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Health Insurance with PenHealthcare has become such a political issue that the concept of “affordable healthcare” has vanished.

There is no single fix for obtaining affordable healthcare because the things making it unaffordable are as diverse as the people needing it.  Let’s look at just three:

Current Issues:

1. Cost of care for CHRONIC DISEASES and overall POOR HEALTH.

The reality is that people with chronic diseases and/or overall poor health have greater medical needs and expenses than the average person.  Medications, hospitals, ER and ambulance services are utilized more frequently by these individuals out of necessity, not because of system abuse.  Finding a system that makes their care affordable is tricky – someone has to pay for all that.

2. Availability and access to DOCTORS and MEDICAL FACILITIES.

The current system may give more insurance coverage to individuals, but that does not equate to access to doctors and medical facilities.  Reimbursements are so low, many doctors will not accept patients who are not part of an employer’s group policy.  Many doctors have refused to accept Medicaid and Medicare patients because of the low reimbursements.  The reality: it’s difficult to find a doctor, and when you do, you cannot get an appointment for weeks (or months).

3. QUALITY of available care.

Many of the providers that will accept the low reimbursements are rated poorly on sites on the internet.  They may be fine providers under normal circumstances.  But with low reimbursements, they are forced to push patients through as quickly as possible just so they can meet their overhead (rent, payroll, utilities, insurance, etc.).  Misdiagnoses is the THIRD leading cause of death in the US (John Hopkins 2016).  Doctors are forced to choose volume over quality.

MISCONCEPTION:

There is a misconception among our politicians that affordable health insurance equals affordable healthcare.  There are two things wrong with that equation:

  1. If you are not subsidized by a government program for your health insurance, it is ANYTHING but affordable. Especially if you are between 60-65 years old.  Your monthly insurance premium could be more than your mortgage.
  2. Deductibles, copays and coinsurance are so high on these insurance plans that people are avoiding going to the doctor when sick or injured.

Having access to insurance does NOT mean you have access to healthcare.  Attempting to manage healthcare through the insurance industry is like relying on your auto mechanic for investment advice.  And if you want to muck it up further, get a politician involved.  YOU DON’T WANT SINGLE-PAYER.

Let’s work on actually addressing the causes of HEALTHCARE unaffordability and not INSURANCE affordability (a symptom).  Coverage without access is an empty promise.

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