[BACK]
Remember the Edsel, that great lollapalooza of a Ford that the
Ford Motor Company told us was the greatest thing since canned
beer? You know, it was big, mammoth really, with a grille that
resembled a pushed in snout. The Madison Avenue types spent millions
persuading Americans that the Edsel would revolutionize American
driving habits. They cited dozens of facts and figures to back
up the enormous investment decision they had made. But we all
know how that story turned out: Americans knew, just knew in their
guts that the Edsel as a dog, a non-starter, a loser.
Managed care companies might have hired those same Madison Avenue pundits, or maybe their Harvard MBA nephews. We've heard all about how they will assure Americans of quality healthcare at a reasonable price. The rest of Americans, and Montanans in particular are wise to that story though. It's just no sale. We've all heard the horror stories about managed care. While the insurers claim that consumers like managed care, they neglect to mention that the people whose opinions they cite are by and large pretty healthy. After all, I don't complain about my car insurance coverage if I haven't had to use it for years. But what about satisfaction with managed care? Some impressive studies have been completed and their results were chilling.
The Kaiser Family Foundation and the Harvard School of Public Health recently did a survey on the effects of managed care. While it is clear that the public is suspicious of managed care, health care professionals, doctors and nurses overwhelmingly believe that "health plans are more concerned about saving money than what's the best treatment" for a patient. 58% of patients were at least somewhat worried that the statement was true, but 85% of doctors and 89% of nurses, who treat sick people every day worried that the managed care companies held their bottom lines more important than the care of their patients. But even the public, the vast majority of them healthy don't have faith that their managed care companies will do the right thing once they get sick.
Bearing the Kaiser-Harvard study in mind, consider this. An ever-increasing percentage of Montanans is deciding that heath insurance just isn't worth it. Make no mistake, many Montanans lack health insurance because they just can't afford it. That is certainly true, but now there is another facet to the problem. For some, health insurance is free or nearly so, and people are staying away in droves. Here is a classic example.
Aimed at catching those who are the most vulnerable amongst us, the children, The Congress passed the Children's Health Insurance Program in 1997. It authorized $39 billion to cover 10 million uninsured children, but so far fewer than 2 million have signed up. Since the coverage cost them virtually nothing why are parents not beating down the doors to enroll their children. Do they know something that we don't?
Have the horror stories on the six o clock news persuaded them,
rightly or wrongly, that managed care the self-proclaimed panacea,
is a crock? With one insurance company in Montana dwarfing everyone
else and the behemoth herding everyone into managed care with
it cut rate reimbursements, precertification hassles and legalistic
mumbo jumbo, are Montanans and all Americans saying Thanks but
no thanks to the whole notion of health insurance. Despite the
self-congratulatory pats on the back by the big insurers here,
the truth seems to be that Montanans by the thousands cut through
the hype and say no to managed care and the companies that tell
us that it's good medicine. I look for the day when a managed
care contract will be as outlandish as an Edsel on Highway 93
or Tenth Avenue South. With luck it won't be long.