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A Call for Better Health Insurance

by | Jul 2, 2014 | Brain Health, Healthcare | 0 comments

Health Insurance

a call for better health insuranceSince January, there has been a major change in health insurance. There was once a $200-$500 deductible, and now there is a $2000-$5000 deductible. Premiums have risen, and with the economy most individuals can’t afford this deductible.  Therefore, it has become a double edged sword.

Today’s Health Insurance Realities

There are several mothers I’ve spoken with on the phone who want services for their children who are dealing with issues such as anxiety, ADD, ADHD, and symptoms related to concussion.  In one situation, the child clearly had a concussion and was taken to the Emergency Department.   The health insurance expenses then had to be paid out of pocket because they had not met the family deductible.

It was recommended to the family to have neuropsychological testing, however, since they have not met their family deductible they could not afford to pay. The child could not receive medical or psychological, let alone neuropsychological services until this deductible was met. Yet, the father is out of work, the mother is working three jobs and they have a choice to put the services on their credit card, which is maxed out.

This story is now the norm. Meanwhile, the insurance companies are making a clear profit and many of the CEO’s last year were given bonuses in the millions. Something is clearly wrong.

A Viable Alternative Health Insurance Plan

In 1996 during the Clinton Administration, there was a request for ideas for healthcare.  Meanwhile, the Commonwealth of Massachusetts was looking at similar proposals. This is when I wrote a Healthcare Proposal, which I still believe is better than anything that is out there today. The basis of this proposal surrounds the idea of individuals taking responsibility over their lives, not a CEO of an insurance company deciding how and where we can receive healthcare services. I do believe that the government and insurance companies need to assure that a provider or faculty meets specific standards, just as it does at a restaurant, to protect public health safety.   However, neither the government nor an insurance company should dictate where you buy your coffee or where you eat fast food. This is not the case with our healthcare, and this is including the wounded warriors in the military who served our country so bravely. They had no choice of where they could go, and many of them have had to wait months to get medical services. Some, even died while waiting for medical treatment, as reported in recent news. Since then, an official report and review by the government has taken place. Why couldn’t these brave individuals have been allowed to be seen by any doctors?

Under my proposal each person and/or family would be given a specific amount of money for preventative, acute, chronic, and catastrophic illness. Emphasis would be on preventative care, and bonus money and/or privileges or perks would be an incentive to stay healthy. All providers and facilities must be licensed and fall under specific guidelines. You would have freedom to choose your provider and the type of care you feel is best for you and on your quality of care.  The provider would be reimbursed based on experience, education, longevity and quality of care based on patient reviews.  Therefore, if you feel that taking medication is best, and/or you feel a combination of medication, acupuncture and neurofeedback is better, all the services would be covered.  Currently, you have no choice in your services or your provider.  The insurance company dictates what services they will or will not cover and how long you can see the providers, along with what doctors or providers you can see.

America was and is based on freedom…..freedom of speech, to travel, to choose what lawyer we want and where to go eat.  However, when it comes to health care, we have very little choice, unless you have unlimited money and can afford such services. No one should be denied the health care they need.

As a provider, I have had to refuse many of the services my integrative team provides because someone at a health insurance company has decided that those services are not covered, or because the increase of the deductible is so huge, the average person can’t cover them.

I hope in the near future our legislature, policy makers, and insurance companies will hear our cry for help for better health care and insurance coverage.

CONTACT DR. DIANE®

Dr. Diane® Roberts Stoler, Ed.D.
7 Hodges Street
N. Andover, MA 01845
Phone: (800) 500-9971
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Dr. Diane is a catalyst for change

Image Credit Elaine Boucher

Within each person shines an inner light that illuminates our path and is the source of hope. Illness, trauma, suffering and grief can diminish the light and shroud hope. I am a catalyst for hope and change, offering a way to rekindle this inner light.

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