I should really say something good about the company I work for. I know people have a tendency to believe that insurance companies are evil (believe me, I was the same several years ago), but really, there is no huge conspiracy to screw people out of paid claims or to hurt anyone.
Let me give you an idea of the efficiency that this company is run. We are a “not for profit” company, which means that all proceeds goes back and is invested back in to the corporation.
Can you guess how much of a person’s monthly premiums go in to operating costs?
The results will surprise you. About 8 cents of every dollar goes in to our operating costs. More to the point, about 8%. Think about that, as that’s a fairly small number for the amount of paperwork, red tape, government regulations, customer service, customer education, seminars, and marketing/advertising we go through.
In comparison, the “Christian’s Children Fund”, a “non-profit” organization, spends 18% of its cash flow on management and fundraising. 18 cents of every dollar you send them will end up paying someone’s salary or some sort of advertising or fundraising.
The CEO of my company is giving his incentive bonus (I wrote about mine in my previous blog post) to a charity. He’s reinvesting it to help people affected by the economic downturn. Our board of directors granted the employees an incentive bonus even though our year end goals weren’t met because, as they put it, “It wasn’t our fault that the economy went the way it did.”
Our executives took a 50% cut on their incentive so that the board would be more comfortable with granting me, a lowly employee, my own.
Now I’m not saying we’re better than a charity. I’m just saying that we run a much tighter ship, much more efficient, and if your insurance policy covers something, I know for a fact we’ll cover it. That’s the way it is. People simply need to learn to check their policies before they agree to every test and surgery without a speck of critical thought.
It’s that lack of critical thinking that has driven us to the healthcare crisis we face now. We assume doctors are the experts on the subject when, in fact, many times they are not. In fact, most doctors, with very few exceptions, have no idea what operations, tests, procedures, etc. are covered and what are not. They never deal with it. That’s the job of their assistants and nurses.
In fact, they’ve never dealt with that.
Most insurance companies (including the one I work for) allow you to get a second (and sometimes a third) opinion. What is the harm in taking an extra day or two to investigating your options? Would you buy the first car you saw on a lot? Would you trust the first politician you saw and vote for him, or would you investigate some of your options?
I know I’m sounding preachy, but in the time that I worked on the customer service phones, I found it amazing how many people did not take charge of their healthcare. They just didn’t. They never asked questions, never put forward that moment of critical thinking. It was always as if, “Hey, the doctor said I need this… give it to me now!”.
Doctors are human. Fallible. They make mistakes. Worse yet, they make huge mistakes sometimes. They kill people, or they improvise the wrong treatment for the wrong ailment.
I’m not saying to disbelieve everything you’re being told. I’m advocating some transparency in your own healthcare. Ask questions about the procedure you’re going to. Ask the costs. You can shop around on how much it’s going to cost. You should always call your health carrier and make sure that that operation is covered. Always get an ICD9 code and, ideally, a CPT code and call your insurance company. Ask them if it’s covered.
Don’t become a victim of a system that is supposed to be serving you. You’re the customer. They are the providers. You should always treat the entire interaction that way. If you don’t like the way things are going, you speak up, you have your voice heard. You can take your business elsewhere.