The past couple of years have been full of promises. There was going to be health care reform, universal coverage, coverage for those who have pre-existing conditions, a sincere attempt to reduce the obscene cost of health care… the list goes on and on. So far, unfortunately, the bottom line is actually a step or three backwards.
Yes, Congress did pass what they CALLED healthcare reform. But it didn’t have one word in it about tort reform. To make matters worse, several states’ supreme courts are now hearing cases that claim that caps on awards are unConstitutional. To make matters worse yet, those cases are winning. At least some of that is because judges don’t like being told what they can or cannot do/award, even if the caps are reasonable. So even when a state makes a tort reform law, the System seems bound and determined to override it.
Part of the new law included that the states would have a high-risk pool, backed by federal funds, for those who had been denied coverage due to pre-existing conditions. Unfortunately, true to predictions, the cost of such premiums are unacceptably high. A 50 year old male with no smoking habits living in northern Colorado will pay just a couple dollars under $400 a month in that high-risk pool. No consideration is given as to why they’re denied coverage due to a pre-existing condition. In the particular case in question, the cause was newly diagnosed type-2 diabetes. The medications for that patient’s condition run about $8 a month. Even allowing one office visit and tests per month, the patient is still far better off to just pay the bill out of pocket than to pay nearly $5000 a year for a policy that has a $2500 annual deductible. So who is all of this “reform” really helping? There may be some who are paying much more for their pre-existing condition, and those people would welcome paying “only” $400 a month. But the relatively healthy individuals aren’t going to see it as any favor. So what will happen? They will remain uninsured as long as possible, and opt in only if their condition deteriorates. But that’s far from the end of the woes.
That relatively healthy 50 year old patient will soon be required to carry health insurance, or suffer paying fines that are nearly equal to that premium. If they can’t afford (or reasonably justify) the premium, how will they afford the fines? Is the United States about to become a nation with a debtor’s prison? Rates are what rates are. The insurance companies may have some mystical means of divining what those rates should be based upon statistical data, but with pre-existing conditions removed, they aren’t allowed to get that information, so even if they wanted to, they couldn’t offer lower rates for those patients who take good care of themselves or have conditions that do not expose the company to extraordinarily high risks. The pools don’t seem to be demonstrating an answer either. More shocking is that, at least in Colorado, that pool is limited to 4,000 people. Four thousand people in the entire state? And what do the rest do?
They have been saying a lot of things, one after another. The one thing They have not been saying is that they will address the real issues in a real and meaningful way. Had they asked doctors and other medical professionals, they’d have been told where the real problems lie, and what it would take to make changes. But They didn’t give Us a place at the table for those discussions. And so, two years later, They are still saying things that just aren’t true.
How do health care professionals become part of the solution? How do you reduce your medical malpractice costs? Start by protecting yourself against those frivolous lawsuits that end up costing so much in defensive medicine, premium increases and the like. For a small fraction of that patient’s monthly health insurance premium, you can have a Medical Justice membership. You can begin seeing real results almost immediately. Protecting your practice is being part of the solution. It helps you and your patients, by keeping the costs down.