Unassuredly insured

I'm not happy with my health insurance, or the state of medical care here in the United States. 2 weeks ago I received a confidential report from my health insurer, addressed to me in my old name. It listed both office visits and lab work completed over the last few years on the left side, and the right side contained bullets stating things like "Past testing has suggested that you suffer from diabetes" and then a couple more bulleted suggestions for further tests.

I was annoyed by this since it wasn't information from my doctor, and it suggested that I spend more money going to see my doctor for something that wasn't necessary. Was this a ploy for people to panic? Was it really meant to be preventive? I suspected that the insurance company caught wind of the adult, onset diabetes that runs in my family, and sent the stuff.

This week another confidential packet arrived in the mail, this time addressed to me under my correct name. It contained a form letter and a packet about my condition, including a survey to return. This condition I have? Diabetes.

That pissed me off. Ultimately, my place of work and I pay for this stuff being sent: glossy brochures, form letters, postage paid return envelopes. Do I want this unsolicited information? No. If I had time during the day I would call to share my feelings, but I do not. I feel strongly about my wish to opt out of health insurance altogether, which is impossible. I feel disappointed by the lack of coverage that I have, given the cost to both me and my employer. I could really live without it. Like everything, insurance of all kinds is a game of risk. I know that I am fortunate to have any insurance at all, but I'm disgusted by the growing divide between the haves and have nots.

I heard Arnold S. Relman on Maine Public Radio the other night. He was about to give a talk at the University of Southern Maine on his most recent book, A Second Opinion: Rescuing America's Healthcare. Relman is Professor Emeritus of Medicine and of Social Medicine at Harvard Medical School and a former editor of the New England Journal of Medicine. He's a smart man. He sees the current state of health care (both the care side and insurance side) as a capitalist venture. He once wrote a letter to the New York Review of Books in response to reviews of several books about the current health care crisis. His criticism of the reviewers is that...

...they make a surprising omission. They say the main source of high US costs "is probably the unique degree to which the US system relies on private rather than public health insurance." And so, they conclude that the way to fix the system is to "shift from private insurance to public insurance, and greater government involvement in the provision of health care." What they seem to ignore, however, is that over the past few decades the private health care delivery system, like the private insurance system, has been converted into a huge commercialized market which in many parts is heavily influenced—if not dominated—by competing investor-owned firms. The "monetarization" of health care (a term used by the late Eli Ginzberg) changed it from a largely not-for-profit, community-oriented social system into an industry, and this has affected the behavior of all providers—hospitals, doctors, and others.

I sat in my driveway listening to Relman, wishing I could drive down to Portland to hear more. This man gets it. I did the next best thing to hearing him, and ordered his book from the library. I can't speak as eloquently as Relman, but I can understand what he's saying.