In Defense of Insurance Companies…

I’ve always been on the edge as it relates to health insurers. Many of the leaders in the health insurance world will tell you that over the years I’ve not been particularly supportive.   My questions have revolved around what do insurance companies contribute to the “health” of the patient besides managing the flow of information?  Are they effective?  Do they really add to the process?  Or, are the insurance companies simply an intermediary that needs to be tolerated?  So, for all of you who think I’m off the edge, I want to give you some evidence that I’m a real “moderate.” I actually think the insurance industry has been getting the blunt end of the stick during the last several weeks.  In many respects, the recent rate hikes announced by the insurance industry are predictable.  Anytime we’ve had a recession, health insurance rates have gone up.  Why?  Because those who lose their jobs and are healthy, opt out of COBRA.  Many people would rather put money in their pocket at a time of need rather buy insurance. For those who are not healthy, keeping insurance is important because they can see the specter of potential catastrophic healthcare expenditures, which are beyond their means.  The end result?  The healthy leave, the sick stay.  Risk shifts.  And, the cost of health insurance rises. It’s totally predictable.  I’m a classic example!!  I’ve got health issues that must be monitored.  I will always have insurance because I couldn’t fathom being without it, and I will use services. I’m one of those “predictable” people that skew the equation for the insurance companies.

This is why we need healthcare reform. And, the storm only gets worse over time.  As the US population ages, as the economy continues to bump along, as costs for healthcare services continue to increase at higher rates than the general cost of inflation – the pressure is inherent.  Can I fault Wellpoint or any other organization involved in health insurance?  No. Can we discuss their level of profit?  Well, yes…  But, then we need to discuss the profit lines of all segments of the healthcare industry.  Who is contributing value?  Who is managing risk?  Who is making a difference?  It’s not one answer but the combination of answers to all these questions that counts.

By simply pointing the finger at insurance companies, we are taking the easy way out.  If – and only if – we had all members of society insured, it would be a different discussion.  We need to get to that point.  While I believe in the importance of the free market approach, I also fundamentally believe that all Americans should have access to basic healthcare services – just as I believe that all Americans should have access to basic education … and, water free of contamination … and, a road system that helps us move from one place to another … and, all of the other expectations we as a society have placed on our leaders.  Let’s not lose sight of what this is all about. We have “great expectations” for our leaders, and the resources do not currently meet the needs of great expectations.  So, perhaps we need to have a national dialogue and debate on where we’re going to invest?

Thirty some years ago, I had a conversation with a good friend in the student cafeteria at the University of North Dakota.  The conversation related to change.  I suggested that it was “better to figure out how to change the institutions from within rather than to throw bricks from the outside to walls that will never change.”  In many respects, my philosophy has not change after many decades.  We need to move forward on change. How can we bring it together?  This is the challenge for healthcare leaders across the US. Let’s move forward…

Kevin Fickenscher, MD

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.