News

Our Opinion: A lack of faith in healthcare providers

3 min
November 30, 2022
 
 
Shelley Lyford
CEO, Chair & Trustee, Gary and Mary West Foundation
CEO & Chair, West Health Institute

All we want for Christmas is good health — and good healthcare — for everyone.

But to hear North Carolinians tell it, that goal is increasingly elusive.

Most North Carolinians don’t believe their health insurance provider has their best interest in mind, according to a Meredith College survey, the results of which were released earlier this month. They also believe their providers are a huge factor in rising healthcare costs, the Winston-Salem Journal’s Richard Craver reported.

Why would people think so?

Survey says: Because of the rise in monthly premium costs and out-of-pocket expenses — both factors determined by health insurance providers.

“Rising premium costs produce very high levels of dissatisfaction for consumers with almost half (48.3%) reporting being very dissatisfied,” according to the poll.

Of the respondents surveyed, only 8.3% felt their health insurer had their best interest in mind.

The others felt varying degrees of “they don’t care.”

About 23% of respondents said they had a procedure not covered by insurance, while 20% said they had a claim denied, and 16% had to go through unnecessary paperwork to get treatment.

Some received surprise bills following treatment; some “just gave up” appealing their bill because doing so was so complicated, the survey said.

These costs contribute directly to the fact that 20% of North Carolinians — one in five of us — carry medical debt on a regular basis. That puts a burden on families and on our state’s economy.

Some, we fear, may put off urgent and essential medical care for fear of increasing their debt. This is especially troublesome when it includes mental healthcare.

The poll respondents were customers of major insurers: About 44% of respondents reported being a Blue Cross Blue Shield of N.C. customer, while 17.6% were with United Healthcare, 10.3% with Aetna and 7.1% with Cigna.

It should be no surprise to anyone that these companies regularly report annual profits in the millions or even billions.

And yet healthcare costs keep rising — about 4.5% annually, according to the American Medical Association — more steeply in the U.S. than in other developed countries. This includes treatment and prescription options.

It’s not because we’re using more healthcare than anyone in any other nation; it’s because … well, it’s complicated, driven by market forces and political decisions, like our Republican-led legislature’s continued refusal to engage in the Medicaid expansion that has benefitted so many in other states.

Prices are driven even higher by the fact that some have access to comprehensive care while others have little or none.

“The way the system is structured now, it is a cure-driven system, not a prevention-driven system,” Yaseen Hayajneh, associate professor of health administration at Western Connecticut State University, told a CNBC reporter earlier this year.

Suggestions for improvement regularly range from allowing market forces to make healthcare services more competitive to increasing government intervention, through methods such as allowing Medicare to negotiate directly for prescription prices. There’s a considerable amount of evidence to suggest that such methods work.

It would seem practical to define what works elsewhere and do the same here — but that still calls for political will.

For all their lack of faith in their insurance providers, we suspect many have even less faith in government leaders to find solutions.

If there’s one area in American life where we’d like to see voters “rise up” and “take it back,” it’s in the field of healthcare coverage, where people should definitely come before profits. Until there’s enough citizen demand to influence political will, we’ll be at the mercy of the dollar.

As Shelley Lyford, president and CEO of the Gary and Mary West Foundation and West Health, said, “Healthcare is about life and death. It cannot be about politics or greed. It is time for us to push politics aside and advance smart policy, not because it is Democratic or Republican but because it is the right thing to do.”

READ FULL ARTICLE ON NEWS & RECORD