In the spotlight today: "policy holders to pay more for health insurance"
Citing a rising cost in medical care and the "money losing" business of medical cards, insurance companies are justifying yet another hike in the premium calculation that will translate to an increase in premiums. This exercise will affect those of at higher risk of poor health, which in general will be the older age group, and worst affected might be those who are at lowest capacity of income generation, ie the retired age group.
It is said that there are 2 sides of a fence to each story. I have 3 perspective instead, as a health practitioner, an insurance agent, and a policy holder.
So let me put it in simple perspective.
1. A person becomes a policy holder when he purchases an insurance policy. Because they are being led to believe that their life has a high worth and that rising future medical care can be combatted by purchasing at today's policy prices.
2. Insurance company leverages the cost between the healthy and the possibly sick to come up with a premium that will be profitable to them. After all insurance is not charity, they need to profit to give a hopeful income to their agents.
3. Policy holders will make use of their pre-paid medical cards to 'rightfully' treat all diseases with minimal payment.
4. Medical centres in the name of defensive medicine (which is to investigate as much as possible a disease beyond reasonable doubt so that they will not be held accountable for a missed diagnosis or ineffective treatment in the court of law in the event) hence alot of tests and extra consultation and prolonged stay can be 'justifiable' and since the policy holder doesn't directly pay, they won't feel it.
5. Insurance companies find their actuarists didn't do a good job to forecast a handsome profit, so they will need to do the ugly deed of raising the insurance premiums whereby a public outcry ensues.
...........
What seemed like a 'noble' business to help protect health costs, has in fact become a business that poaches the masses for the inappropriateness of some. The lack of honourable due diligence in the part of insurance companies in researching a better business model to promote preventive health instead of reactive payment to poor lifestyle related health problem has contributed to the on going cycle of premium increase with no solutions in sight apart from the current easy way out, which is to increase premiums across the board.
Why do I oppose it?
Because a healthy policy holder who looks after himself and may probably almost never end up in the hospital except in the final stages of life would be subjected to the same increase of premium rates as another policy holder who after purchasing their policy at a ynger healthier age, start to partake in poor lifestyle choices such as over eat, over drink, over work, over smoke, under exercise, etc. There is no mechanism to rightfully adjust and justify the premium hikes.
Likewise, in the expenditure department, professional and procedural fees are regulated by law to have a maximum cap for the fees a doctor or health professional may receive, but there is no standard or law that governs how much a box of tissue would cost in a hospital room. How well versed are the insurance company in justifying multiple professional consult for an admitted patient, or what is deemed as objectively sufficient or subjectively excessive amounts of investigation to conclude the treatment plan?
While in the medical and health related business (including insurance), we talk the talk of "prevention is better than cure", just how serious are we to walk that talk?
To prey on the emotions of people by talking about their health, many people are commited to insurance, but how committed are the insurance companies to their policy holders' health. We all know how committed the companies are to their financial health with each increase.....
Put into a different context, when a financial institution provides a car loan, they fix an interest to the loan. If on subsequent years the economy improves and interest rates increase, they cannot just tell their customer "hey you know, these are good times, so we are going to have to charge you more". And even such, if there is a floating interest system tied to a base lending rate, the variation occurs according to the economy. The BLR can either increase or decrease which will be reflected accordingly.
So why can't health insurance also have such a floating system? If one maintain in good health within a certain parameter accounted for age and lifestyle, then their premium remains, or is discounted. Something like how car insurance applies, whereby there is a non-claim bonus. Why can't there be a good health bonus?
By doing such, much more can be gained in the conext of preventive health, whereby the responsibility of good health (and low premiums) are in the hands of policy holders. Health care costs will decrease because the rate of illness can be reduced with preventive measures. I believe this will form a bigger part of Corporate Social Responsibility as opposed to these companies sponsoring charity events having open days or marathons only that serve more as an advertisement than sustainable health prevention efforts.
After all, how many more real life companies do we need who tells us life is great and claims to always listen and always understand, when the fundamentals of health are not being practiced, heeded, heard or understood, making life miserable because all policy holder can see are these companies making business from real life problems.
