#Get Covered

The goal of real healthcare reform must be high-quality, universal coverage in a cost-effective way. - Bernie Sanders

#Get Covered

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...Whether we get covered through an employer or the Affordable Care Act exchanges, we’ll be told to carefully review our options to find a plan that will give us the best coverage for the least amount of money.

We will be told we need to shop.

“I encourage you to shop around,” Senator Jeanne Shaheen, Democrat of New Hampshire, told her Facebook followers who are choosing plans from the A.C.A. marketplaces. The human resources giant Mercer wrote last year, “This open enrollment, think of employees as shoppers.” The American Diabetes Association, the American Institute of Architects, the Robert Wood Johnson Foundation and Aetna all use the terms in their literature or on their websites.

Make it stop!

This is not shopping. Shopping is a fun activity, like choosing a pie from the bakery or picking out cereal at the supermarket. The farthest thing from “shopping” is the arduous annual ritual of reviewing the complex and all but impossible to decipher health insurance options.

That’s partly because insurers do their best to make the experience as miserable as possible. Many of them offer up less-than-accurate lists of providers and participating institutions. They reserve the right to deny you coverage of a service, and you won’t know if they have until the day you need it — and maybe after the fact. Prospectuses are complex, and few of us fully understand them. Only 9 percent of Americans can properly define all four of these rather vital phrases: health plan premium, health plan deductible, out-of-pocket maximum and coinsurance, according a survey recently released by United Healthcare.

No surprise, reviewing our health insurance options doesn’t score high on the fun-o-meter. A 2016 Harris Poll discovered almost half of the employees they questioned always found choosing an insurance plan stressful. A similar number told Aflac they would rather talk to an ex or walk across hot coals than enroll in a health insurance plan. And yet another United Healthcare survey found more than a quarter of respondents would rather lose their credit card, smartphone or luggage, not to mention suffer a flat tire, than review their health insurance options during open-enrollment periods.

Plus, we have choices when we do the real kind of shopping. If we don’t like the luggage in one store, we can always head to another. But if we don’t like the health insurance options our employer selects, or the options on the local exchange — well, short of changing jobs or moving, we’re stuck. That’s hardly the definition of consumer empowerment.

Yet the term “shopping” puts the onus on the patient, not the overpriced American system of medical care. This is no exaggeration. At an election town hall last year, a woman confronted Hillary Clinton, explaining that her health insurance costs doubled to over $1,000 a month after the Affordable Care Act went into effect. Mrs. Clinton responded that she would work to keep costs down but told the woman to “keep shopping, because what you’re telling me is much higher than what I hear from other families.”

Isn’t it absurd to describe us as shoppers? When I go shopping at the mall, I get perfume samples and free chocolates. When I consider health insurance plans, I am offered no such things.

Moreover, 326 million Americans cannot combat our high-cost medical system with one savvy purchase. The term prioritizes the values of the marketplace and financial world. It also signals that instead of contemplating how to make the medical-industrial complex work for us, our energy is channeled into getting the best deal we can from a system that’s designed not for our benefit, but to extract the greatest amount of profit from every patient.

Health care is much more than a mere consumer item, even if we do spend money to get it. It’s fundamental to our lives. So hear me out. Whether you are a reporter on deadline, an insurance official discussing plans or someone reviewing your options, just say people should “choose” or “pick” a plan. But whatever you do, don’t conflate the pleasurable experience of real shopping with the dreary task of finding a health insurance plan.

Source: Helaine Olen, Choosing a Health Insurance Plan Is Not ‘Shopping’, The New York Times, November 2, 2017.

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Last Updated : Thursday, October 15, 2020