Inspiration By Experience

Archive for the ‘Health Insurance’ Category

When is a doctor not a doctor? When is a clinic not a clinic? All questions of this type sound a little nonsensical. You can check whether someone has a degree and the credentials to be a doctor. Similarly, you always rely on a doctor in a clinic to diagnose and treat your medical condition. Right? Well, not necessarily. Here’s a slightly different question for you. Suppose a nurse works in a hospital for years and has vast experience in dealing with certain types of medical problem. You have that problem and are lying in a bed when this nurse gets in an argument with an intern – that’s a new medical graduate going through supervised training. The nurse effectively tells the doctor-to-be he has made a mistake. Whose judgement do you trust?

In other countries, experienced nurses are trusted to make limited diagnoses and prescribe some drugs. This allows urgent treatment to be given. If a consultant has to be summoned to confirm the treatment, this delay could be dangerous to health. In America, doctors are careful to protect their status and reputation. There are also medical malpractice implications if nurses are allowed to assume responsibility for critical parts of the treatment regime. It’s therefore interesting to observe the spread of medical clinics in drugstores and other retail environments. As an example, the Minute Clinic chain has more than 600 outlets in 24 states. These clinics are staffed by family nurse practitioners and physician assistants. Why should they have become so popular? Read the rest of this entry »

As and when 2014 comes along, we may be looking at mandatory health coverage. That’s all rather uncertain given all the cases that are lining up to attract the attention of the Supreme Court. So instead of guessing what the final decision will be, let’s focus on the here and now. As children, we shelter on our parent’s health plans and policies. Except, of course, these have become increasingly unaffordable for the poor and self-employed. Even employers have been feeling the pinch and pass on some of the cost to their employees. It’s tough out there right now. But when you start to grow up, there are decisions to be made. The health plans offered by many employers allow dependents to stay on the plan up to around 26 years old. This actually varies by state. Some actually allow employers to go up to 30 years old but this is a small minority. So, keeping this real, there’s a good case for leeching on your parent’s plan or policy for the maximum possible number of years. But not every parent is insured. Read the rest of this entry »

A theory is always a wonderful thing. Everyone can look at it and admire it. Except, when it comes to applying it, people can suddenly realize that theories don’t always work so well in the real world. Here we are with one of those swings and roundabouts situations. Ask any insurer and, when it comes to driving, they will all sing the same tune. Women drivers are the safest on the roads. That means they earn the maximum discounts and generally have the lowest premium rates. But, when it comes to health, all the statistical evidence is reversed. Women are the first through the doors of their regular healthcare provider’s door, they make the highest demands on hospital time and have more drugs prescribed to them (although whether they take them all is a different question). So how should equality work when it comes to insurance? More importantly, should there be laws requiring insurers to avoid discrimination on the ground of sex?

Well, let’s start with the theory of insurance. We gather a group of people, all of whom face the same risks, and we share the cost of all the losses among all the members of the group. Since not everyone suffers a loss, this works out cheaper for everyone. So, if we group all drivers together, the good drivers who never get into an accident subsidize the bad drivers. Hmmm. Well, that doesn’t seem very fair does it? If people have no price incentive to drive well, why should they bother? Or, if the price of insurance keeps going up, does this not encourage bad drivers to improve? So the theory breaks down in practice because, although we want to spread the cost of the losses around the group, we do want to use price to influence driving behavior. That means women drivers pay less than men. When it comes to health, the same reasoning applies to justify men paying significantly less than women. Men never complain about their health unless the pain is too much to ignore. Fewer claims means lower premiums. Read the rest of this entry »