| Many of us, particularly those who get their | | | | 10-14,000 per year, we give a lot of control to |
| healthcare 'free' from an employer, take it for | | | | faceless companies for whom our best interests |
| granted that the best coverage is the coverage | | | | are not their primary goal. |
| that offers the closest to "first dollar" coverage, | | | | Insurance companies relationship to your doctor |
| where we pay as little out-of-pocket as possible | | | | I have heard a report that one insurance |
| for our basic, non-hospitalized care. But is the 'best | | | | company has a goal of reducing by 10% per year |
| coverage' really better for you? This guide to | | | | what it pays out for chiropractic care. Even if this |
| insurance will present some views of health | | | | is not true, insurance companies will lie to patients |
| insurance (and health) that you may not get | | | | and doctors about what coverage they have, |
| elsewhere, to help inform your own answer that | | | | (they call it "oh sorry, I must have misread that"), |
| personal question. | | | | lose claims, do repeated reviews, ask for money |
| How your insurance company sees you: The | | | | back for what they term as 'false billings' in which |
| dealer holds all the cards and makes the rules | | | | the doctor is guilty until they can prove their |
| Whether you pay for your own insurance totally | | | | innocence. Drugs and surgery are covered, with |
| by yourself, or your employer covers you, there | | | | little question on most policies, while exercise, |
| are strategies out there to get yourself healthier | | | | nutritional supplements and therapies like |
| and save money at the same time, but you have | | | | chiropractic, acupuncture and rolfing, to name just |
| to know yourself and the system to take | | | | a few, which work naturally to restore normal |
| maximal advantage of them. | | | | function are covered less, if at all. Practitioners of |
| We have a range of choices for insurance, from | | | | all types who may be doing innovative work are |
| no-out-of-pocket (NOOP), first-dollar (no | | | | generally weeded out, as less personalized care |
| deductible), no co-pay (your doctor visits covered | | | | becomes the norm because of greater time and |
| 100% after you meet your deductible) coverage | | | | paperwork pressures, and outright denial of |
| all the way to catastrophic insurance, where only | | | | anything that isn't 'by the book.' |
| the costs over $3,000, 5,000, or even 10,000 are | | | | Insurance companies bury healthcare providers of |
| covered. When we have NOOP coverage, or | | | | all types under a mountain of rules and |
| close to it, we have the illusion that 'they' are | | | | paperwork. Each company has different |
| paying the bill. But without the thousands given to | | | | requirements, and it has been estimated that up |
| 'them' by us or our employers, (also 'us', because | | | | to 1/3 of doctor and staff time (read: money) is |
| it ultimately reduces our paychecks), 'they' would | | | | spent on paperwork for insurance. |
| not be able to provide these 'generous' benefits. If | | | | To quote a pharmacist that I know, "the only |
| you choose to have higher deductibles and | | | | people who are satisfied with their insurance |
| co-pays, many employers will give you a larger | | | | company are those who are not sick." |
| paycheck or take less out for insurance. | | | | Our relationship to them: no-out-of-pocket |
| The bottom line first. Your insurance company is | | | | coverage tempts us act against our own best |
| NOT quite your friend, whatever their promotional | | | | interests. |
| literature and big-bucks advertising indicates. They | | | | When someone else is paying the bill we tend to |
| are a corporation, whose primary reason for | | | | give up our personal initiative and judgment. I used |
| being is profit. This is not to say that there is | | | | to work as a chiropractor and acupuncturist at a |
| anything wrong with profit, it is just important to | | | | facility with several medical doctors who would |
| remember they are in business for the benefit of | | | | refer patients for chiropractic. Chiropractors, |
| their stockholders first. | | | | having little clout as a group, are at the rump-end |
| Even when the system works smoothly, we | | | | of the insurance business; we get paid by |
| mustn't forget who invented the game that we | | | | insurance only as an afterthought on many |
| are playing. The contracts that we sign were set | | | | policies, if at all, and regularly have claims denied |
| up with teams of lawyers for the benefit of the | | | | or reduced for little or no reason. Many times |
| insurance company, not us. They make the rules | | | | where I worked, patients would come in to see |
| and have the power to decide how to follow | | | | the medical doctor who would refer them to me, |
| them. If our claims are denied we have little | | | | but their insurance wouldn't cover my services. |
| recourse outside of begging and pleading, | | | | Most of those patients would not come to see |
| according to your contract. The laws that govern | | | | me. They actually chose to stay in pain rather |
| the insurance industry were set up, for the most | | | | than pay to be healthy! |
| part, by legislators with the help of lobbyists for | | | | While we don't intend it, insurance that covers |
| the insurance companies and large donations to | | | | most of our healthcare herds us towards certain |
| those legislators. | | | | types of healthcare and certain doctors, and |
| Insurance companies have to take in more than | | | | un-natural ways of thinking about health, sapping |
| they pay out, or they wouldn't be in business. | | | | our own initiative and feeling of control and |
| Even before their CEO gets his or her tens or | | | | responsibility for our own health. We may |
| hundreds of millions (even 1.7 Billion, in the case of | | | | (understandably) feel entitled to the free services |
| William W. McGuire of United Healthcare) and | | | | that we have spent so much on, and |
| other profits are doled out to shareholders, about | | | | understandably don't want to take any more out |
| 1/3 of what we pay them goes to administrative | | | | of our pockets. Psychologically, it is hard to resist |
| costs. | | | | the feeling that we have a guarantee on our lives; |
| In many states, insurance companies can even | | | | if we're broken, we'll just get ourselves fixed. |
| cancel your policy or raise your premium if you | | | | We're covered, like a warranty on our cars |
| get sick. Like in Vegas, you can't beat the house. | | | | computers. |
| Being that a family 4 generously gives them | | | | |