How much is health insurance really about “health”? Well, when it comes to preventative healthcare, health insurance seems to be more about insuring companies make a profit than about caring about health.
You are likely familiar with the preventative healthcare measures insurance companies do currently subsidize for patients: vaccines, including things like flu shots that many insurance plans cover at no cost, and disease screenings, including things like colonoscopies and blood testing for high cholesterol.
Preventing illnesses would seem to make a lot of financial sense for health insurance companies. After all, once someone insured gets sick, their health insurance company is then on the hook with helping pay for their care thanks to new regulations that make it harder for insurance companies to abandon sick patients after a diagnosis. You would think, then, that disease prevention would be a first priority for health insurance companies, as having healthy people insured brings them lots of money in monthly payments with little loss in doctor’s bills.
But in reality, much of the preventative healthcare we laud right now is not very lucrative for insurance companies. Perhaps that is why insurance companies balk at covering any preventative healthcare costs. For example, even some of the preventative things insurance companies cover, like screening colonoscopies that can help find early evidence of colon cancer, still come with twists for patients, like being thrown bills for the anesthesia necessary for the procedure or even bills for using the facilities where the procedure was held.
Other preventive screening measures, like blood tests for high cholesterol, are extremely helpful in detecting future health problems before they arise, but as one article from The New York Times notes, “Unless it’s restricted to people at risk for heart disease, the costs outstrip the benefits.” In other words, because we are not more selective about who can access blood tests for high cholesterol (e.g. restricting it to those who are at high risk), the screening ultimately becomes an overpriced endeavor for insurance companies nationwide.
Health insurance companies also have a very narrow definition of what “preventative screening” even means. For example, if a preventative screening breast exam reveals a lump that could be cancerous that needs further evaluation to ensure it is not cancerous, that necessary follow-up no longer falls under the umbrella, as far as insurance companies are concerned, of “preventative screening,” and instead becomes an exam with a deductible, even though it is still preventative and screening for something that may or may not be there.
More concerning than the few tests insurance companies select to do and how they select to do them, though, are the dozens of preventative healthcare measures insurance companies do not invest in that would have a positive impact on the health of thousands.
For example, that same New York Times article notes that 40% of United States deaths annually are “the result of smoking, poor diet, lack of exercise or alcohol abuse.” Thankfully health insurance companies are already mandated to provide alcohol and tobacco misuse screenings, which helps address smoking and alcohol abuse, but why are insurance companies failing to invest in preventing some of the other causes of death, such as poor diet and lack of exercise?
While health insurance companies getting involved in things that initially appear to be life decisions may seem far-fetched, it is not really that out of the question. Insurance companies could invest in ensuring equal access to healthy food, including fresh fruits and vegetables, or in helping pay for the creation of more spaces to encourage exercise, such as public parks or gyms. These simple investments outside of a typical clinical setting could help combat poor diet and lack of exercise at a very low cost for insurance companies with a potentially very high reward, both profit-wise and health-wise.
There is so much discussion about synthetic
anti-aging products, but
too little about the ways in which health insurance companies are
failing to help us stay alive longer in natural ways, such as through
promoting better diet and exercise. Through investment in simple
preventative healthcare, even preventative healthcare outside of strict
clinical settings, health insurance companies can make a tremendous
impact on thousands of lives at little cost to themselves.
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