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How to keep
the doctor’s bill away!
Lack
of primary medical care by the government has helped the medical
insurance industry become one of the largest and fastest growing
sectors in the US, says Mohan Babu
Most
of us have probably heard the popular adage that goes...”A
healthy mind resides in a healthy body”. All of us work hard
towards maintaining a balance between a healthy physique and
busy lifestyle. It is of paramount importance to continue
to maintain good health, especially if one lives and works
in a foreign country.
The
western lifestyle, although relatively free of pollutants,
dust and common infections, still has its share of diseases
and health related problems. Of course, there is the risk
of accidents to which we are all susceptible. Many of us who
leave India in our twenties and thirties, come abroad to live
and work do not think twice about these matters but we probably
should. We are blissfully unaware of the necessity or importance
of having access to assured medical care.
United
States has some of the most advanced medical research, diagnostic
and treatment facilities that can be found anywhere in the
world. Many a Hindi film has portrayed scenes of wealthy Indians
coming to the US for advanced treatment and people from around
the world come here for research, medical studies and treatment.
However, all the medical systems, treatment and access to
it, come at a price which is not normally affordable to all
but the extremely wealthy. Even the federal government that
collects a percentage of salaries and wages towards ‘medicare’
(retirement medical care) has all but absolved itself of the
responsibility of medical care for its citizens and residents.
I
do not mean to imply there are no laws in place to force hospitals
and medical care providers to provide basic care to everyone
in the US. On the contrary, there are laws that ensure that
everyone, regardless of their ability to pay, is guaranteed
emergency care. The ubiquitous ‘911 system’ ensures that anyone
in the US who picks up a phone and dials 911 can call for
police, fire or medical help that will arrive within a few
minutes.
However,
for non-emergency medical care, one has to pay through their
nose. Even a simple doctor’s visit can run up a few hundred
dollars if not more. What then is the recourse available to
us, the ordinary working professionals who might meet with
an unforeseen accident, illness or medical condition that
might set us back by thousands of dollars? The answer is medical
insurance.
The lack of primary medical care by the government has helped
the medical insurance industry become one of the largest and
fastest sectors in the US. There are more than a dozen multinationals
and hundreds of small insurance companies that provide insurance
ranging from individual plans to group and corporate medical
plans.
It
would be an understatement to say that medical insurance is
almost mandatory for everyone coming to the US. This applies
even to visitors who may be spending only a few months with
their relatives here. Employers lure employees with the bait
of good medical benefits. Case in point: During the dotcom
revolution, when employees were bending over their backs to
entice prospective employees, a Silicon Valley firm was offering
a ‘BMW Z3 roadster’ as a sign-on bonus. Employees were also
given an option of full medical/dental coverage for 10 years
in lieu of the roadster. Guess what most employees opted for?
The insurance package of course!
Why
is it that insurance is given such importance in the US society?
There are many reasons. Medical expenses are extremely high
and not subsidised by the government. Another reason is that
in a land of lawsuits, no one, not even doctors and medical
professionals are immune. In order to protect themselves from
frivolous lawsuits, doctors and medical professionals refrain
from diagnosing all but the most common afflictions and make
the patient undergo a slew of tests before any recommendation
can be made. This over-diagnosing costs money.
A
couple of years ago, the morning after I played a game of
hectic racquet-ball, my back just snapped. Actually I had
just pulled a muscle and not wanting to take any chances,
my friend called an ambulance and rushed me to the ER - Emergency
Room. The doctors there knew right-away that it was a muscle
pull, but not wanting to take any chances, ordered an array
of tests and X-rays of my back from different angles. After
looking at the results they shrugged their shoulder, gave
me a painkiller shot and a few aspirins. The bill — a whopping
three thousand dollars.
Not
all insurance packages provided by employers are the same.
Some employers provide complete coverage without any charge
or co-pay. Others expect the employee to chip in a fixed amount
every month towards the insurance. Even the coverage is highly
subjective and varies from (insurance) provider to provider.
Many insurance companies try to scuttle huge bills that people
run up, leaving them high and dry. Incidentally one of President
Bush’s biggest political victories in recent times was the
passage of “Patient’s Bill of Rights” that allows individuals
to sue their medical care providers. It is hoped that this
will bring much needed accountability into the system.
It
is heartening to note that most large Indian software houses
provide adequate insurance coverage to their consultants and
employees before sending them to the US. However, some of
the smaller houses and body-shoppers try to cut corners by
luring prospective employees with a pay package alone. Medical
benefits are not talked about, leaving the employees in a
big financial mess if the unforeseen medical problem arises.
Most American companies provide medical coverage for employees
for a month after they quit their job or are laid-off. They
also allow the ex-employees to ‘purchase’ insurance from the
group plan.
In
the US, expenses related to medical contingencies cannot be
prevented but adequate insurance can at least help offset
the unforeseen.
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