Monday, December 8, 2008

It's the Holidays which means... Open Enrollment

by Insurance Guru

Open enrollment, the bane of my December existence... While trying to budget for Christmas presents, cope with the extra workload at the office and praying I get to keep my job, I must sort through the various insurance plans being offered for the next year.

I use the term insurance with a bit of sarcasm here. You would think being employed by one of the nation's largest Insurance Companies, I would have the Cadillac Escalade of plans to pick from at a cost that would make mere mortals weep. NOT. The last 5 years have seen a steady decline in plan options and increase in cost for we cube farmers.

The plans offered to me are so hideous that I don't even use my employer's insurance. I've got the Guru's family enrolled on the Future Ex-husband's retiree plan. How absurd is that?

If I worked at Wal-Mart, I would get an employee discount, if I worked at a gym, I would get free membership, if I worked at AIG, I would get spa days. I guess I should just suck it up and count the twin blessings of employment and medical insurance.

During this joyous season of Open Enrollment, I encourage you to look at all the plan offerings and how each would cover you and your family in the year ahead. Consider if that dodgy knee or new baby is a concern. New glasses? Braces?

Most of all, if you are lucky enough to have an employer sponsored insurance plan, take advantage of it! A little insurance is better than none. Take a look at this little video that Dethmama dug up.


Gail Rae said...

I've often wondered about exactly the subject of this video. Interesting point. Some observations:
1. Drew Carey is the executive producer. Interesting.
2. The situation of people not being insured simply because they don't want to budget for it is, I would guess, probably similar to what existed in countries who now have universal health coverage. It's hard, universally, I think, to get people to "save for a rainy day", unless its automatic. Maybe our brains aren't individually wired for such practicality.
3. One aspect, as I understand it, that applies to universal health care coverage managed by governments that does not apply to medicine for profit systems is that medical care is standardized, thus it carries far less risk of, for instance, lack of availability, lack of quality care, the proliferation of "empty" medicines and treatments and the need for prospective patients to be so conscious and critical of the medical choices being proposed to them that they become frightened, burn out and decide not to seek treatment when needed.
3. Despite Gillespie's belief that affordable medical insurance is available but people just don't want to cough up for it, countries who provide universal, government sponsored health insurance remain far ahead of us in many medical quality of life standards. This should tell everyone something; for instance, could it be that our current medicine-for-profit system is well aware that people tend not to cover themselves medically if left to their own devices, so, even factoring in charity cases, etc., it remains more profitable to medical corporations to support our citizen's seemingly irresponsible attitude toward health insurance because the fewer people they insure, the more money they make? Certainly they'd be making less money under a universal health care system. They would not, however, have to give up their desire to lead appropriately doctor-comfortable lives, as is evidenced, for instance, in France. And, as well, private health insurance remains a viable supplement in many countries with universal health care.
4. Although all universal health insurance systems incorporate standards of treatment that may delay or deny certain treatments based on availability and cost, our for-profit medical insurance system, as it stands, most likely denies far more necessary treatments TO THEIR INSURED than universal health insurance systems do.
5. To summarize, I have to wonder why Gillespie believes that our society is better off scolding its citizens to do something that they are obviously not going to do, that most citizens in most universal health care countries probably didn't do prior to universal health care coverage, than to allow our government to mediate between what appears to be people's natural reluctance to insure themselves if left to their own devices and corporate medicine's desire to take advantage of this reluctance.

Thanks for this. Thought provoking.

insuranceguru said...

Hi Gail,
wow - you've brought up some very interesting points! Let me attempt in my poor Guru fashion to answer with the knowledge I have.

1. Drew Carey - I think he's the perfect person to present some of these non-mainstream ideas.

2. One of my frustrations with the subjects in this video is that to insure the employee only is so inexpensive. $100.00/month? That's 25 bucks a week and if you have children - not insuring them at a minimum if you have a certain income level should be criminal.

3. Our medical infrastructure is more standardized than many might think. All hospitals, labs, surgical centers, etc. have national accredidation processes and ANY provider that accepts Medicare has government oversight - add to that each indidividual state's Dept of Insurance and it's quite a tangle.

For profit medicine can make it difficult for the individual to get treatment but it gives us more choices. It's a tricky balance.

3. An insurance company is all about spreading risk. The more insured you have, the larger the risk pool. Many types of insurance won't cover pre-exisiting conditions and this can really be a problem but under a standard employer based coverage - if the employer elects not to limit coverage - all are welcome.

I haven't researched all the standard of living issues but many countries can attribute some of these numbers simply to cultural differences. We Americans are not known for our healthy diets.

4. In all my years in the insurance industry - I've never run across denials just for the sake of denying or trying to save some bucks. Insurance companies have strict rules about the steps to take to get a procedure or treatment and this is when your doctor can make or break the process.

5. I agree, scolding folks won't get them to insure themselves so that when they need services, the taxpayers will have to cover it in some fashion ... medical costs go up to cover indigent costs...premiums go up...

We will likely have some type of Universal Coverage in my lifetime. It would be glorious if done right but remember - we do have a form of Universal Coverage running in America right now. It's the Veteran's Administration.