Seldom, if ever, have we experienced individuals in the upper management levels of the health insurance/managed healthcare industry who speak out with the voice of reason, common sense and intelligence on the subject of “healthcare†vs. health “insurance.†Thus it was with extreme surprise and appreciation that I listened to the comments on this subject recently from Georganne Chapin, JD, MPhil, CEO of Hudson Health Plan in New York. The webcast is available at: http://www.medscape.com/viewarticle/559758?src=mp.
The text of her comments follows:
I am a health insurance and managed care executive so you may find this editorial a bit strange. I believe that the way to fix our healthcare system is to stop relying on insurance and focus instead on healthcare.
So, what’s wrong with health insurance?
Well, first, it’s temporary. This may work for auto policies, but not for human health.
Second, health insurance is mostly contingent on where you live and whom you work for. It’s easy to transfer car insurance, but not health insurance.
Finally, insurance companies make more money by minimizing pay-outs than by keeping people healthy. Human beings — who need preventive care, who have babies, who may lack living wages and job security, and who get older–find the house rules stacked against them.
Plans in Massachusetts,[1] California,[2] and soon New York[3] propose to strew the same old red tape over even more people. Members of the same family could end up with separate policies, with different benefits and different expiration dates. This will make it even harder for doctors and hospitals to figure out whom to bill, which services are covered, and – worst of all – whether coverage will last long enough to complete treatment for a sick patient.
Other developed nations have universal healthcare, not “insurance.” They give healthcare to everybody, they spend less, and they are healthier for it.[4]
But, we have an example of success in this country, too. It’s called Medicare. And while flawed, Medicare meets the most important criteria for a universal healthcare system: it’s permanent, it’s portable, and it’s simple and inexpensive to administer.
The health insurance model is flawed because it depends on people falling between the cracks after they pay their premiums and before they collect their “benefits.” Rather than insurance, providing healthcare to everyone would cost less and deliver more in the long run.
That’s my opinion. I’m Georganne Chapin, President and CEO, Hudson Health Plan.
References
1. Fahrenthold DA. Mass. bill requires health coverage. Washington Post. April 5, 2006;A01
2. Steinhauer J. California plan for health care would cover all. New York Times. January 9, 2007;A1
3. Holahan D, Hubert E, Schoen C. A Blueprint for Universal Health Insurance Coverage in New York. New York: United Hospital Fund and the Commonwealth Fund; December 19, 2006
4. Davis K, Schoen C, Schoenbaum SC, et al. Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care. New York: Commonwealth Fund; May 2007: pub. no. 1027