The Realities of Health Insurance: Part 2

What role do you think insurance should play in your health goals? 

With costs higher than ever, our collective answer to that question will ultimately help determine the future of healthcare and health insurance. 

A few months ago, in Part 1 of this exploration of modern insurance, health was clearly defined as the condition in which an organism performs its vital operations properly and a simplified process was identified to serve as the basic standard for how to achieve it; in review, health is most readily restored or maintained through the combination of optimal nervous system function, proper nutrition, stress management, regular exercise, and structural balance.

The process of regaining and sustaining health is analogous to car maintenance.  The human body is a well-oiled machine designed to heal itself but, like an automobile, it has foundational requirements.  We are educated at a young age of the importance of car maintenance; we become aware that there are certain items on a list that must be checked off to ensure that our vehicles work as well and last for as long as possible.  Oil changes, tire rotations, fluid level checks, air filter replacements, etc., they are all part of a preventative model established from the time a car is purchased.  We budget for car maintenance accordingly. 

Most of us treat our cars much better than we treat our bodies.  When the check engine light comes on in a car, for example, we know it to be a small warning sign of a potentially bigger problem that may not have yet exhibited significant symptoms.  In healthcare as we know it today, the common protocol for the physical version of the check engine light coming on is to do the equivalent of covering up the light with a piece of electrical tape and pretending it is not there; the underlying problem persists without addressing the early warning sign and eventually manifests as a more substantial issue sooner or later. 

Particularly apt for the current season, the example of the air conditioning unit provides another relevant analogy.  Having it serviced is far more cost effective than waiting for something major to malfunction because it was not maintained.  Like any other machine, it needs maintenance to ensure that it operates at peak efficiency and will otherwise break down; the human body is the same. 

Insurance is designed to act as a failsafe should health requirements not be met and should your body experience the catastrophic results of physical decay; it is also designed to meet the needs brought about by the unforeseeable circumstances that we have no control over such as car accidents.  Treating sickness and disease is not the same thing as becoming (or staying) healthy; neither is crisis management.  The preventative-maintenance model utilized with our automobiles and A/C units is the type of mindset that American healthcare principally lacks and needs to adopt. 

Redefining health and reshaping our understanding of how to become healthy are vitally important to establishing economic equilibrium for healthcare costs.  Right now, there is a huge demand for health, but basic health education and knowledge about those practitioners who can facilitate and guide you toward maximizing your health potential is in comparatively low supply. 

Consider that 99% of the $3.27 trillion total expenditure for healthcare in the United States last year was spent on conventional medical practices (mainly drug therapy and surgical procedures) and on the health insurance designed to cover these treatments.  The unfortunate facts of the matter are that the average American spent over $10,000 on healthcare in 2015, all but 1% of which went toward a methodology that has yielded America as a whole dead last among its peers in the industrialized world, statistically, when it comes to being healthy. 

We are collectively stuck in a vicious cycle.  For several decades, we have demanded health from sources that are primarily tasked with treating symptoms, disease, and trauma.  That alone has kept healthcare spending higher (15% of the average American yearly income) because we have utilized insurance coverage more often to help cover medical fees.  The basic law of health insurance is that the greater the likelihood of using medical services, the more money it will cost to have medical insurance.  Insurance is, therefore, most affordable when fewer claims are being filed for medical services.   

The cycle will not slow down – much less end – until we command it to change.  First and foremost among the changes is our mindset.  Health is a goal, its various aspects in need of evaluation and intention.  Education is very important in changing the way that we think about health; we need to bring greater awareness to the gaping holes in our current system and put programs in place to outline for the general public the pillars of healthy-living.  If we jointly move away from the symptom-based model and toward a preventative model, we will be collectively healthier and be more consistently productive members of society, resulting in less insurance usage and decreases in cost accordingly. 

Coinciding with a more constructive approach to healthcare will be a shift in our way of thinking about who should cover health expenses.  Going back to the opening question, insurance should go back to playing its original role of disaster relief – the role it plays in all other aspects of life.  So, just as maintenance of a car or AC unit is a separate cost from car or home owner’s insurance, 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 become healthy are understandably separate, in many cases, from your “health” insurance.  In reality, being healthy is the best insurance, its premiums small and its dividends large. 

Sources: Centers for Medicare and Medicaid Services, National Institute of Health

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.