It's Good—No…GREAT—To Have Good Quality Health Insurance

I recently heard about Senator McCain’s brain cancer and I am saddened by it. I am sure his family is focused on deciding whether to proceed with chemotherapy, radiation treatment, more surgery and whether to get treated at their local hospital or go to a ‘big specialty’ hospital, whether to seek out a nationally recognized cancer physician or whether to get treatment at all.

And if Senator McCain decides to undergo a combination of surgery, radiation and chemotherapy (a common approach for this type of cancer), the total costs will be between $450,000.00 and $700,000.00, according to The Brain Tumor Foundation.

What I’m also fairly certain of is that Senator McCain and his family are not spending time worrying about whether his insurance covers chemotherapy, radiation treatments, surgeries, physician fees, the hospital visits, medications, home care visits, the walkers, canes, etc. And I’m happy that is the case.

And I wish it was the case for all Americans. When a new diagnosis is given to a patient—especially one so devastating as brain cancer—it stops patients cold…as if the very air in the room has fallen out of the sky and there is not enough oxygen to breathe. Feeling overwhelmed by the uncertainly of dealing with the bad news and then having to come to terms with what it all means is truly too much for anyone to cope with in the moment. However the moment passes, patients and their families usually want to “forge ahead” with all treatment options (and who wouldn’t?). 

And then for so many patients, they ask the question, ‘Does my insurance cover this?’ or ‘I don’t have insurance, can I still get treated for my cancer? Will a cancer doctor treat me without insurance?’ And to those questions, we doctors and nurses can only respond one way: ‘I don’t know. You have to call your insurance company.’

I remember a patient who needed surgery because she was bleeding internally but because she was “down and out” and did not have insurance, we couldn’t find a surgeon to take the case and she eventually died in our ED.

Those of us “in the health care business” know that health care is no longer only about doctors making decisions and working with the patient to find the best treatment path. It’s about whether the patient has good insurance (not skimpy coverage) and whether the doctor accepts the insurance coverage plan (not all physicians accept all insurance coverage plans). It’s about which doctors are a part of what medical group and if that medical group has the rights to admit patients to a particular hospital. And it’s about if that hospital is well managed or cutting costs to make their budget. 

Keeping patients well or helping patients when they are sick is fairly straight forward for doctors and nurses….we might not always save lives but we try. We might not always have the best “bed side manners,” but we try.

However, how patients pay for these services has become very complicated.

It should be fairly straight forward since patients want the same thing: they want quality health care that is reasonably priced and which they can afford. They need access to doctors, nurses, pharmacists, physical therapists….(the list is long) and high quality, local hospitals. 

In times of sickness patients want to focus on getting well…not whether they can pay their bills. Whether we see ourselves as ‘patients,’ the fact is (real fact), we are all patients…some of us are ‘Patients-In-Waiting.’ But whether it happens today, tomorrow, next month or next year, every single one of us will become a patient, needing good quality health care delivered by supportive, experienced health care professionals. 

About the author: Recognized by LinkedIn as a "Top Voice" in Health Care in 2015 & 2106, author Julie Kliger is passionate about improving health care. She is a consultant, author and speaker. She specializes in healthcare quality, organizational change and improvement.