Healthcare Sins aren’t unique to any one person or entity. We all commit them. Individuals commit them. Healthcare providers commit them. Corporations commit them. Yes, we are all guilty of actions that separate not only ourselves but our neighbors from the highest value healthcare we could experience.
One of the biggest Healthcare Sins we commit on an individual level is being complicit in the waste and overutilization that is pushed upon us in our current healthcare system. And while this action often goes completely unnoticed, we must all strive to become an active disrupter to the norms that often rob the financial and time resources from ourselves and our neighbors. We must actively seek a better healthcare future and become the redeemers if not for ourselves, then for our family and community.
My family has had a big year of healthcare experiences.
Nothing hopeless or terminal, just expensive, time-consuming and emotionally draining. Being sick isn’t the healthcare sin, it’s part of our life journey. Where things went wrong was that moment as the caregiver that I was a mute bystander while watching at least 2, if not 3 needless tests being performed.
How do I know these are useless? Because the same tests were run 24 hours prior with all good results leading to a full clearance for surgery. These tests were however at 2 different facilities. On Wednesday, June 13th, I watched a family member receive an EKG, blood draw, and X-rays. By itself, this would have been totally normal, except they weren’t needed. Let me repeat, these procedures were just done 24 hours earlier. We both uttered that those test results were available if they would make a phone call, but honestly, we weren’t interested enough in being a disruptor to the system to demand that phone call is made.
Once removed from that office visit and I had a chance to reflect, that EKG test really irritated me and in turn, my mute objections became more shameful. The more I reflected on that interaction, it was clear that the clinic performed test for the sole purpose of stacking the billable charges and not seeking a cure.
After checking with my wife to make sure I wasn’t crazy or creating an alternate history, I can clearly vouch for the fact that the patient spoke up 3 to the fact we just had an EKG and they should just get a copy from our primary care doctor’s office. We both felt like they chose not to hear us speaking, like we were uttering gibberish. And we both admitted that because we had met our insurance deductible and were at 100% coverage we didn’t fight hard.
Damn the repercussions
Both of us we really wanted to just get better, healthier and back to normal. Damn the repercussions on our neighbors and employers in our community and damn the pittance of complicit waste we participated in. When you aren’t well, it’s overwhelmingly hard not to commit a healthcare sin. Hell, it’s like you need to send the providers office an advance directive to perform no test unless absolutely necessary.
It is extremely hard to put on that tough game-face and play the role of the disruptor when you are in the personal crosshairs of illness and recovery. When you don’t feel well, when you aren’t at your fullest and most vibrant mental and emotional capacity it is easy to lose sight of how vital our own individual role is to be part of the solution for the greater good of society. Bucking the system for the greater good is often at odds of receiving immediate care desired to heal yourself or your family,
When wanting to heal fast and recover, you are willing to speak softly and not buck the system. When in the crosshairs of illness and recovery, it’s easier to surrender than consider our community impact.
But isn’t this a faceless and victimless waste?
I mean, if the faceless behemoth insurance company doesn’t care about their money, why should I?
Paying more for healthcare services begets paying more for healthcare related insurance.
Most of America gets their health insurance through private/corporate health plans regardless of whether they are self-insured, quasi self-insured or fully insured.
Self-Insured plans understand well that paying more for healthcare has a truly direct impact on health insurance costs. As a matter of fact, the most inspiring health plans are those when an employer or executive team takes an intimate level of interest and they personally engage to fight fraud, waste and poor-quality care on behalf of their employees. They get it, healthcare sins are bad for their community. They live out their community responsibility in their culture.
Employers in a hybrid self-insured/stop loss insurance arrangement do a slightly worse job participating in a driving a better plan outcome. For those groups, it often isn’t apparent to the employee workforce how powerful of a role they play, as often they have no idea their company’s health plan costs and their wages have yin and yang type relationship. And for these groups, there is nothing holding them back from their full potential other than that culture shift to employee empowerment in their healthcare decisions.
And then there are the vast amounts of fully insured plans. Those where we trust then big brand name giants to have our company’s and personal best interests to keep health care sins at bay. We trust their oversight and negotiating power through their large pooling of groups to spread the risk of expensive healthcare. And that trust has been a miscalculation by many accounts as we see those players owning bits, chunks and whole portions of the clinical side that is incentivized to drive revenue by service volume or to maximize value-based reimbursement incentives. We outsourced our communities to giant faceless corporations that answer only to investors in these plans.
And we come back to my family’s role of denying the greater good in a moment of weakness.
We were complicit in higher and unnecessary costs of healthcare. Our employees, our neighbors, our city-league softball teammates, business owners in our local civic organizations, friends at the chamber of commerce, you know–our community. This small act contributes to the burdens of unnecessary higher health insurance rates because we participated in a healthcare sin. An act which didn’t benefit our health, our company’s financials or our community.
Yes, it wasn’t the biggest of the Healthcare Sins on June 13th. But we were complicit.
We must not be complicit, and we must find a reason to remember the costs to ourselves, our coworkers, our friends, and our community.
To redeem our health plans, to redeem our community, No more #HealthcareSins.
About the author: An avid learner and resourceful leader with a passion for problem solving, Bret is a calming force in the chaos and fast paced evolution of health insurance, employee benefits, and the growing burden of regulatory compliance. He helps people develop the confidence to see beyond the problem at hand and start to re-imagine their goals. Whether he’s helping a client or a colleague, Bret believes a successful interaction is one that allows us all to dream a little bigger when we’re done.
About AG Insurance: AG Insurance (www.agiainc.com) helps employers and their employees with solutions focused on positive organizational impact and improved employee experiences.