Why We Really Need Healthcare Reform
SOURCE: LA Times ~ January 31, 2010
By David Lazarus
As the prospects for meaningful healthcare reform grow murkier by the day, it’s helpful to remember why we started this discussion in the first place. It wasn’t so we could socialize the U.S. healthcare system, and it wasn’t so we could create death panels, or make it easier for insurance and drug companies to practice their trades.
It was so we could help people like Hollywood resident Lisa France, 42, who does her best to stay healthy. She exercises regularly, does yoga, does Pilates. She has no medical problems to speak of and no preexisting conditions.
But when France recently applied for individual coverage offered by Anthem Blue Cross, she received a letter saying that her monthly premium would be 25% higher than expected because she sees a chiropractor from time to time.
“It’s crazy,” she told me. “I go to the chiropractor maybe once every four or five months, just for maintenance. If you’ve been working out a lot, you can always use a little adjustment. Then you feel awesome.”
That’s not how Anthem sees it.
Jerry Slowey, a spokesman for the insurer, said applicants for individual coverage are judged on “underlying medical conditions and their current treatment for those conditions, including any services such as chiropractic care.”
Because France disclosed during the application process that she’d seen a chiropractor in early December, she was told she must pay about $141 a month for health insurance (including a whopping $1,000 deductible) instead of Anthem’s originally offered $113.
“I guess it would have been better if I’d lied and didn’t mention the chiropractor,” she said. “I feel like I’m being punished for telling the truth, even though I’m completely healthy.”
That’s a dangerous game, and I’d advise people not to play it. If an insurer finds something — anything — that you didn’t disclose upfront, it could drop your coverage when you need it most.
Unfortunately, that means you have to lay it all on the table, including seemingly benign things like occasionally seeing a chiropractor to work out the kinks from exercise. And in Anthem’s case, that can be an invitation to jack up your rates.
France said a service rep for the insurer explained that chiropractic treatment is riskier, and that’s why her premiums would be higher.
Anthem’s Slowey declined to elaborate on the company’s policy regarding the perceived risks of chiropractic care. But he said higher premiums are typically based on underlying medical conditions, not the treatment that people receive.
I pointed out that the letter France received didn’t mention an underlying medical condition. It said only that her premium was going up because of a “chiropractic adjustment” in December.
“That may not be the most appropriate way for us to inform a member about an underlying medical condition,” Slowey acknowledged.
Kassie Donoghue, a Sacramento chiropractor and vice president of the California Chiropractic Assn., said it’s nuts for an insurance company to see chiropractic care as representing an increased or costlier risk to patients.
“Every healthcare treatment has some risks,” she said. “Prescription drugs have risks. Surgery has risks. But studies show that the risk of chiropractic treatment tends to be very, very low.”
Donoghue said she was amazed that any insurer would boost a person’s rates by 25% just because he or she visited a chiropractor. “I’m frankly shocked that anyone could have this for a policy,” she said.
Apparently someone at Anthem came to the same conclusion.
A day after I started looking into the matter, France said she received a call from a company representative. “He told me they had decided to lower my premium back to $113,” she said.
Did he say why? “No. No explanation. He just said they had reevaluated my situation. That’s all.”
Like I say, there’s a reason we’re talking about healthcare reform.
This is why.
When you call a company and ask about the lowest price for a product — that shouldn’t be so hard, right?
Encinitas, Calif., resident Carol McIver recently called AT&T to find out the cheapest plan available for the company’s U-verse TV service. She told me she was offered the U-family plan for $49 a month.
As it happens, McIver had looked online and saw another plan, U-basic, for just $19 monthly. What about that one?
“That was available,” McIver told me. “But the woman I spoke with said I had to specifically ask about it in order to get it. That was AT&T’s policy.”
I called AT&T and followed McIver’s footsteps. I asked for the lowest-price U-verse plan. The rep said I could go for either the U100 or the U-family plan, both now priced at $54.
“That’s it?” I asked.
“What about U-basic?”
I could hear the rep shuffling some papers. Yes, he said, I could have U-basic for $19 monthly.
“Why didn’t you tell me about that in the first place?”
“You have to ask for it,” the rep answered. “I can’t proactively give it to you. That’s our policy.”
I put this to John Britton, an AT&T spokesman. How could the company have a policy of not telling customers about their most economical option?
Britton replied a day later that my question “made us aware of some confusion, and we have taken action to correct it.”
Glad to help.
David Lazarus’ column runs Wednesdays and Sundays. Send your tips or feedback to email@example.com.
Thanks to the LA Times (1-31-2010) for access to this article!