Ringing in the New Year with visions, dreams and intentions is part of our contemporary culture. The ball drops in New York; the sun rises wherever you are, and we all seem to sense change is in the air. January 1 marks the time when many people decide to make a change and transform some aspect of their lives in ways they believe will make their lives better. Often resolutions are related to health and well-being. Here’s a new resolution: recognize health insurance is not heathcare; and vow to seek healthcare, not a payment system.
For the approximately 45% of Americans with health insurance through their employers, January 1 is also the start of the year for most health insurance policy annual contracts. The same holds true for the approximately 11% of Americans have some other type of insurance, and the 25% with a government plan. Whatever the type of insurance, it’s likely the insurance company changed the rules as of 12:01 January 1. And their changes may have a substantial impact on the care of your health, impacting what you envision as a means to have a better life in 2012.
The insurance company didn’t consult you on the policy changes. They didn’t ask you want you need or want to feel and be healthy. In the paradigm of the 80% of insured Americans, insurance companies are in the driver’s seat to decide what healthcare is and who can provide it. It could mean different types of treatments are covered or not covered; different types of allowable “doctors” are considered acceptable or not acceptable; and of course it all revolves around a method to parse the dollars between providers, patients and insurance companies – the power triad of today’s “healthcare system.”
Making money in the healthcare system: insurance & pharmaceutical companies
Insurance is a contractual payment system. It’s a method to pay to certain people what the company determines is allowable care, under the terms of the policy. The payment system has very little to do with actual care that relieves suffering and improves well-being. When you let a payment system determine what care or well-being is, that substantially limits your options to make your life better in any way that resembles your personal concept of well-being.
Stephan A. Schwartz, a regular contributor to Explore: The Journal of Science and Healing has coined our current healthcare system as the “illness profit system.” And there seems to be plenty of profit to go around. Insurance companies, by their very nature of being corporations, have as their number one job to return shareholder value – to make money. CEO’s get paid a lot of money to do this. The heads of health insurance companies, healthcare consulting firms and other health related companies are among the highest paid executives in any industry. According to the LA Times, McKesson CEO John Hammergren received $145.3 million in compensation in 2010. Fierce HealthCare reports Omnicare CEO John Figueroa was compensated 98 million last year; and Aetna’s Ronald Williams took home $57.8 million before retiring in April 2010.
Pharmaceutical companies are also big winners in the power triad. In 2009-2010, seven of the big pharmaceutical companies paid 17,700 presenters a total of $281.9 million to promote their products. These presentations to physicians were instrumental in a"combined prescription drug sales amounting to 36 percent of the $300 billion U.S. market in 2009." Only 10% of what big pharma makes is spent on research to cure diseases and save lives.
The losers in this system: patients and physicians
According to Bloomberg.com, “Forty-nine million Americans reported spending 10 percent or more of their income on insurance premiums and out-of-pocket costs last year, according to the Commonwealth Fund study.” Patients spend more and more. As of 2008, 38% of adults used some sort of “complementary alternative medicine” (CAM). Anything labeled CAM is generally not covered by insurance, with rare exceptions of some limited use of acupuncture or chiropractic. Not only do people spend money on insurance premiums, they’re paying providers directly for health care that actually works for them. No wonder we have the most expensive health care system in the world.
Many M.D.s are also struggling with this current power triad. Holistic physicians who want to spend more than 7 – 10 minutes with their patients, and want to provide CAM care that works are seeking ways walk away from the insurance model, and serve patients in ways that help patients fundamentally heal. While they’re reluctant to talk about it, a recent CNN article discusses the economic challenges for M.D.s trying to operate in this system, and how many of them are going broke. http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm?hpt=hp_t3&hpt=hp_c1
Your resolution for the care of your health
The month of January didn’t even exist until about 700 B.C. when the Romans adjusted the calendar and move the “new year” from March to the new January. Julius Caesar introduced the Roman calendar, a solar-based system, in 46 B.C., and decreed the new year would be January 1. During the middle ages the new year was celebrated on various days in December, January and March. Even today, cultures around the world celebrate the new year on dozens of different days.
So, while January 1 has passed, any day can be the start of a new year. What will you resolve about the care of your health? There is an opportunity for transformation just as significant, if not more significant, than the common “eat right and exercise” resolution. At the core of your being, what’s your vision for the well-being of yourself, your family, or even the planet? Bring your vision, your resolution, to fruition by really knowing what you mean by “health” and “care” and spend your money accordingly. Resolve to not confuse health insurance with healthcare. Those two terms mean vastly different things.
About the author:
Deb Andelt is co-owner of Experience In Motion, which equips organizations with tools to curate meaningful experiences for customers and employees. Deb’s personal journey from decay to wellbeing inspired an emphasis in improving healthcare experiences for patients and practitioners by focusing on experiences that heal and self-caring as a way of organizational being. www.experienceinmotion.net.