For example, the Cyber Seniors program was a high school project launched by two sisters. Teenagers taught senior citizens how to use the internet.
The Pollyanna in me loves stories like this one. Two seemingly dissimilar groups of people – teenagers and seniors – connect in a most meaningful way.
Do you think we will ever connect old and new health insurance? Or are we doomed to decades of more bickering?
What is Old is New Again
Live long enough and you see history repeat itself.
- Bands who never die (Rock on!)
- Fashion you’d rather forget (Thank you, 70s)
- Toys that survive the test of time (Hula-hoop, anyone?)
With over three decades in employees benefits and insurance, I have seen plenty of repeat performances. In the early part of my career, maternity benefits had a flat rate coverage maximum. A large portion of the cost for hospital and delivery services fell on Mom and Dad.
- Then legislators passed regulations to treat the pregnancy condition as any other disability (AAOD in the acronym-crazy insurance industry)
- That meant insurers couldn’t cap what they paid out on pregnancy-related charges (unless all disabilities had similar caps)
- Sounds great, until expectant moms found out they were subject to limits on pre-existing conditions
- If Dad changed jobs (and health benefits) in the middle of Mom’s pregnancy, future expenses (including hospitalization and delivery charges) could be denied under pre-existing limitations
And here we are today. Arguing over pregnancy as a possible pre-existing condition.
Meaningful Health Insurance
One of the problems with health reform is the blending of insurance, benefits, and health care. That’s a recipe for disaster, as illustrated by our current mix of regulations.
Each element has its own challenges.
- Insurance has its risks
- Benefits must balance cost and coverage
- Health care strives to manage overall health
The three elements are like a bad marriage with a known affair on the side. Can we have meaningful health insurance without reigning in the cost of health care? How much cost-shifting can go on until employer-sponsored benefits collapse?
Blending Old and New
Physician and financial planner, Carolyn McClanahan, summed up the codependency of our current system in this tweet.
Her Forbes article offers both an old and a new approach.
- The old approach incorporates the traditional use of insurance – coverage for catastrophic events (such as serious illness, hospitalizations, or high-cost treatment)
- The new approach carves out primary care from insurance and channels it through Community Health Centers (with an option to receive care elsewhere and pay for it through direct primary care providers)
State high-risk pools, as promoted by the current administration, are another not-so-new idea for managing costs. So you carve out those using “disproportionate amounts of medical care” from the state’s entire pool of individuals.
In theory, the separation makes for more affordable costs for all.
- Healthy individuals enjoy lower costs
- States and the federal government help fund high-risk pools
However, lower costs are an illusive target.
- Health insurance premiums rise with the high cost of care
- State and federal funds fall way short for the high-risk pool
A Happy Marriage
Is a happy marriage of old and new ideas even possible? Or do we continue to drag this bitter divorce through the courts where all sides lose?
Perhaps if we took a lesson from Cyber Seniors, we’d move beyond the political impasse. Emulate the sisters who saw the good in teaching their grandparents the internet, and shared those lessons with other seniors.
- Focus on contributing to the overall health of the individual
- Be open to new ideas and learn from the old
I know. My Pollyanna persona is showing. And you may have heard – it’s complicated.
Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.