Health Insurance Companies and Healthcare
More than 50% of U.S. bankruptcies are from medical bills. In 75% of those bankruptcies, the people had health insurance.
What are insurance companies concerned about?
Keeping premiums up and claims down, which equals higher profits for them and their shareholders. In theory, they will look for any loophole available to deny a claim, raise premiums, and get more shareholder value than their competitors. This is what our current system encourages and as a corporation, they are required to increase value for their shareholders, first and foremost.
Why are people with health insurance going bankrupt?
Research has shown two categories of medical expense bankruptcies:
– People with a severe medical condition became too sick to work, then lost their job and the group health insurance with it (reported average medical bills of $22,568).
– People who kept coverage had too many copays, too high of deductibles, and too many loopholes that they could not afford to pay the cost of their care. Most bankruptcies occurred in this category (reported average medical bills of $17,749).
What does the data say?
For those in bankruptcy due to medical expenses, the breakdown was:
– Hospital costs – 48%
– Prescription drugs – 18.6%
– Doctor’s bills – 15.1%
– Insurance premiums – 4.1%
The health problems that left patients with the highest out-of-pocket expenses were ranked as follows:
– Neurologic (i.e., multiple sclerosis): $34,167
– Diabetes: $26,971
– Injuries: $25,096
– Stroke: $23,380
– Mental illnesses: $23,178
– Heart disease: $21,955
What can be done?
– Make healthy living your main health strategy (to address chronic diseases like Diabetes, Heart Disease, Stroke, and Cancer) and purchase insurance for what is needed for catastrophic conditions and emergencies
– Use health savings accounts (HSAs) and other tax-advantaged accounts to minimize your dependence upon health insurance
– Get a professional and ethical agent who can take the time to explain what your contract covers and doesn’t cover
– Find out ratings of different insurance carriers based not only on financial stability and provider networks but on timely claims payment and customer service and satisfaction
– Become familiar with insurance terms and learn to read your proposed or existing insurance contracts and be ready to fight
– Subscribe to a health advocacy group that helps to audit your healthcare bills, pleads your case and who can advise you on least cost procedures.
– Identify the gaps in coverage and seek to fill them with affordable supplemental alternatives like:
— Disability insurance
— Accident insurance
— Critical Illness Insurance
– Read and learn. Think then act! It is time for a change.