Monday, January 11, 2010

More about health care

They need to figure out a way to tell people what procedures cost. The important costs are: 1) Cost out of my pocket 2) Cost to the insurance company.

My insurance company didn't even know what they covered me for, without a 1 hour phone call which involved me correcting them (asking them to check again) for a coverage on a certain procedure.

You seemed to be encouraged to get the procedure/medicine/whatever, and then figure out if you are covered for it later. That seems to be backwards to me, for many types of healthcare that are voluntary.

Everyone seems to be in a battle and try and push things off to other people. I am stuck wondering who I am paying and what exactly for. There are 3 conflicts, you vs the doctor, the doctor vs the insurance, you vs the insurance. You vs the doctor is them not wanting to have responsibility if they screw up. Doctor vs insurance is the insurance not wanting to pay the doctor and the doctor wanting as much as possible. You vs insurance is basically the insurance not wanting to pay for anything and you wanting to get services for your money.

Considering how much I am paying/will be paying (costs are on the up and up), this stuff needs to be figured out. It should be easy for the consumer and anything hard/complicated should be pushed to the doctors or the insurance. Everyone seems to have forgotten that the consumer is the customer, they are the one that supplies the money that greases all of the wheels. I suppose they have us in a lock though, as sometimes its life or death on healthcare, so you jump through the hoops because you value your survival.

Maybe I should invent a new profession, the health care planner. Sort of like the financial planner is to banking. Or a tax preparer is to taxes. You pay this person and all of your problems about that part of your life are simplified. They know how to work the system. They have the time to play with it. The thing is, I assumed that the insurance company would serve that function, working together with the doctors.

[stray idea]
What if we had a smart card in our insurance card. We would stick it into the machine at the doctor's and select what procedures we want to have/will have. It hashes some stuff, and green lights come on if it is covered(it also shows what you have to pay, and what the total was), or red lights (if it is not covered, and shows the total out of pocket cost). Completely verified with some strong crypto, no issues with a person mishearing/being told wrong about coverage so liability is a non-issue. You could also use it at home with a usb reader or something. Maybe you just put in your unique id at the doctor's website and select the procedures.

I am whining alot about this, I am just surprised at how complicated something is that I assumed would be simple.


mike faria said...

insurance is a scam

Anonymous said...

Those are really some good ideas, Joe. And the technology is there. You're right - it shouldn't be this hard to understand what is covered. And if you think you have problems figuring it out, think about that 65+ person.