There is very little I enjoy about any aspect of health insurance. In theory, it’s pretty great; if you have it and you get sick, you can go to the doctor without having to pawn your TV. But in practice, it’s a big mess.
.
Whenever I start a new job and I am lucky enough to be eligible for health insurance through it, I tend to find myself inundated with information that I am not sure how to use and also that scares me. There are too many choices. I know choices seem like a good thing to have, but health insurance choices invariably involve an intimidating handout and occasionally a degrading PowerPoint presentation. The handout is worse though. At least the PowerPoint usually has pictures-like that stylized ClipArt graphic of the guy scratching his head. I can relate to that guy. Both of us are probably thinking, “Do I need a lot of health insurance, or a little? What are the odds of getting hit by a bus if I opt for the minimal coverage I can afford?” (Ok, maybe that’s just me thinking that. The guy is just thinking “?”).
I think those handouts need to simplify. They ought to consist of one sentence followed by two boxes: The sentence should say “Do you want Health Insurance? Check Yes or No.” Bam! Done.
.
But instead, we have choices. Like, do I want a $2,000 deductable, or a $5,000 deductable? Do I want a $25 co-pay for doctor’s visits, or a $45 co-pay? What about specialists? Do I really see that many specialists? What about that weird mole I’ve been meaning to have checked out? What exactly constitutes a specialist anyway? And do I want dental coverage? Do I want terrible dental coverage, and I can go to any dentist I want? Do I want excellent dental coverage, and there’s only one dentist in my network and he only works on Wednesday mornings in months with an “r” in them? Do I want to have to pay $75 for an Emergency room visit, or $150? If I end up going to the emergency room, and I’ve opted for the plan with the $75 copay, will it lessen my pain, knowing I could have had to pay twice that much? Will the ER doctors treat me sooner if they know I paid more to get in?
.
How are my cells feeling? Any of them planning on going rogue in the next few years? Is there a history of heart disease in my family? Or just a lot of complainers? What are the odds that I’ll fall into a chasm and then get hit by lightning, and would that be covered?
.
How about life insurance? I’m 27, and I have a net worth of negative $3,200.00. Is this what I want to leave my family with in the event of my untimely demise? On the other hand, do I really want to put away money every month for such a morbid cause, when I could spend it on beer and downloading Nintendo games for the wii?
.
These are the questions that will earn you blank stares from the person whose job it is to explain your benefits to you. But they are the questions I need answered! There is nothing more frustrating than hearing this person say, “Each individual is different and has very different health insurance needs.” Yes…but wait, NO! Everyone has the same exact needs. If something happens to them; if they get sick, they want to be treated and get better, and they don’t want to have to pay through the nose for it. True, some people will have head colds and others will have cancer-but nobody knows who is going to have what. Therein lies the crux of the health insurance provider’s song and dance: “The type of coverage that best fits you,” they’ll add, “really depends on who you are as an individual, your lifestyle, and your comfort level with risk.”
.
Ah, risk. Now we’re getting to the heart of the matter. And this is what bothers me the most about any kind of insurance, really-they’re asking you to make a bet on your own health and chances of survival. I have asthma, and terrible eyesight. I have the reflexes of a dead chicken and the sense of direction of a headless chicken. I never wear hats when it’s cold. I have high arches. Grocery shopping depresses me. Even I think my odds aren’t great.
.
Also, I plain don’t like gambling. I don’t enjoy risk. I don’t even play poker except with pennies. My fear of losing borders on psychopathic. Don’t even get me started on retirement; I have a 401k plan with risk options suited to an 80 year old. But that’s exactly what health insurance companies expect us to merrily do–calculate our own risk of illness, and then lay down money that we got it right.
.
Well, damn it. My unfortunate inability to see into the future makes this a tough call. I could live to be 90 without a single hospitalization, or I could trip over the dog and break both my legs tomorrow. That’s life! Who knows! No one does! But with insurance, we’re asked to guess. This is what bothered me so much when I was being aggressively pursued by Health Insurance Agents after my initial move to North Carolina, when I gave the free market a whirl. Health Insurance Agents are like used car salesmen crossed with snake oil salesmen crossed with vampires who know your phone number. Talk to one of them for ten minutes and you will be suddenly gripped by the fear that at any moment you could slip on the carpet and break your spine.
.
I only wish you could be rewarded for making the right choice. That there were some kind of positive reinforcement for skillfully placing your bets. “Hey, you picked the plan with the low rate for Specialist visits and then ended up having to see several Specialists dozens of times! Congratulations-you’ve tripled your money and doubled your health!” I guess good health is a reward unto itself…for the insured and insurance companies alike. Everybody wins.
.
So, fine. Take a leap of faith. Take bad vision coverage, and good dental. Take maximum life insurance and minimum disability. Make as educated a decision as you can after viewing a PowerPoint presentation, then roll the dice and see what happens. It’s a gamble, but it’s the best you can do-and I guess it’s better than nothing.
If you haven’t had a stranger call you on the phone and ask, within five minutes, how much you weigh, and whether you’ve ever been hospitalized, then you’ve never experienced the magic of searching for an individual health insurance plan.
I recognize that being in a decent physical condition is something to value. But I’ve never thought of it in monetary terms before, and talking to someone whose job it is to think that way can make you feel uneasy.
“This guy I’m on the phone with,” I began to realize, “works for a company that wants to make money off of me, which they won’t do if I get sick or hurt. And if I AM sick or hurt, he wants nothing to do with me. I’m on my own!”
It’s enough to give you the creeps, even before the agent who told me, “You’ll notice that health insurance coverage is slightly more expensive for women.” I had noticed that, I replied. “It’s because THEY actually go to the doctor!” he said, and chuckled. Health insurance brokers: not only persistent—they’re also hilarious!
Another agent warned me that certain prescription medicines might not be covered under various plans—but that I likely wouldn’t know which ones those were until I tried to fill them. “If the prescriptions are too expensive, the insurance company isn’t going to want to pay for them,” he reasoned. Certainly not! Why should I expect my health insurance company to pay for my expensive medicine? It should get to keep all of my money!
Nearly every agent I’ve spoken with (and there have been quite a few—once you put your phone number out there and request a quote, they crawl out of the woodwork), as has asked me why I am interested in acquiring health insurance. I began to wonder—is this a trick question? Are they hoping you’ll slip up and say, “Because I have a heart conditio—uh, I mean…no reason.” I usually level with them. “I need health insurance because I don’t want to go bankrupt if I break my leg and have to go to the hospital. I’m scared that I might be injured and suddenly I’ll be $500,000 in debt.” The best part is, they always respond, “Oh, I know—totally. It’s scary.” This response does not increase my sympathy for the cause of privatized healthcare. At least SOME form of gambling is legal in every state.
I Heard Tell 