Currently viewing the category: "health insurance"
Been getting lots of flak on a recent post about health care costs, and you know how much I love that. But one thing that comes up time and again, because people just can’t seem to see past the political brainwashing, is that my message is NOT about whether people should have, get, or pay (or not pay) for health insurance. No, that’s what the politicians talk about…that’s not my message.

My message is this: Health comes from within. It’s what you do for your body, regularly, that determines whether you will experience wellness or not. Absolutely no medicine will give you health. No organ removal will give you health. Either one may help you get over a hump, but none will provide you with health–only YOU can do that.

The western medical system is necessary for, and outstanding at, saving lives–it’s crisis care, or more aptly, sick care. As far as saving lives goes, nothing is better then western medicine. But let’s not mistake that for health. The reality is that the medical system has been the dominant system for over a century; and in its desire to protect the public (and retain full and absolute power economically, politically and as the cultural authority), it has infused its sick-care paradigm into every facet of the cultural psyche. The predominant view of “health care” is of going to the doctor for a check-up and then getting medication.

Except for one little problem: What medical doctors provide for the public has nothing to do with good health. Now let me explain, because certainly, saving lives preserves health in the most fundamental sense. Yes, I will give you that. But is health merely the absence of illness or disease? No! No logical person believes that today. In fact the World Health Organization’s (WHO) definition is just that:

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Duh.

Worse yet, we see now how irresponsible use and/or overuse of the medical system actually makes people sicker. Why the hell are people fighting for more of that? Everybody in the U.S. has access to emergency care, so nobody is ever left out in the street to die because they have no medical insurance–nobody.

Do not fool yourself into thinking that the current health care debates are about that. Nobody gets turned away from crisis care. No, what some people and politicians are so desperately fighting for is for medical care to continue as the predominant form of “health care”, beyond crisis care, in illness or in health.

And the medical industry sits well in the paradigm it has created, with many people never really thinking about their health until it goes awry.

It’s the I-can-neglect-my-health-and-then-be-saved-by-medical-care syndrome; the “just give me the statins, it’s too hard to change my lifestyle” mentality; the “I just can’t get myself to exercise and change my diet, so I think I’ll get a stomach staple” way of thinking, just perfect for the elective-c-section,-run-to the-doctor-for-every-sniffle,-and-undergo-multiple-cosmetic-enhancements crowd.

Yes, today’s medical care has very little to do with health–it’s the sickness paradigm imposed onto the public perceptions of health. And you wonder why the U.S. ranks so poorly in health status for a developed nation that spends a large portion of its economy of medical care? Duh.

No, medical care ain’t health care–it’s sick care. And it’s foolish to so adamantly demand it as an inalienable right. You want the drug addiction and the poor health that comes along with the reliance on modern medicine and it’s prehistoric “health” paradigm? Then be my guest. But not me…I’ll take my chances taking care of my health. And if I have a crisis, well I know the best place to go, insurance or not.

Well, looks like I’ve been right all along. The best health insurance policy is the one you provide for yourself. I’ve known it, and now you do too. Here’s the proof:

According to a large study conducted at the German Institute of Human Nutrition, living a healthy lifestyle can significantly reduce the incidence of chronic disease. Adopting four habits–not smoking, exercising regularly, eating a healthy diet, and maintaining a healthy weight–reduced the probability of developing cancer, diabetes, heart disease, and stroke. While practicing all four behaviors provided the greatest benefit, adopting them one by one had significant protective effects too.

The study followed more than 23,000 middle-aged Germans for eight years. The participants were aged 35-65 years old. They found that the people who practiced all four habits had a 1/2% per year per person risk of developing chronic disease. Think about it–4% chance of developing chronic disease during the eight years of the study; extrapolate that to 20 years and the risk is only ten percent! For those people that did none of the habits, however, the risk went to 3% per person per year. That’s a full 24% during the study period and a whopping 60% in twenty years. Does anybody else see the enormity of this?

Here are some more facts:

  • A BMI lower than 30 was a particularly strong protective factor against development of diabetes
  • Physical activity protected more strongly against diabetes and heart attack than against cancer
  • Following good dietary principles provided a similar degree of protection against diabetes, stroke, and cancer
  • The largest reduction in risk was associated with having a BMI lower than 30, followed by never smoking, at least 3.5 hours of physical activity and then adhering to good dietary principles

None of this is a surprise to me or my regular readers. It’s the major premise of my book, The Six Keys to Optimal Health, and it’s what I focus on most here in this blog. Despite the focus on health insurance as a means toward better health, the reality is that nothing in the current health care model is going to improve health as a whole. This recent study provides the proof. Now the difficult part will be to convince lawmakers, and more importantly, people that focusing on personal health habits is the only true path to health reform.

Check the scenario: Family gets health insurance coverage through wife’s employer, pay their premiums, and then husband gets into car accident. When the bills reached more than the annual premium, the insurance company canceled the policy. Why? They went back into the man’s health records and found that he failed to disclose previous conditions. It’s now a big court case in California.

This is a fairly typical scenario when it comes to private insurers. Insurers are in the business of making money–nothing wrong with that, I mean, who isn’t? But what makes this case important is a question of “good faith.” What that means is: Did the insurance company violate good faith practices by failing to check on the man’s health history before accepting him as an insured. That’s the main question that will determine this case.

According to the insurance company, and rightly so, the man withheld that he had been treated for complications related to obesity and a stomach condition two months prior to obtaining the Blue Shield coverage. This omission is legally cause for rescinding of an insurance policy. You lie, you lose–that’s fair. However, Blue Shield failed to carry out its due diligence, and according to the Health Insurance Access and Equity Act of 1993

“No health care service plan shall engage in the practice of postclaims underwriting. For purposes of this section, ‘postclaims underwriting’ means the rescinding, canceling, or limiting of a plan contract due to the plan’s failure to complete medical underwriting and resolve all reasonable questions arising from written information submitted on or with an application before issuing the plan contract. This section shall not limit a plan’s remedies upon a showing of willful misrepresentation.”

The last line is the important one, “a showing of willful misrepresentation.” The insurance company is trying to prove that the family willfully withheld the previous conditions. The family states they did not, they thought that only the wife’s information was required since the policy was under her name (from her employer).

This case will be very important as far as how insurance companies will be required to treat incoming clients. Why would an insurance company not carry out its due diligence to the tee before insuring someone? Cha-ching…premium dollars, that’s why. What are the chances one person will run up a $45,000 medical bill? Slim, most people don’t (sorry, universal health care groupies, despite the propaganda, this type of medical expensive is not as common as we are being Kool-Aid drugged into believing), so health insurers make a nice chunk of change from each underwritten premium. It’s not until they have to pay out that a foul is committed–at least in their eyes. But, this might just be a case of the health insurance industry’s game just coming back to bite them. Oh well.

Anyway, this type of shenanigan is not an isolated incidence when it comes to health insurance. Many people find themselves at the losing end of rescinding policies for “withholding medical information” which happen after an medical expense is incurred. In fact, health insurers have been shown to reward employees for rescinding policies (cutting coverage), an act described as “reprehensible” by a California arbitration judge in an earlier case. We’ll find out how this one turns out, but I think the insurance company will get nailed on this one.

I hate to say I told you so, but well…I did. Here’s the latest on American health insurance habits: Americans spend more on medical care than their foreign counterparts. But not their own money…oh no, uh uh…Americans spend more insurance dollars, because the perception is that their health is somebody else’s responsibility.

According to new research conducted at George Washington University, insured immigrants spend less on medical expenses than U.S.-born citizens, even after accounting for lower levels of insurance coverage. Well, no kidding; you don’t say. In fact, overall health care spending was 20% less for American immigrants, even when controlling for factors like health status and age.

No surprise to me–I’ve been reporting on the convoluted American health paradigm for quite some time. Americans, in general, think that health care is an entitlement–which might not be a problem if the average citizen did all they could to take care of themselves. But when a large number of all illnesses are lifestyle related, it really skews the stats, doesn’t it?

The authors of the study point out that these results “contradict the popular belief that immigrants are a drain on the U.S. health system.” I agree. But even more telling in my opinion is that Americans overuse the medical system for one simple reason: They aren’t footing the entire bill. Truth is that all insured people foot the bill for those using health care the most–the obese, drug addicts (both recreational and pharmaceutical), and the neglectful. And our current government wants to now give us more to pay for with universal health care. You really think this is the answer to “fixing” the health care crisis? Wake up call: not only is there not a crisis, but universal health care is going to cost way more than ever imagined. You’ll see.

President Obama and his crew have got this health care thing all wrong. Socializing–damn it, I mean universalizing–health care isn’t the answer. And the data they’re using to come to their conclusions is convoluted.

Take the latest report from the Business Roundtable, a gathering of U.S. CEOs from major companies that provide health insurance to their employees. This meeting produced the usual appeal from American businesses to get medical spending under control. Yeah, no kidding–if you’re footing the bill for hundreds of thousands of people, you’ll want costs to come down significantly. But having the taxpayer pick up the tab isn’t going to change the facts. And the facts are what’s under contention.

The conventional wisdom is that medical care in the U.S. is too expensive. The numbers show that Americans spend $1,928 per capita on health care. That’s two grand a person per year on average. This number is then compared to what’s spent in G-5 countries (Canada, Germany, Great Britain, France and Japan), all with government-funded systems, albeit different from each other. In these countries, the per capita health care spending is $1,100 (all data is from 2006). In the emerging competitive economies, the BIC group–Brazil, India and China–per capita health care spending is about $290. Looking at these numbers, I guess you would conclude that our health care is more expensive and burdensome.

But I think these numbers only tell part of the story. To begin with, I don’t find the BIC group worth comparing. These three countries have huge populations, large numbers of poor people, and they still lag behind the more developed countries in quality of life amenities that we take for granted in the modern western world. This includes health care. In fact, I am certain that hoards of people in those countries have no health care available whatsoever. This isn’t the case in the U.S. where we have free clinics and laws against turning away patients from emergency care.

So, in my opinion, the only worthy comparison is G-5 countries. The only way to know if our care in the U.S. is too costly is to have comparative pricing–that is, we’ve got to know how much mending a fracture is, not only from country to country, but from hospital to hospital. Without that information, we’re shooting blindly in the dark. And how about an overnight hospital stay, or a shot of morphine, or how about a simple doctor’s visit–you know, those useless physicals or whatever it is that we get duped into every year. Without that information, there is simply no way to know what’s too expensive.

Then there is the issue of comfort. Some people demand that their hospital room resemble a suite at the Ritz Carlton. Hey, I’ve got no problem with that concept–money talks and BS walks, so they say (check out how this Japanese mobster got a liver transplant and five-star service in the U.S. for one reason only–cha-ching!). So lowering cost will invariably lower comfort (which I believe will lead to high-priced boutique medical care and private hospitals, and then you’ll really hear the masses scream).

Finally, by the sheer fact that everyone has government-funded insurance, I’m certain that things get pret-ty busy in those G-5 hospitals, probably similar to any big city’s general hospital–you know what I mean, looooong wait times. Swollen elbow? You’re sitting in the waiting room for nine hours, Laddy. My guess is that this keeps only the most critical emergencies from going into the ER. Anything of a lesser severity has to wait for a doctor’s appointment. There you go: controlled visits, controlled costs.

Here’s the real problem as I see it: Americans have been brainwashed–OK perhaps spoiled is a better word–into believing that you run to the doctor for any minor ailment. I can’t tell you how many people I’ve talked to in the last month who have gone to the doctor for antibiotics for that miserable cold and flu that has come upon us–the same one my daughter and I had, and got over with zero medication, just sleep, water and lots of TLC. Listen up people: antibiotics don’t do diddly against the common cold OR the flu–both viruses. So how many of you ran up the nation’s health care costs this month?

And also Americans have immediate access to medical care at any time. Call it an emergency and you can’t be turned away, or the hospital will liable. Can’t pay the bill? Most hospitals have charity plans–they’ll write off your care if you can’t afford it. So add the notion that you’ve got to run to the fancy schmancy hospital or doctor in Century City (Upper East Side, UCSF, whatever) whenever you have a boo boo; and you have the ability to do so no matter what your income level, and what do you think the result will be? You think we might spend a little more money than the Euros who are sitting at home nursing their own colds and flu?

I actually hope we do nationalize the system, because I think it’s the only way Americans will see that it’s their lifestyles that lead to their poor health.

Well, you know what they say, “As Hawaii goes, so does the nation.” OK, nobody really says that. And good thing, too; because judging by what’s just happened in Hawaii with their universal child care program, following suit could be disastrous for American health care.

According to recent reports, Hawaii is dropping the only state universal child health care system in the country just seven months after it launched. You don’t say…I wonder why. Apparently the program was set up for families who couldn’t afford their own private health insurance; however, many families began dropping their private health insurance to get the freebie. No kidding. Wow, why would they do that? Essentially, the program became unaffordable. Duh.

In another unrelated report, government officials have declared spending on the Medicaid health program for the poor as “unsustainable.” Medicaid benefits will increase by 7.9% per year over the next decade, costing $674 billion by 2017. Woowee! That’s a lot of dough. The program is inflating at a higher rate than the Medicare program for the elderly and disabled. Health and Human Services Secretary Mike Leavitt said in a statement, “This report should serve as an urgent reminder that the current path of Medicaid spending is unsustainable for both federal and state governments.”

Yeah. Well, I can’t see a proposed national universal health care plan being any different. For a country as large and addicted to medical care as the good ol’ U.S. of A, the price tag for such a program will be astronomical. Good campaign slogan, poor idea overall. Listen, I’ve got nothing against helping people who can’t afford this and that, but the problem in health care isn’t that people have no access to it–people have access, it’s called Medicaid (50 million cardholders and counting)–it’s that people in this country have become overly reliant on medical care.

This concept is a major premise of my book, The Six Keys To Optimal Health. People have simply neglected their health for years. We are one of the most unhealthy industrialuzed countries on the planet. Why? Because people don’t have access to medical care? BS! Walk into any big city ER on a Saturday night. I did it three weeks ago when my daughter was being born, it was packed–packed!–with low income citizens. Go ahead, walk into Cedar Sinai in Beverly Hills on a Saturday night; you’ll see the truth. People have access to care. The bottom line is that the average American takes very little care of their health. THAT’S WHY WE ARE HAVING A HEALTH CARE CRISIS! Not because we don’t have universal health care. It doesn’t matter if we do get this type of system; until people make a conscious effort to change their lifestyles into one of movement, wholesome eating, regular bodywork, proper sleep, mental balnce and conditioning, and toxin avoidance, HEALTH CARE COST WILL CONTINUE TO SOAR!

The only thing we are going to get with a universal health care system is more cost for the taxpayer, to pay for the health care of the people down the street who continue to neglect their health. Mark my words.

Copyright © 2013 Dr. Nick Campos - All Rights Reserved.