Insurance Companies and Health Care Reform

Since before winning the election, President Obama has stated that part of the reason for health care reform is to better control the medical expenses incurred by American citizens and the nation as a whole. For years, too many citizens have been forced into bankruptcy due to medical expenses; many others must regularly choose between their medical needs and what they can afford.

Health care reform will be neither inexpensive nor simple. Finding the balance between the needs of the patients, the needs of the physicians, the desires of the insurance companies, and the financial issues woven through them all will be no easy feat. And, it is certainly not a change that should be rushed through or approached recklessly.

Yet, for all of the speeches and debates about potential changes to the health care system that have graced the media and the floors of Washington, and for all those still to come, some questions linger on.

Is it really the health care system that is in need of an overhaul or is it the insurance companies alone that need to be changed? Each month, millions of people dutifully pay their insurance premiums. Yet, every month, people with chronic illnesses must hire attorneys to attempt to convince the insurance companies to pay what they are contractually obligated to pay. Additionally, millions who pay hundreds or thousands of dollars each year in insurance premiums may visit a doctor only once or twice, spending far more in insurance premiums (and co-pays) for the year than they would have had they paid for the visits completely out-of-pocket. Then, there are the millions without any health insurance who find it difficult to be seen by a doctor when it is necessary, resulting in expensive hospital emergency room visits.

Patients have gone bankrupt, doctors report frustration with the system and an inability to do their job, hospitals often report having difficulty balancing expenses with income and patient care, but have there been any insurance companies going bankrupt?

It seems that the common denominator amongst all of the issues regarding health care is the insurance companies. What an insurance policy covers often dictates the length of a hospital stay, what medical tests or procedures are performed, what referrals to specialists are made, and what medications are prescribed. Hospitals and doctors are charged exuberant fees for malpractice and other insurance policies by the insurance companies, a cost that is passed on to the patient. Patients seem to fall into two categories: People who cannot afford insurance premiums or people who can afford insurance premiums but are forced into bankruptcy due to the insurance companies not covering medical bills when premiums are paid, canceling coverage about the same time a diagnosis is made, or refusing coverage due to a pre-existing condition. The end result seems to be that the insurance companies are making profits while the patients and the medical providers are suffering.

Perhaps the real medical reform needed in America is legislation to regulate how insurance companies work, how much they can charge, how they fulfill their contracts, and how much control they have over the decision of physicians and patient care. Perhaps then doctors and patients can get back down to the business at hand: Healing.