Health Insurance Guide - Samaritan Health Insurance Section

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TITLE: Health Insurance: The-More-The-Better, Or No-
More-HMO?
AUTHOR: Irina
LENGTH: 571 words
FORMAT: 58 characters per line
CONTACT: irbonness@ureach.com
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Health Insurance: The-More-The-Better, Or No-More-HMO?

By Irina

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The author grants permission to publish this article, in
its entirety, electronically or in print, as long as the
bylines are included. Other articles by Irina are available
from http://www.megaone.com/hbb/savemoney/articles.html
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In the movie "John Q," Academy award winner Denzel
Washington fights the HMO restrictions to provide the
necessary cure for his dying son. When such a lackluster
topic like health insurance generates enough drama for a
Hollywood movie, you know that something must be seriously
wrong...

The problem indeed is severe. Almost 45 million Americans
are uninsured and the number continues to rise. Those
still insured are frustrated by the double-digit premium
increases outpacing all other sectors of the economy. High
costs and HMO limitations discourage seeking an immediate
medical help. As a result, "little aches" often develop
into the life-threatening illnesses and financial
disasters for some unfortunate individuals and further
escalate already intolerably high health care costs for
the rest of us.

To endure the existing health care crisis, we all must
recognize one simple fact. There are TWO DIFFERENT LEVELS
of health care needs that must be covered with two
separate tiers of payment. One level is catastrophic
illness - and for that, insurance may still be the answer.
Policies that carry a high deductible (say $5,000 a year)
are relatively inexpensive, even when the coverage is very
high ($1 million or more) or unlimited. That is because
most people do not get catastrophic illnesses or injuries.

In fact, most of us only need health maintenance and
routine medical procedures that comprise a totally
different level of health care needs. For these, the
present INSURANCE-based model is not the answer because it
is financially incompatible with any efficient HEALTH CARE
system.

Everyone knows that the INSURANCE works best when the
fewest number of participants actually use it (i.e. make
claims). Then the system generates profit, which lowers
the premium that, in turn, brings more paying
participants. The participants are happy NOT TO USE the
insurance, especially if it does not cost them too much.
On the contrary, the HEALTH CARE system works best when
the most people use it (i.e. get teeth cleaning, checkups
and vaccinations).

Fortunately, back in the 1980s, the idea of so-called
patient advocacy via health care savings programs was
introduced to the U.S. These programs negotiate prices
with health care providers on behalf of their members.
Since they represent large groups, the resulting discounts
are usually the same that the hospitals and physicians
give to big insurance companies.

This innovative approach benefits medical providers
because they get paid "on the spot" without enormous
paperwork and disputes with insurance companies. It also
benefits you and me by providing an access to the
discounted "insurance rates" without high premiums.

Many of such programs also allow their members to
contribute money to medical savings accounts that are tax
deductible or not taxable. Monthly membership fee is
affordable and no one can be turned down because of a pre-
existing condition.

It does not look like the current health care crisis is
going to have a Hollywood-style "happy ending". It's up to
us to analyze the situation and find the solution...
otherwise, the next blockbuster about healthcare may well
be a horror movie.

(C) by Irina 2003.

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About the Author:
Irina helps people save money on healthcare and create
steady stream of residual income working from home
http://www.megaone.com/hbb/savemoney/
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About the Author

Irina helps people save money on healthcare and create
steady stream of residual income working from home
http://www.megaone.com/hbb/savemoney/