A recent story on NPR about why cardiac rehab is underutilized brings up some of the nuances of our broken healthcare system. One of the reasons identified in the report for patients not using cardiac rehab is because of the ‘co-payments’ charged by insurance. Copayments are charges that the patient must pay to the provider at the time of treatment, even if the treatment is fully covered by insurance. These charges “can be $20, $40 — or even $50 a class.” For many patients these costs are prohibitive and many might not feel that the benefit is worth the cost. The patient is thus forced to make an uninformed medical judgement that might adversely affect his or her life.
Despite an effort by those framing the Affordable Care Act to eliminate such dilemmas, our healthcare system is full of similar examples of nickel-and-dime annoyances. These include the practice of having large-and constantly growing- ‘deductibles’ (required out of pocket payments before insurance kicks in), even for therapies that can save a patient’s life. This practice is becoming most noticeable in private insurance plans bought through the healthcare exchanges, where there is pressure on the insurers to offer cheaper plans. These cheaper plans often have such a high deductible that the patient might pay most of his or her routine medical care out of pocket. This in turn defeats the effort of the ACA to not charge copayments for preventative services.
Another way our system nickel-and-dimes us to death is by constructing bureaucratic hurdles for patients who need life saving and preventative services. Insurance companies have set up a bureaucratic infrastructure that would make Kafka proud. Although they claim these hurdles are necessary to lower costs, their real reason is to increase profits. They rarely improve patient care.
There are many more examples of nickel-and-diming the consumers in our healthcare systems, including the practice of charging the patient more if he or she sees a doctor or visits a hospital that is “out of network” or if the patient did not get the proper “referral” for such a visit.
EMBRACE eliminates all of these nickel-and-dime annoyances. In fact, it is constructed so that all preventative and life saving services almost never involve insurance. There is no charge and no copayment. There are no deductibles or physician/hospital networks. It is a system truly designed to deliver the optimal patient-friendly healthcare with the minimal bother.
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