Health Insurance Nightmare – Where is Catastrophic Insurance?

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No Health Insurance

Over the past decade, I have been one that has elected to not have health insurance for me or for my family members.  Rather, we pay for an inexpensive Accident Policy through Aflac.

“What?!?  Are you crazy,” people ask me.

No, I’m not crazy.  Health insurance, unlike other types of insurance, does not make any sense – at all.  It is not even insurance.  Insurance should be a good investment with a return on investment (ROI) – a sense of security and peace for the coverage paid for.  Health insurance is a poor investment with no return.  According to my point of view, it does not even cover health.  Rather, it covers disease and sickness – it should really be called “Disease Insurance.”  True preventative procedures – acupuncture, massage, nutrition, herbal remedies, homeopathics, chiropractic – are usually not covered by most health insurance companies and there are no incentives for the collective group to choose healthy choices.  Why would I pay into a system of which I am not an elective participant?

 

Non-sensical

It is imperative to understand what insurance is designed for.  Insurance comes from the root word insure, meaning to make certain.  Ultimately, life is not certain at all, so one can never be fully insured.  However, with any financial matter, one should consider a return on investment (ROI).  Life insurance (whether term, whole-life, or universal) may provide a ROI that allows one to consider the benefit of financial security for their family should they pass away unexpectedly.  Auto insurance provides an ROI on not having to cover buying a victim a new car and paying for their medical therapy due to an unexpected accident.

Second, health insurance is not really insurance.  Most insurances actually insure only what needs insuring – the catastrophic event.  For example:

  • Auto insurance – covers automobile accidents.  It does not cover refueling your car, windshield wipers, oil changes, or other day-to-day expenses of operating your vehicle.
  • Life insurance – covers an unexpected death.  It does not cover groceries, mortgage payments, vacations, recreational activities, or other day-to-day expenses of living your life.

As these types of insurance cover the catastrophic events, they are relatively affordable.  With auto insurance, premiums go up with irresponsible driving and car accidents.  The “at-fault” party will pay more for the same insurance coverage as they are responsible for statistically raising the accidents and medical premiums.  With life insurance, premiums go up with age and with evidence of poor health.  Have you ever seen that scenario with health insurance?  No, every one pays the same premium regardless of health choices – no examination, no responsibility, and no penalty for being the irresponsible party.  I personally refuse to pay for another’s preventable heart condition, diabetes, or stroke when I am living a responsible lifestyle of healthy habits.

Third, health insurance premiums continue to rise based upon the lack of integrity inherent in the system of health insurance.  Insurance is a business – they need to make money to pay their bills, pay their employees, and turn a profit.  With auto and life insurance companies, they only cover catastrophic events and find excess funding to stay afloat and flourishing.  However, with health insurance companies, there are payments that need to be made for every little procedure, referral, and record transfers.  Payments back up, paper work and documentation becomes daunting, and doctors get discouraged for not receiving payment for services rendered months ago.  The companies, eager to save money, delay payments and pay health practitioners only a percentage of the billed amount.  The practitioners, feeling gypped for the lack of full payment and time awaiting payment, raise their prices so that they can earn what they should be paid.  The cycle continues… again… and again… and again.

 

Insurance Scenario

I just went online for a health insurance quote for my family of six.  The only thing they asked for was gender, age, and whether I or my dependents smoked.  I received 61 instant quotes (of course, at a later time they may change the premium based on electronic medical records or “pre-existing” conditions).  The monthly premiums ranged from:

  • $248.05/mo. with a $10,000 individual / $20,000 family deductible and 30% co-insurance
  • $843.08/mo. with a $1000 individual / $2,000 family deductible with a 20% co-insurance

Let’s break this down according to some options, high vs. low:

Option 1:  If I pay $248.05/mo. to an insurance company, I spend $2,976.60 on annual premiums – money spent that I will never see again.  In addition, if any health problems occur, I am responsible for the first $10,000 worth of medical expenses (if it is only one individual in my family), and then must cover 30% of all expenses thereafter.

Option 2:  With this policy, I pay $843.08/mo., spending a total of $10,116.96 on annual premiums.  I am responsible for the first $1000 worth of medical expenses (if it is only one individual in my family), and then must cover 20% of all expenses thereafter.

Option 3:  If you are a health conscious individual / family and practice many means of preventative medicine, you rarely spend more than $3000 on medical expenses each year for your family.  More money is spent buying quality nutrition, herbs, and herbal remedies, homeopathics, and paying cash for your needed health care services from knowledgeable and caring practitioners.  This route is less expensive and usually entails a cash discount for the services you seek from health practitioners.  With cash payments, the practitioner does not have to spend countless hours dealing with a third-party payer to request payment, paying an “insurance collections” employee, and waiting to be paid only a percentage of the billed service months later.  The cash payment is immediate, secure, and hassle-free.  Health practitioners love it!  In this scenario, you don’t pay costly premiums and have abundant money to set aside for the unexpected “rainy day.”

 

Catastrophic Insurance

After analyzing the above scenarios, most will feel comfortable with the common-sense approach to Option 3.  It is economical, smart, and healthy.  However, it is lacking the inexpensive true health insurance – the coverage for the “what if” catastrophic event.

Where is catastrophic insurance when it comes to health?  As far as I have been able to search, there is none!  With Obamacare pending in 2014, it will probably never be a reality.  The Aflac Accident Insurance comes close, but is not an exact “catastrophic insurance” policy.  I am, however, more than happy to pay $76.24/mo. to cover my entire family to receive cash benefits in the event one of us experiences a catastrophic event.

I stand by the truth that a solution to our health care dilemma is a health insurance company with the guts to market and sell a catastrophic health insurance plan.  Coverage premiums would be based upon a health history and physical (similar to a health history and physical with life insurance) to assess risk.  Discounts could be provided for demonstrating healthy lifestyle habits – regular exercise and nutritious eating.  Coverage would be for catastrophic events – heart attack, stroke, emergencies, etc.  There would be no coverage for chronic / progressive diseases such as cancer, diabetes, and hypertension.  In addition, there would be no coverage for the simple day-to-day expenses of wellness check-ups, screenings, or simple procedures such as wart removal, eczema, sleep disorders, etc.  Rather, there would be a network of holistic healthcare practitioners that understand the human body and have success with treating a variety of disorders through inexpensive and effective therapies including: low-level laser therapy, acupuncture, massage, herbs, nutraceuticals, homeopathy, and more.  There would be no need to cover most pharmaceuticals – only those that are necessary during recovery from an emergency situation.  Most pharmaceuticals are expensive due to patents and development expenses and are just knock-offs of more effective, natural plant-derived substances.

Where is catastrophic insurance?  Where is the end to the health insurance nightmare?  Where is the true health insurance coverage for me and my family?  I am only one man with an idea – a man among many… but I can dream.

Dr. Nate
Dr. Nate is both a Neuroscience Researcher and Chiropractic Physician specialized in Applied Kinesiology. His passion is to heal through education - he knows that everyone can bring about better health, healing, and wellness through education and implementation. He currently is researching how to overcome addiction through use of non-invasive and herbal-based therapeutics.