A human right to health care means more than a guarantee of an insurance card in your pocket. It means that you have access to quality, comprehensive health care, because being healthy is as fundamental to fulfilling our full human potential as are food, clothing, and shelter. An insurance card in every American’s pocket is a start, but not much of one if that card only leads to unaffordable and unexpected bills, or bueracratic nightmares. Unfortunately, the status quo Americans currently face within the private insurance market is too much of the unaffordable, unexpected, and bueracratic, as the Wall Street Journal recently reported:
Company health plans increasingly are offering to pay the full cost of preventive services such as physicals, colonoscopies and mammograms to help employees stay healthy. But some patients then find they owe money for such screenings, sometimes hundreds or thousands of dollars, because their insurers didn’t consider certain procedures preventive. When the mix-ups stem from simple billing errors, consumers may be able to get them corrected quickly. But sometimes patients are stuck with unexpected bills, or have to wage a protracted battle to get them reversed.[…]
This type of billing problem is tied to the system of codes that doctors use in the claims they send to insurers. Every service performed by a physician is translated into a code. So is the patient’s diagnosis. Based on those codes, insurers automatically send out payments and generate explanations of benefits for consumers. Health-care providers must choose from among thousands of separate codes, which are developed by medical groups and government agencies. Patients get socked with unforeseen bills when their doctors’ offices don’t use the specific codes that their insurers classify as preventive.[…]
Insurers say they can review the order of codes on a claim, and may be able to reclassify the payment. But they can’t add or remove codes. "We’ll actually advise the individual to go back to the doctor’s office" if there appears to be an error, says Ingrid Lindberg, customer experience officer at Cigna Corp.
Quality health care that lives up to our human right means comprehensive health care that offers everyone the services they need, including all preventative care, screening, treatments, therapies, and drugs needed to protect our health, and the reproductive services, mental health and substance abuse treatment central to healthy communities. But it also means that Americans shouldn’t have to fight through bueracratic red tape in order to access those rights, especially when it comes to preventative care. Any health care reform that includes private insurance plan options must ensure that Americans who go to their doctor to prevent future illnesses don’t all end up with unnecessary headaches.
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