Things that make you go …hmmmm!

Ok, let’s talk healthcare. We constantly hear about the uninsured and the underinsured (an undeniable problem in this country). I am over insured! By thrice! Could this be one solution?

Some things I know about healthcare from education [a degree in Biology; 3 degrees in Nursing; a Law degree focused in health, elder and American Indian law; a postdoc fellowship in aging research; and a health policy fellowship staffing the Senate Special Committee on Aging]. Some things I know from working in the healthcare space- bench science research, nurse for over 20 years- positions in large VA Medical Centers, positions in a tiny Indian Health Service (IHS) Hospital, positions in academic Medical Centers, and private facilities, nursing faculty in research 1 institutions, literally coast to coast and north to south. But some things I know just from being f (cough) ty something years old!

This is one such of those latter things. In August of 2008, I moved my family from Minneapolis where I was tenured faculty in the school of nursing, to Bethesda, MD (coincidently where I grew up-a story for another time). I had been accepted as an RWJF Health Policy Fellow and settled in for a long-ish temporary relocation.
My family of six settled into its new routine. By ‘benefits open season’ in December of that year, I realized I was paying for 6 people to have healthcare which none of us could access as we were WAY out of area. My husband had healthcare in our new area and that is what we all used. So, thinking I would save us all some money as we maintained the house in MN and rented in MD, I dropped all but myself (employer rule) from all plans- health and dental. I eagerly awaited my paystub for the next month. But it was decidedly lower! By hundreds.

Since this was a pretax issue, it would have been less expensive for me to keep insurance I would never use—are you seeing solutions from this challenge??—than only insuring as it made sense to insure. When I worked in IHS and in the VA there were programs to donate vacation and sick time to other employees when they had either a catastrophic illness, several maternity leaves in a few short years, etc. Now call me crazy, but what if I could have donated the healthcare I had ‘just laying there’ to a family in the system? It would have been less expensive for me, insured several other people (a family?), and cost the US federal system-nothing.

The current numbers being bandied about are 45 million, or 14% uninsured. Of these the current wisdom is that 12 million are undocumented immigrants and another 10 million ‘opt out’ (i.e. could pay and have access to signing up and don’t). That leaves 23 million uninsured-likely NOT of their own choosing. Could such a program make a dent in this population? Was there a family at the University whose primary breadwinner either didn’t work the necessary 32 hours a week or was not in a benefit earning position or who could only afford to take the employee benefit but not the additional cost of a family benefit? Believe me I searched for ‘real numbers’ but no-one is reporting on over-insured as regards to health care. How many families like mine had HealthPartners- MN; Kaiser-MD; and Indian Health Services? How many people are doubly insured and never use the secondary insurance??

Now trust me I am not so naïve as to not see that there would be questions as to matching families, or health statuses, or …..(fill in the blank). But if ‘risk’ is a barrier- it is important for the reader to know that no one asked my family of 6 what health problems we may or may not have had when we enrolled- just sayin’.

This is the type of solution that gets me excited- this type of thinking- whether this particular solution or any iteration therein could ever work or not, this is another facet of how and what we need to ‘fix’ healthcare…This is a thirty fifteen thousand foot view of a possible solution. It sits as an example of an ‘innovative solution’ that doesn’t seek more government, more taxes and maybe makes just a little too much sense…


One thought on “Things that make you go …hmmmm!

  1. Since not all employees use the health insurance benefits connected to their jobs, maybe companies could create a financial pool equivalent to the value of those benefits to provide benefits to people not covered by other options. My 23 year old son works for Walmart, but since he can be covered by my employee health insurance until he’s 26, he is not collecting a certain modest value of benefits Walmart would otherwise be giving him. But I’m thinking that employers have the percentage of people who don’t use their entire benefit package factored into their expense predictions.
    My husband qualifies for Medicare on his next birthday (and was soooo delighted to get his Medicare card in the mail :-/) If he were my only dependent, we’d do a cost benefit analysis whether his cost of joining a Medicare B/D plan would be cheaper than staying on my policy.
    I wonder what the value of unused benefits across all industries really is. Some would probably say i’s insignificant, but as Everett Dirkson famously said, “a million here, and a million there, and after a while you’re talking about real money.

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