Why is our national health insurance extension program called COBRA? Are they really hoping to associate their service with a venomous snake? Or perhaps they wanted to evoke memories of GI Joe’s nemesis, a ruthless terrorist organization bent on world domination?
In each of the last 18 months I sent a check for $350 to COBRA, but no more! That’s about four thousand bucks a year for health expenses — quite a lot to pay for an annual checkup. Why so much? Because I was too lazy to look into it when I left my job, and assumed that the health care plan I had before was the “right” one for me. After all, I was working for a company with wonderfully good perks that really took care of its employees — surely the plan they gave me would be superior to anything I could negotiate as an individual customer. That was a costly mistake! By taking some time to look at the costs of various health plans, I was able to find a much better plan with a much lower rate.
Before continuing, I should pause for a moment to thank my parents for giving me healthy genes and a healthy upbringing, and cultivating healthy habits in me. Without these things which I was fortunate to receive, I could have been denied coverage based on a pre-existing condition which might otherwise exist in me. It’s difficult to say that everyone has an equal opportunity to be healthy, given the variation in these factors which are established very early in life. I’m lucky.
The new plan I chose costs less than half of my old plan, and the maximum out-of-pocket expense per year is LESS than the 12 monthly payments I made before. I was shocked to find this possible. I kept my same provider (Kaiser) and as far as I can tell, the coverage is comparable.
Enough about saving money. Something interesting happened while I was shopping around for my health plan. I found myself asking taking responsibility for the relationship between me and my health care provider. In the past I felt like a “health care passenger,” because my company decided what to offer and I went along for the ride. Now I was a “health care consumer” and I approached it as I would a major purchase like a car. I weighed the options and asked myself what I wanted from the provider and balanced that against the costs. In my case, I looked for a combination of low premiums and good coverage in the event of catastrophe.
In my new role as customer, I found my ideas about health plans changed. There is now a clear distinction in my experience of the two parts of a health plan:
- INSURANCE. In my mind I associate the monthly payments with coverage for catastrophe. It’s the entitlement part of the plan. I pay every month, therefore I get certain rights and privileges.
- HEALTHCARE. Instead of paying a trivial $5 or $10 per visit, I now expect to pay around $100 to $200 each time I go to the doctor. Paying at the same time as when I receive the care, this is much clearer to me. And paying more makes me feel like the services I receive are more valuable. It also makes me more demanding - for instance, I will be changing my primary care physician to find someone I can appreciate better.
I’d like to see that portion increase, because I think moving away from an entitlement relationship and towards a customer perspective would be appropriate. It feels good to know how much health care costs - a wise man once yelled, “and knowing is half the battle!”
