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Writer's pictureTimothy Pieri, LMSW

The Insurance Conundrum

Updated: Aug 24, 2022

A conundrum is a confusing and difficult problem, vexing, a quandary and dilemma. There are many serious issues and concerns which Our civilization faces which might be defined by such terminology. If I were speaking of climate change some would suggest that it is the existential threat to our very existence. And we wonder why suicide is the second leading cause of death among the young. There is great value in Our society having the tools and the space to engage in dialogue in order to resolve these dynamic problems of the age. The therapist space is a really good space to explore both the small issues of Our self worth, as well as these monumental existential crises. It seems clear to many of Us that Our "health care industry" is a significant conundrum that We have been unable to resolve over many decades of supposed effort. We are the wealthiest nation on the planet. If We cared about each other, We would resolve the dilemma,as We have the resources, We appear to lack the will. We citizens of the United States are the last of the developed first world nations to offer comprehensive health care to all its citizens. Ever other industrialized nation offers some form of a single payer system which covers every man, woman and child, from womb to tomb. In Our land, we still gain health coverage from our job. If we change jobs, and we do so more often than at any prior time in our history, We either lose Our health insurance or We pay an exorbitant premium called COBRA. Many of us have been paying exorbitant premiums for Our health insurance. In the case of my family, we have paid $700. a month over much of the last four decades for health insurance. Of course that is not the home insurance or the car insurance, or the life insurance ect... Yet it does seem to be a significant tax. I would be much more willing to pay it as a tax, Medicare for All, rather than 30 to 50% of all health premiums being profit for executives and shareholders. There are 40,000,000 United States citizens who lack health insurance. This number was lower a couple of years ago. Through the Affordable Care Act the number of uninsured dropped to 29,000,000. I recognize that nobody accepts anyone's word anymore, as it is all 'fake news'. The number one reason for bankruptcy is costs related to lack of health care insurance coverage. As a health care provider I recognize and have used the slightly exaggerated line: "there are 100's of insurance companies who offer 100's of different policies". Some of Us have really good plans with no deductible and no copay (Our Congressional leaders), and then there are the rest of Us, somewhere between the gold standard and the uninsured. One of my frustrations regarding Our health crisis, we are not charged the same fee for the same service. I went into the doctor's office a few months back. I was concerned due to some family history of heart disease. I had a stress test at a local hospital and my insurance company was charged several thousand dollars, of which i was charged several hundred dollars due to deductible. If i had a different insurance company the test would have been charged significantly less, about half, depending on the insurance company. So the hospital charged literally twice as much for my test as they would if i had this other huge national health insurance company. The largest health insurance companies often pay providers a mere pittance, of the actual costs of services. There is a fix, Medicare for All, but the fix isn't going to happen without some pain. The insurance and pharmaceutical industries are bloated, fat with profit. And those who have grown fat with profit from the conundrum of Our health care crisis, ought to feel a bit of pain, as they ought to diet from Our terribly inflated health care premiums. For another time, Our health care crisis, is one defined by Capitalism, the economic system, under which most of us toil, but do not reap an equitable return. I suspect one reason we have not resolved Our health care conundrum is too many of Our legislative representatives are in the hip pocket of the insurance and pharmaceutical industry.

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