Taking Your Health to a Personal Level

Professor,

Well said! I believe patient behavior has been a complete disconnect concerning a wellness plan, when you are not directly paying for it and strains the system from scarce resources.

It was true in my personal journey when diagnosed diabetic, caring the Cadillac card of Blue Cross and Blue Shield at the time. I cared little to comply because my plan had no restrictions to health care and I continued to take the easy way out by medication, insulin, ER visits if my blood sugar became to high because I ate the wrong things that day.

Through one tragic experience to the next I lost coverage, could not afford to gap it with COBRA, and the walls went up and I had no access to health care. I had to spend down to lower paying jobs so I could get on a Government program for diabetics. Realizing that this was a self defeating course and would lead to poverty I had to take a hard look at my wellness plan.

I turned to folkways, and alternate medication found in natural herbs. I achieved 12% body fat through diet and exercise, I learned the value of meditation and how it greatly combats stress which causes sugar spikes. In short I reversed my chronic condition, caused by healthy life style changes alone.

I am no miracle, but stand in awe of what is possible, when you apply what you learn by incorporating it in every day living. Insurance companies do not support wellness or their policies would reflect that direction. Rather they exploit the system and lobbied for restrictive measures when profits fall. Through large contracts they get the better price, far bellow an individual cost with no insurance. This is why the system is not transparent to the general public. It would be refreshing to see a billboard of prices for services on the wall.

Policy Answers:

Deflating premium when less resources are used in a definable period for a policy holder. In contrast inflated premiums when more resources are used. This would promote wellness.

Concerning chronic disease, you have to be even more focused and disciplined so in that respect the same scale should be used in changing premiums. With diabetics, we have blood work every three months that gives you a blood sugar level average for the last 120 days. This is a definable scale on how well the patient is practicing good life style changes or just using the system as I once entertained.

I am convinced Large insurance giants are out for the quick profit when they should be striking a cord for sustainability. However, they can always rely on Government bailouts when their greed crosses the line to RED.

Disparity found in insurance

For those who are uninsured, or under-insured my prayers are with you. for I am one of them and understand the disparity this causes. First I will tell my story, then explain why this situation is present and my hope for the future.

At one time in my life I had the best of the best Blue Cross and Blue Shield have to offer. It was in this time I had found out that I was a diabetic, I had access to any specialist in any field in the medical community. I was an executive and my premium was paid for by the company, any co-pays I en cured was submitted to my company and I was reimburse. So essentially my health care was free. Through the possibility of losing my family I resigned my position with the company not knowing what would befall me concerning my access to health care. Cobra was the first to contact me to breach my coverage but the premium for the same benefits were nearly $900.00 per month, hardly affordable being recently unemployed. With luck my wife went back to her old job and they bridged the gap from when she left and she received full benefits and I was added to her policy. The insurance was comparable to Blue Cross, and Blue Shield so I felt no disparity in this transition. However a year later we divorced and my coverage was lost permanently. It has been four years now that I have been without any insurance and my disparity abounds. Currently I have a chronic sinus infection that requires a specialist and possibly an operation to correct. Way beyond my ability to pay for so my condition remains and has been almost a year now that I continue to dispare over this. I have found in this time because of the pre-existing condition I am unable to get coverage for a year even if I elect to get insurance through my workplace which at the moment does not even offer health care insurance. So I am left without choice, access, and help.

The system we have in place now is problematic in two areas and leaves everyone without choice, although this is what we are always hearing in the news today that people want to keep their choice. Insurance as it stands now is coupled to your employment and you get what they have to offer, and if you were to lose that job you lose your insurance. Cobra is sadly not the answer to bridging the gap because in most cases it is unaffordable.

Why insurance companies came up with the idea of employment based health care was to broaden their customer base and offset high risk patients. If that was not enough for them to offset cost the insurance through lobbying set up the pre-excisting condition clause to thwart obvious risks. All of which has made them money a lot of money and in contrast threw many of us in complete despair. To make matters even worst and to allow insurance companies to gain even more financially they came up with policies that are laughable. I just recently reviewed a policy from a friend who works for Burger King and was enraged by what I saw. With high co-pays, limitations, and capitations it would be better just to burn the policy to keep warm at least then it would be beneficial to the employee.

Outcomes from these money driven policies are devastating our heath care system. People will seek health care through emergency rooms but it has a high price tag which ends up on your credit report for non payment and is only for acute problems. Chronic conditions cannot be address in an acute setting so in the end you get the diagnosis and sent home with little to no help and a large bill.

The future has to hold these concepts for it to change and combat disparity. Quality and safety driven not financially driven. Pre-existing condition clause must be eliminated. True portability is only achieved when you can take your insurance plan from one job to the next. The very concept of insurance has humble beginnings to thwart catastrophe by pooling money together within a community and when catastrophe happens to one all contribute to eliminate the dispair of one or a few. Sadly as it stands now insurance companies are causing the disparity by doing everything they can do to eliminate the risk and by so doing leaving millions without any help or access to their health care needs. Furthermore, we must bring into public focus what we have learned with informatics and how it is changing the landscape of health care delivery and putting the decision making more in the consumer hands. A consumer driven market creates choices, lowers cost, and infuses competition. In contrast a business driven market creates monopolies and takes away choice.