Design Your Own Health Care?

Politicians of all stripes are discussing it. Millions of Americans are losing sleep over it, particularly those who have lost their health plans in recent layoffs or workplace cutbacks. Every day we read more news about the state and debate of health care in this country. People are delaying recommended tests or important procedures – sometimes with dangerous and/or costly consequences. Because of rising costs, employers are less likely to offer health coverage. All the while, individual plans are out of reach for many working people. For those who find themselves unemployed, COBRA plans can likewise seem unaffordable.

And it isn’t just older Americans impacted by these trends, but also young adults. A recent poll conducted by Medco (pharmaceutical benefit manager – but still…) showed that more than 70% of those 25-34 reported having a harder time paying for health care, fewer than 50% of adults 55+ felt the same. According to research conducted by the Commonwealth Fund, a center for health care policy, young adults (19-29) make up approximately thirty percent of the nation’s uninsured population. (The trend has sparked the label “the young invincibles,” a blanket characterization to be sure. While some in this age group believe their youth renders insurance unnecessary, most go without because of financial limitations.) Still others in this younger age group (and, indeed, in all age groups) are happy in professions that don’t offer group health plans. Many attempt to make a go of it with cheaper “catastrophic” policies for major events and personal savings or health reimbursement accounts for the majority of their health care. The result for many is a very different, more individualized health network and care focus than those who rely on insurance “approved” providers and treatments.

For some with or without health insurance, the bad economy is encouraging a commitment to preventative care and/or an interest in cheaper, alternative treatments for existing health concerns. In the last quarter of 2008, “nationwide retail sales of vitamins and supplements totaled nearly $639 million, up almost 10 percent from the same period in 2007.” And though the bottom line in the family budget may influence this recent rise, the trend toward alternative measures has been growing for some time. A survey conducted by the National Center for Complementary and Alternative Medicine (NIH) and the National Center for Health Statistics (CDC) revealed that some 38% of American adults and 17% of children “use some form of complementary and alternative medicine.” (“Complementary and alternative” medicine for the survey included health related services and products as diverse as non-vitamin/mineral supplements, meditation, massage, chiropractic, naturopathy and acupuncture.)

With the economic upheaval and political focus, we thought it would be an opportune time to step back from how we view health care in this country and envision what we wish it could look like. While the country debates the broader issues of funding and plan structures, we thought we’d zero in on the individual experience.

Insurance, like our health care system in general, addresses health as an absence of symptoms. We wondered what true wellness-based health care – both programming/services and coverage – would look like. What would an annual physical be like? Would there be one? Would there be more than one? What kinds of follow up would exist? How could a health care system/cooperative effectively offer preventative care for the common physical and mental ailments of our society?

If we step outside the box of catastrophic events and serious illness, what can we imagine as true “wellness” care? Does the thought conjure a set of universal principles or perhaps a more individualized design? There’s been debate for years about coverage of “alternative” medical providers, practices and products. What do you think should be covered but isn’t? (On the flip side – a fair question, we think: what is covered that shouldn’t be?) What kinds of health education opportunities do you see as promising, cost-effective possibilities? What kinds of incentives and rebates could/should insurance companies offer to encourage good health in their customers?

Whether your vision focuses more on what could serve the larger common good or what would be an ideal customized plan for you/your family, the questions ultimately get us thinking about what we want from health care. When it comes to our health, for what do we as individuals take responsibility? When do we feel we need to work in partnership with medical/alternative experts and resources? Does our current system work with or against the vision you have for our own care?

We want to know what you think. Tell us your best and boldest ideas, ponderings, rants, raves and solutions.

Further Reading:

Deconstructing Healthcare in America – a Modest Proposal

The Importance of Second Opinions

The High-Tech, High-Risk State of Maternity Care

Should I Get a Flu Shot?

The Heart Scan Blog – Self-Directed Health: At Home Lab Testing

TAGS:  Big Pharma

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