Retired business journalist tells his story in the New York Times.
On 12-1-12, I noticed a story by Frank Lalli, entitled A Health Insurance Detective Story. He was writing about the nightmare endured while trying to figure out how he was going to pay for his cancer medication after the coverage by his former employer (Time Warner) finally ended.
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His story was all about the incredible hassle one must face in dealing with an extremely complicated and bureaucratic system. As he said:
If a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?
As he told his story of detail, hassle and endless red tape and paperwork—I was hearing a different story. The one about who actually pays for our medical bills in this country. Frank documents his ordeal very well—over 70 phone calls to 16 organizations in just a few weeks.
In Mr. Lalli’s case, the annual cost of his cancer drug had been running $132,000 a year ($524/pill)—but his out-of-pocket exposure had been $1,000—less than one percent of actual cost of the drug. Time Warner was picking up the balance. Now, he was being told that his $1,000 out-of-pocket deal had been eliminated.
Ultimately, after all those phone calls and endless stress, he ended up with an even sweeter deal than he had before—he would now be paying just $60/month for his cancer drug—Leaving $131,280 to be paid by the rest of the system.
My concern is about who pays for the other 99.5% of the cost of his drug.
The rest of the system includes individuals, employers, U.S. government and state governments. But regardless of which one of those four actually cuts the final check, the cost is eventually felt by all of us individuals in the system. In total, our cost of health care is now $2.8 trillion or almost $9,000 for every man, woman or child in the United States.
The real issue here is that our entire system is one big money game. We put the cancer industry on a pedestal as the great savior who is out there searching for the cure. But, they’re really an industry bent on making money—like any other industry that sells a product.
In Mr. Lalli’s case, he was probably never told about the lifestyle issues that probably caused his cancer in the first place. There is no money to be made in that kind of business.
He probably never realized that up to 80% of our health care dollars are driven by what we choose to eat. Although he was lucky in finding a $60 a month solution to his cancer drug dilemma—his good luck resulted in the rest of us sharing the remaining $10,106 per month.
This is the reason why our cost of health care is so high—and this is simply not fair to the portion of the population that has chosen to take charge of their own health. We shouldn’t have to pay the medical bills for those who have not made that step.
Like Dr. John McDougall says, we need our own health insurance formula—one that does not offer many of the medical services that have been deemed unnecessary for people who choose to eat an optimal diet.
The second link below contains my blog about Dr. John McDougall’s innovative insurance idea. It also contains a one-hour video, in which Dr. McDougall shares all of his thinking.
- Source article. A Health Insurance Detective Story – NYTimes.com.
- Earlier blog. Health insurance of the future; an idea that can work.
- Earlier blog. Why are insurance companies not “really” promoting health?
- Earlier blog. Do insurance companies “really” want us to be healthy?
Handy 4-piece take-charge-of-your-health kit—from Amazon.com
- The movie that’s changing the lives of millions: Forks Over Knives DVD
- Healthy Eating, Healthy World, The ”big picture” about food (our book)
- An essential scientific resource: The China Study by Dr. T. Colin Campbell
- Dr. McDougall’s new book, The Starch Solution, with lots of great recipes.
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—J. Morris Hicks, board member, T. Colin Campbell Foundation