The Realities of Health Insurance, Part 1

The Realities of Health Insurance, Part 1

The more money that we spend, the more thought gets put into the purchase.  For the vast majority, that is a fact of life.  When performing a costs vs. benefits analysis, it is necessary to know the right questions to ask.  Unfortunately, as costs have continued to rise in healthcare, it has become increasingly difficult to know what needs to be evaluated in order to make sound decisions.  It can be very confusing. 

At the heart of the confusion is so-termed “health” insurance.  Years ago, it was purchased by consumers to protect themselves in the event of a crisis requiring hospitalization.  As the modern American mindset toward health changed to fit a philosophy primarily concerned with treating symptoms in as instantly gratifying a manner as possible, what constituted an emergency began to encompass a much larger scope of issues, most of which had not previously necessitated evaluation.  The healthcare industry exploded.  The last resort became one of the first options and the number of unnecessary hospitalizations soared to nearly 10 million per year. 

The primary therapy for nearly every ailment became pharmaceutical; the by-product of expanding the list of reasons to visit doctors is that Americans now consume 80% of all the medication produced in the entire world despite making up just 5% of the world’s population.  This “ready, fire!, aim” mentality that often ignores the cause and context of symptoms has been instigated by direct-to-consumer advertising from pharmaceutical companies.  Since the turn of the century, between $2.5-4.5 billion annually has been spent on prescription drug advertising; six times that amount was paid yearly to promote medications to doctors.  The average 17 year old has seen over 20,000 hours worth of drug commercials.  Everywhere you turn, you are reminded about the various symptoms of the thousands of modern diagnoses.  The insurance industry has jumped in and assumed a lot of the corresponding astronomical spike in cost, but the premiums to afford insurance have skyrocketed accordingly. 

Quality of healthcare has plummeted down as costs have continued trending up.  Despite spending nine times more per household on healthcare today than was spent in 1980 (adjusted for inflation), our health system is one of the worst in the world among industrialized nations. 

Our healthcare system, around which the health insurance system is built, has been operating on shaky ground for several decades.  The term “health” is defined as the condition in which an organism performs its vital functions properly.  Yet, over 90% of our healthcare system is designed to get patients to treat their symptoms with medications that may or may not stop the symptoms, but unquestionably do disrupt vital functions; such is why the drug advertisements are two-thirds full of side effect warnings.  If health is about maximizing function, the primary means by which Americans supposedly achieve health – drug therapy – serves the opposite purpose.  No wonder our health system is in shambles.

In order to lower health insurance costs, progress must be made in fundamentally changing our healthcare system.  For that to happen, the consumers that drive the system need to be empowered to thoroughly appraise the current state of affairs.  One important question to ask is: what role should insurance play?

One of the basic laws of the insurance business is that the greater the likelihood of dire circumstances, the more money it will cost to purchase insurance against it.  Insurance is, therefore, most affordable when fewer claims are being filed due to dire circumstances.  A fundamental problem with modern “health” insurance – more appropriately named “sick” insurance – is that we have collectively lost sight of when it is and when it is not appropriate to use it.  The more we utilize it, the higher the premiums will be; the more the public is educated to visit the doctor for even minor concerns, the more money the public will spend.  The best way, then, to keep your insurance costs to a minimum is to be healthy enough to avoid using it. 

That begs the question: how does one go about becoming healthy?  How does your body, as the definition states, perform its vital functions properly?  First, its central nervous system must be capable of working normally; that means limited to zero interference within your body’s electrical network – the body cannot function properly if its brainstem, brain, or spinal cord has been even subtly injured due to even minor trauma no more than a faulty smart phone is capable of performing 100% of its advertised features.  Second, if the structural foundation is properly balanced, the body can develop normally and sustain itself physically over time, but the opposite is true if the foundation has shifted, making a simple task like exercise far more difficult.  Third, the body needs constructive sources for sustenance; it accepts water, naturally grown fruits and vegetables, and animals farmed without antibiotics or hormones much easier than it does soda, processed meats, and food from crops sprayed with chemicals.  Finally, learning to navigate emotional highs and lows is quite important, for the less stress on the body the better; stability is one of the primary things necessary for functioning properly. 

You may then ask: shouldn’t your insurance cover the above?  Not necessarily, because the reality is that insurance is not designed to support how you go about achieving health; it is most readily accessed by the cumulative effects of not being healthy and/or by catastrophic events.  Tweaks to the insurance system to include within its costs the ability to seek preventative care are inherently flawed because the basic law of insurance is that catastrophes are going to happen (why else would people buy insurance?); preventing calamity breaks that law.  So, it is important to recognize that the associated costs for the education and guidance that health professionals can offer to help you and your family achieve the above and become healthy are understandably separate, in many cases, from your insurance premiums.   

The confusion ends when the understanding begins.  If we cooperatively redefine health, we consequently demand that healthcare changes.  If we inspire healthcare to change, we simultaneously hold insurance companies accountable.  The consumers will have to be the ones that initiate the grassroots process, one person at a time.  With a better grasp of the right questions to ask, sounder decisions can be made, health can increase, and costs can decrease. 

Sources: The Washington Post, The American Thinker, American Medical Association, Sciencebasedmedicine.org, Harvard Medical School

Dr. Chad McIntyre owns and operates the Triad Upper Cervical Clinic in Kernersville.  Specializing in Upper Cervical Care, his practice emphasizes a proactive, goal-oriented approach to health heavily rooted in thorough patient education.