Health Insurance-A Sad State of Affairs…
Healthcare in the United States is said to be some of the most advanced in the world, yet it is not always the most accessible. Millions of Americans are finding they can no longer afford traditional insurance, and it is estimated that approximately 41% of all privately insured Americans under the age of 65 are enrolled in high-deductible health plans that may make it cost-prohibitive to even use their insurance (due to the deductible and upfront cost to the patient before the plan pays anything towards care).
Historically, insurance was something that was purchased to prevent a catastrophic loss due to a rare event such as hospitalizations, accidents, natural disasters, and other low-probability-high-cost events. The risk was pooled among thousands of subscribers who each paid a relatively small premium so the few unlucky individuals who experienced these traumatic events could be covered.
Healthcare in general was still a provider-patient financial relationship until World War II. The government implemented wage controls to prevent inflation, and employers started competing for workers by offering non-wage benefits. In1943, the IRS ruled that employers could offer health insurance as a non-taxed benefit. As a result, employers began offering health insurance, workers expected it as a standard benefit, and the proliferation of insurance plans began.
Over time, U.S. health insurance shifted away from catastrophic protection and towards prepayment for routine medical care such as office visits, prescriptions, preventative care, testing, and minor procedures. Health insurance now functions as a third-party payment system of everyday healthcare rather than pure risk protection. This shift has caused issues such as rising healthcare costs, administrative complexity, and insurance tied to employment (ie: lose your job, lose your healthcare).
Many modern reform ideas including Direct Primary Care (DPC), Health Savings Accounts (HSAs), and price transparency models are attempts to reintroduce the patient-provider financial relationship that existed before this policy shift in order to lower the overall cost to the patient and give more control to the provider on what can be offered without insurance restrictions. It removes the middleman, reducing the overall administrative burdens and added expenses.
At Four Corners Health Care, we are bringing back that traditional model of charging a low-cost fee for healthcare, eliminating insurance issues from everyday primary care, and providing our patients with the time and attention they need to build a healthy lifestyle that once again focuses on prevention and responding in a timely manner to everyday primary healthcare needs.
