May 2004

Money for nothing?

by Dr. Madeline Behrendt

I'm a consumer. I'm a small business owner. I pay for my own medical insurance ‑‑ catastrophic policy, big deductible, with a big insurance company. Why? Because when I'm not glued to my practice, my computer, or my phone, I am glued to my bike, and God forbid I should ever get hit by a car or ride down a cliff in a less‑than‑graceful and controlled manner resulting in re‑arranging my cranium. Re‑arranging my cranium could be a bloody, and expensive situation. How many jokes have there been that the trauma of an accident was less than the trauma caused by the medical bills?

The privilege of having a "God forbid" policy is not cheap. In fact it's very expensive to be a healthy person carrying the expense of the numerous unhealthy people also in the insurance company who utilize the menu of approved "sick services."

And it's getting more expensive.

This past year, my high deductible insurance policy with a huge insurance company (that has never, ever, ever sent me a penny because I don't use really use it) went up almost $500.

Yes, a $500 increase in ONE year. Money for nothing? Aren't there so many things wrong about that kind of health care system? Are you with me here?

Why do healthy people, who pay out of pocket for organic food and holistic health care (chiropractic care, massages, naturopathic care, nutritional products, exercise/sports), who pay the premium charged for products and services that are healthier ‑‑ WHY do people who pay to be healthy also have to pay out of their pocket for people who are not actively making positive changes to their well being?

Why does "the system" basically tell unhealthy people that the financial consequences of poor choices and lifestyle habits will be carried on someone else's dime? How about improving the system and using financial incentives to shift unhealthy behavior?

And why are insurance providers paying for services that have questionable results and are very expensive?

A small percentage of people benefit from back surgery when it's an appropriate choice, but there's no screening that determines success. The medical literature is growing regarding the debate on this largely unsuccessful and extremely expensive (as high as $30,000) procedure, so why are insurance companies paying for this, especially when more conservative care is not utilized first? Also expensive and highly controversial are routine hysterectomies, c sections, and mind altering medication in children.

Costs and benefits must be discussed without prejudice. For $30,000, one person can have 10 20 years of chiropractic care. Are the cost/benefit factors of a one‑time elective procedure with side effects and limited success being compared to cost/benefit factors received from 10-20 years of vitalistic care? I'd love to see that study done!

Are insurance companies paying for expensive surgeries because they can pass the costs onto us? The city I live in has the highest rate of back surgery in the country ‑‑ three times the national average. How much does that affect my $500 rate hike?

What incentives are there for insurance companies to change? As a policyholder, I want to know.

Consumer behavior is a part of this, as people are agreeing to have elective, expensive procedures and treatment. Why? What questions are they asking about safety, benefits, and cost effectiveness? Or, is there only one question some consumers ask: "Does insurance cover this?"

There's a reason why I'm covering the topic of health care insurance in a column devoted to women's health, because women are the leading consumers of health care. And they also strongly influence the other health care consumers ‑‑ children and men.

When someone is healthy, they influence their environment. But when someone is unhealthy, the environment influences them. So, a common theme in my writing is encouraging women to reconnect to their power, to realize that they affect the health care system through their choices, through their economic strength.

The health care system notices where women spend money, so my message to women is: SPEND money where you want, CHOOSE only care that you want, ASK for better choices, DON'T SETTLE for "this is all we have."

And yes, I walk my talk. I left that insurance company and found a different one with a better price and policy. I couldn't stay with the same company and give them the message that it was "ok" for them to raise my rates $500 in a single year. Know that what each of us does counts and don't trade your money for nothing.

On a happier note, big hugs to all the moms out there, as well as all those who mother. Happy Mother's Day ‑‑ we love you!

(Dr. Madeline Behrendt is chair of the WCA Council on Women's Health and associate editor of the Journal of Vertebral Subluxation [JVSR]. An author and speaker, she is committed to connecting women to chiropractic and chiropractors to women, and may be contacted at drmadeline@drmadelinedc.com)