Drag Me to Hellthy

I'm not a fan of horror movies so won't be seeing the latest bloody blockbuster. Besides, having just completed our health insurance renewal at work, I've already experienced enough frayed nerves and screaming for a while. It was a two month process of receiving the annual premium increases, researching potential options, revamping the benefits package again (twice in 3 years), holding a general staff meeting to explain the changes, and then meeting with employees individually to make sure they understood the information. I'm telling you, it's draining.

It's coincidental that our renewal period is happening at the same time as the health care reform "debates". Although it's a bit masochistic, I try to pay attention to the issue because it affects me both personally and professionally. Sorting through the various voices and opinions is not easy - and no one, including the current administration, seems to actually have a solution. When I was in management classes (almost 20 years ago!) I was taught to define the problem and then keep backing away from it until I could identify a root cause. At that point, it was possible to start developing an action plan. But that technique doesn't seem to be working on a problem this massive. Perhaps it's because we haven't clearly defined the problem - is it that health care in the US is too expensive or is it that too many people are uninsured? Is it the chicken or the egg?

Some pp think the insurance companies are too greedy and profit motivated. Some pp think that doctors are overpaid and focused on "lifestyle" rather than health care. Some pp think the American public is to blame for their unhealthy addictions to junk food, alcohol, tobacco, and lazy-boy recliners. Some think it's the fault of illegal immigrants and the uninsured who are using the health care system and contributing nothing. Some feel it's the fault of Medicare/government programs for underpaying and forcing inflation by other payers. Some pp think it's Big Pharma, or research expenses, or elective, unnecessary procedures, or...or...or - it goes on and on with no workable plan in sight.

I read three columns in the Wall St. Journal recently explaining why Obama's plans won't work. After pondering those for a while, I reached the conclusion that those particular writers don't think there is a problem - the current system is working fine for them apparently. Several days later, in the same publication, I read a well written column on page A13 by the CEO of Safeway claiming that the company wellness program had eliminated premium increases for his company for the last 5 years. Impressive. But on page A11 there was a news article stating that extensive research has shown that wellness programs have minimum impact - companies report less than 5% overall participation and cannot show any measurable improvement in employees' overall health. So the "consumer-driven health plans accompanied by wellness programs" are not effective in keeping costs down. Which is it gentlemen? I'm confused.

My company carries insurance with United Healthcare, one of the largest providers in the USA. Depending on perspective, UHC is a life saver or a b*ll buster. Some of our local MD's won't work with UHC. According to Forbes magazine, the CEO of UHC earned $124.8 million in 2005 through a combination of salary, perks, and stock options. (I have no idea what my young, hardworking primary care doc makes, but I'm pretty sure it's not $125 million.) But at the same time, UHC is paying for my co-worker's cancer treatment and is providing close, personal support. His final bill for 10 days of immunotherapy treatment: $593,000. He was responsible for $1,500 of that. So, insurance company bad? or insurance company good? Depends on perspective.

I have more, but I'm tired of writing right now. I'm going to try not to think of health care reform today. I don't know what the solution is and I don't want US citizens to keep suffering. I would like to see some positive changes come from the reform process. Otherwise, we might as well be dragged to Dante's hell and "Abandon hope, all ye who enter here."