Thursday, October 13, 2005

I hate these people:

In the case of employer-paid health insurance, the main proposal [President Bush's tax advisory commission] discussed would limit tax-free premium payments....

The main proponent of the health insurance proposal, Timothy J. Muris, ... said limitless tax-free health insurance premiums encouraged workers to demand and companies to offer overly generous insurance and resulted in increased health costs.

Here's the reality:

Mitch Mayne, 38, is a marketing executive in San Francisco who considers himself basically healthy.

Mr. Mayne went to his doctor three times between March and June for the same thing: recurring bronchitis.

Yet the explanation of benefits statements he received from his insurer after each office visit differed drastically in the amount he owed, varying from $10.66 to $90, with no explanation of the services provided.

"What did I do on June 27 that was different than what I did on April 6 that was different than what I did on March 4?" Mr. Mayne asked.

When he calls for an explanation of the E.O.B.'s [explanations of benefits], he said, the most tangible result he sees is a new card in the mail with no indication of the amount he owes as a co-payment printed on the card.

"I'm paying through the nose for this premium, and when I go to the doctor it's a roll of the dice as to whether or not they'll pay it," said Mr. Mayne. "It seems like it depends on the mood of whoever happens to be doing the claim that day, or on the phases of the moon."

Mr. Mayne recently grew so fed up that he decided to try to beat the bronchitis on his own. "I can't deal with all this paperwork," he recalled saying. "It's just too much of a hassle." That turned out to be a mistake. Mr. Mayne became so sick that he finally relented and saw his doctor.

What if something truly catastrophic should happen to the state of his health?

"Oh wow, I hadn't even thought of that," Mr. Mayne said. "That's actually a pretty scary proposition. If I can't manage my health care as a healthy individual, the prospect of trying to manage it and be really sick at the same time - I don't know that I could do it."

I'm grateful to The New York Times for running that second article today, but the Times has had a big hand in spreading the myth retailed by Timothy Muris in the first article -- that our health care woes are all the fault of cosseted middle-class employees who avail themselves of the medical system at the drop of a hat. As if we really enjoy the paperwork, the maddening insurance company phone trees; as if we're not facing ever increasing premiums and co-payments.

Back in the '90s, the Times -- fat with ads from drug companies -- strongly suggested that managed care was a magic bullet for our health care woes, and scolded us just the way Muris is scolding us now. Yeah, managed care -- that was really an efficient solution to our problems, wasn't it?

No comments: