John Creighton

November 12th, 2009 by John Creighton in Dispatches

Tags: Healthcare

I sat with a group of friends recently when a health care discussion broke out.  The group included people mostly in their late fifties and early sixties.  It also is a group of people who have, individually, dealt with a number of serious health issues.

“Those #@$% insurance companies are the real problem,” stated one person as the group tried to hone in on what’s wrong with health care and what needs to be fixed.  “They just rip you off.”  The chorus of agreement from the ten-plus at the table was quick and nearly unanimous.

I hear these types of sentiments all the time not just from friends but when I do health care focus groups.  Health insurance companies are trusted less than government and hated more.  This is a prevailing sentiment even in highly conservative communities that vote overwhelmingly for anti-government politicians.

A Gallup survey conducted in June of this year found that only thirty-five percent of Americans are confident that health insurance companies will recommend the right thing for reforming the U.S. healthcare system.  That compares to seventy three percent who believe doctors will recommend the right thing and fifty-eight percent who have confidence in President Barack Obama.

But, here’s an interesting twist.  Back at the table of friends who were railing against insurance companies, one of the women in the group asked, “Do you think we’ve paid more to insurance companies than we’ve gotten back?”

Remember, this is a group that has dealt with several serious health issues.  The response to the query was eye-opening.  The first person to answer said, “My heart surgery cost $80,000 or $90,000.  I think we paid $3,000 ourselves.”

“My surgery was over $60,000.  I don’t think we paid much,” added another.

“When I was in the hospital for several weeks, I didn’t end up spending a dime beyond our deductable,” said a third.

The pattern held.  The group clearly had come out ahead in terms of money paid to insurance companies versus claims paid by these companies.  But, before the group completed its accounting, one person raised his voice, “I’m telling you those #$@% insurance companies are the real problem with health care.”  No one disagreed.

Why do people who have benefitted financially from their relationship with health insurance companies still hate these companies?  I will share two personal anecdotes that illustrate common responses I hear when I ask people this question.

My mother was diagnosed with late stage breast cancer when she was forty-eight years old.  Surgery and many months of chemotherapy swiftly ensued.  The actions extended her life by fifteen years.

From that point forward, for the next eighteen months to two years, Mom began a weekly ritual of filling out insurance forms and talking to insurance company representatives.  The reams of paper flowing through the mail to her desk into the copy machine and back through the mail seemed endless.  She bought a personal fax machine to expedite the process.

Some phone calls to the insurance company would last well over an hour.  She had to be transferred from department to department and provide the same information to one representative after another.  She felt crappy a lot of the time.  Chemo will do that to a person.  Yet, she had to keep up the most tedious type of paperwork one can imagine.

My wife had surgery early in our marriage to relieve a very painful ailment.  We were concerned that we might not be able to have children because of the severity of her condition.  Her doctor said surgery was the best course of action and it proved to be a success.

I was on the telephone with an insurance company representative seeking approval for the surgery while my wife lay in the pre-op room of the hospital.  We had been trying to get approval for more than three weeks.  The insurance company kept asking for more tests to verify surgery was need.

The doctor, whom my wife liked and trusted, was telling us that surgery was important.  We were scared.  The insurance company remained skeptical until literally the last minute.

I don’t doubt that doctors sometimes, perhaps often, prescribe unnecessary procedures and therapies.  I respect insurance companies desire to reign in unneeded costs.  I understand the need to protect the bottom line.  The bottom line is important to all organizations – for profit and non-profit alike.

But, here’s the rub.  People who I interview are able to easily recall personal experiences or those of friends who have had hassles with insurance companies.  Insurance companies often treat people as nameless, faceless creatures to be processed at the most vulnerable moments in people’s lives.  It’s an aggravation to work with these companies.  It’s tedious, time consuming and frustrating.  Sometimes it’s demeaning.

Even if you come out ahead monetarily, feeling diminished as a person leaves a bad taste in your mouth for a long time.  Talk to anyone who has spent much time navigating the health insurance process and it’s not too hard to understand why people hold these companies in low regard.

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Photo credit: Flickr user litherland.