid accordingly.

This is the crux of the problem with our health care system: consumers expect insurance companies to cover all expenses without ever knowing what these expenses are.

The solution is to involve the consumer in the cost analysis, and the first step towards this goal is mandating that medical providers must present a full and complete bill for patient approval before it can be submitted to the insurance company. In this system it would then be possible for a patient to immediately dispute one or more expenses, and at that point a billing representative must be designated by the physician to address any grievances on that bill.

A few years ago during a hospital stay my insurance company was billed $50 for a small container of Vasoline. This is an absurd cost, and as a consumer it would have been something that I could have easily disputed. Of course, my insurance company was completely unaware of this specific item and was more than happy to pay the hospital.

Furthermore, the patient requires a champion to defend against these costs. At the moment, the insurance companies are not doing this. If you feel an item has been overbilled or that a procedure was not actually performed, the insurance company will not delay payment and in fact will refuse to intervene with your approval on your behalf.

Recently, my insurance company was billed for a simple repeat procedure that had been unbundled by the doctor. The unbundled version was more than three times the cost of that same procedure at any previous visit. The insurance company did not express any interest in correcting this error, nor did they seem concerned that they were additionally billed for procedures that had been done on previous visits that should have already been billed.

This situation is unacceptable, the insurance company should be defending their customers because it is in their interest. It is easily possible to correct this problem by mandating that insurance companies defend their patients and in fact delay payment until all aspects of a bill can be resolved.

Using our government to write a blank check to medical insurance companies is not going to address the problem. As long as medical consumers are oblivious to the costs the insurance companies will continue to pay the amounts invoiced by the medical establishment. If we can fix this problem, we can get our medical expenses under control and save our country from bankcrupcy in the process.