Think about your health insurance for a moment. Would you be able to tell me exactly where your insurance ends and your actual healthcare begins? Believe it or not (and you may be a part of this group,) most Americans don’t really understand the difference between healthcare and health insurance. Most people would group them together and assume that it’s all part of one big package. Let’s take a look at why the two can be confusingly intertwined:
- Most National Initiatives Encourage Increased Coverage – We’re looking at you Affordable Care Act. When the healthcare conversation starts, it goes immediately to the amount of covered Americans and the affordability of the coverage. See what we did there? We aren’t talking about where people get care or how much they pay for care. We’re talking about how much we pay for coverage. Very different.
- Insurance Companies Have Contracts with Providers – This is called your “network” (even PPO) of doctors that you’re able to see on your plan. Sure, they aren’t owned by the provider (mostly), but they do work hand in hand. When thinking of your doctor, you’re forced to think about your insurance.
- 20% of Economic Spending goes to Healthcare – why does this matter? Because what the consumer sees is simply the point of sale, and it happens primarily at 2 intervals: 1 being your bill from your doctor, and 2 being your monthly paycheck deduction for health coverage (interesting take on that here).
- It’s not a True Insurance – Think about the things that you insure for yourself. Your car, your home. These are things that are covered in the unlikely event that they were to be destroyed in a fire. Your health insurance runs the gamut of your care. Each piece of the pie is covered (to some degree), leaving you with more of a payment plan.
With these thoughts in mind, it’s important to consider that without understanding the degree of separation that happens between health care and health coverage. I’m a huge proponent of turning people into educated healthcare consumers. This means shopping around for your healthcare like you would for any other commodity. In order to do this, especially on a large scale (say, larger than you and your significant other,) you have to make people understand that your healthcare is not your health insurance.
So if you’re reading this for yourself, just understand that your doctor and your insurance plan aren’t part of the same organization. If you’re reading this because you’re in charge of a company health plan – you should help your employees understand this differentiation. Ask them about their doctor, and who they work with, explain to them that their “network” is an arrangement with your insurance firm, and not a direct company affiliate.