Big brother medicine

[Smallsteps]

So Our plan through DH work was easy to fill out all the paperwork cards came in a timely fashion that was an improvement over some, but Today we both got letters in which they wrote a specific list of medical tests they would like us to take and then let them know we did this. Not a random list of these are usually done at this age or that but looked like a diagnostic printout you might get on your car.
I find this creepy that some ( I certainly Hope) medically trained person looks over our records and decides we need to get tests. I realize preemptive care is important but I do not need BIG brother telling me to get this test or that and find it an over-reach.

[kork13]

DisneySteve will likely chime in, but personally I'm quite happy that I get those recommendations. Some are based on age (like the dreaded prostate exams), or time since the last time you had it done (bloodwork), or sometimes based on your personal medical history (positive TB/PPD test means a chest X-ray every 5 or 10 years). Frankly, I don't pay attention to it, so knowing that my/a/some doctor checks on the currency of that stuff on a preventative basis is a relief to me.

Besides, most people never get the regular checkups that they should. If someone doesn't look at your records periodically to see if you're due for something, when else will it be caught? Stories abound, but serious medical problems are frequently caught early by this kind of preventative medicine.

[disneysteve]

I find this creepy that some ( I certainly Hope) medically trained person looks over our records and decides we need to get tests. I realize preemptive care is important but I do not need BIG brother telling me to get this test or that and find it an over-reach.

DisneySteve will likely chime in, but personally I'm quite happy that I get those recommendations. Some are based on age (like the dreaded prostate exams), or time since the last time you had it done (bloodwork), or sometimes based on your personal medical history (positive TB/PPD test means a chest X-ray every 5 or 10 years). Frankly, I don't pay attention to it, so knowing that my/a/some doctor checks on the currency of that stuff on a preventative basis is a relief to me.

Besides, most people never get the regular checkups that they should. If someone doesn't look at your records periodically to see if you're due for something, when else will it be caught?

So you recognize the importance of preventative care but are upset that someone involved in your care is sending you a reminder about things you are due for.

I agree 100% with what kork posted. Most patients don't keep track of when they last had a tetanus shot or a blood sugar screening or a mammogram or whatever. And most don't even know what they are supposed to have or when. I fail to see the problem with getting a personalized letter as you describe spelling out the things that are recommended for you. As a physician, I see that as a good thing. It's the health care system being proactive rather than reactive.

I wonder if you would have been equally bothered had that letter come from your family doctor instead of your insurance company. If so, why is that any different?

[Smallsteps]

perhaps it was the wording or the fact I have not had one thing to do with this company before that bothers me.
It was not a small reminder like my dentist reminding me of cleaning even personal doctor would be ok because it comes off as friendly.
This was not even "we noticed you are over due for xyz test" but more of a directive that
"THIS MUST be done ASAP and they are waiting for RESPONSE" not the same AT ALL and quite frankly was rude.

[disneysteve]

more of a directive that
"THIS MUST be done ASAP and they are waiting for RESPONSE" not the same AT ALL and quite frankly was rude.

Ah. That's a different issue. Sure, if it was presented in that manner, it sounds like it could be handled a lot better. It's not so much the content but the delivery.

[creditcardfree]

And some people have done their research about certain procedures and know that standard of care can be more harmful to their health, so they don't need a secondary party directing them for X procedure. Health care is currently a for profit business. But if I got that letter and it wasn't something that interested me for my own health I would ignore. Health care can suggest and explain, but it is always with in our right to deny or consent to any medical procedure, regardless of the reason why.

[Smallsteps]

Disneysteve this was way over the line.
Not a proactive partnership with health in mind. I have had friendlier letters from the IRS. I really do NOT think that makes a great first impression as this company is new to even offering insurance in my state. As I become eligible for insurance through my new job I will be HAPPY to get off this overbearing plan.
It is my choice what tests I will take... suggestion is ok / DEMANDS are NOT.
I wonder if it is just a harsh person with NO understanding of how that would be taken.

[TexasHusker]

Your complaints/expectations underscore the fundamental problem with health insurance today: It isn't health insurance; it's welfare. We have created this expectation - if not outright demand - in our culture.

In any true insurance relationship, there is an underwriter (risk taker) of whatever the object of insurance is, whether it is a boat, a house, or a car. In order to establish a fair "premium" in exchange for assuming the risk of the object, the risk taker (insurance company) must be able to fairly judge the element of risk by analyzing the object (actuarial analysis). If an insurance company is going to take the risk of insuring a house, they will want to know the age of the house, the condition of the roof, etc., as part of their underwriting process. That is only fair.

In regard to health insurance, it really shouldn't have gotten to the point of "health" insurance; it should have remained "medical insurance." An insurance company cannot adequately take on the risk to keep you healthy. Yet that is what our government has demanded of insurers in recent years, which is a big part of why the costs have spiraled out of control.

We want a blanket of insurance around us and our health with zero accountability or "checks and balances", and we want it for a $30 copay. That's not insurance; that's welfare.

Let's look at homeowners insurance: What if the government mandated that all homes have to be insured for appliances, windows, roofs, plumbing, electrical, mechanical --- regardless of the current condition of the house, regardless of whether anything is in working order. And for a lot of repairs - windows, toilet stoppages, etc., a $30 copay was the law.

What do you think your homeowners insurance would then cost? Again, that wouldn't be insurance, that would be welfare. Yet this is what we now demand of insurance companies for our "health", which is why few insurers are even in the business of medical insurance any more.

Back to your question: Your DH's self insured company is trying to be responsible and identify and mitigate risk, so that they can offer this benefit to everyone while keeping a healthy bottom line so that they can continue making product and keeping folks employed. That is not only their right, but it is their responsibility.

Sounds very "healthy" to me.

[disneysteve]

they wrote a specific list of medical tests they would like us to take

a directive that
"THIS MUST be done ASAP"

suggestion is ok / DEMANDS are NOT.

Your initial post was worded very differently than your later posts. What you said first sounded perfectly reasonable. What you said later not so much. I'd love to see the actual letter to see how it was presented.

[disneysteve]

Health care can suggest and explain, but it is always with in our right to deny or consent to any medical procedure, regardless of the reason why.

Certainly, but that is a separate issue than what this thread is about. OP is just talking about getting a letter with those recommendations, which is perfectly normal and appropriate, though it sounds like it might have been worded poorly.

[disneysteve]

Back to your question: Your DH's self insured company is trying to be responsible and identify and mitigate risk, so that they can offer this benefit to everyone while keeping a healthy bottom line so that they can continue making product and keeping folks employed. That is not only their right, but it is their responsibility.

Exactly. Without seeing the actual letter, I'm not sure they did anything wrong here.

[TexasHusker]

And some people have done their research about certain procedures and know that standard of care can be more harmful to their health, so they don't need a secondary party directing them for X procedure. Health care is currently a for profit business. But if I got that letter and it wasn't something that interested me for my own health I would ignore. Health care can suggest and explain, but it is always with in our right to deny or consent to any medical procedure, regardless of the reason why.

Not all health care is for-profit by any stretch.

As in every other risk arrangement, it should also be the insurer's right to refuse the risk if, by their actuarial analysis, it is unreasonable and/or unpredictable.

If I want an insurer to insure my roof but I refuse to allow them to inspect it, it should also be their right to refuse insurance.

I'm not quite sure how we ended up with the mentality that we can and should dictate medical insurance arrangements; we are trying to transfer our risk to an insurer in exchange for a premium - surely they have a right to have some conditions?

[disneysteve]

As in every other risk arrangement, it should also be the insurer's right to refuse the risk if, by their actuarial analysis, it is unreasonable and/or unpredictable.

If I want an insurer to insure my roof but I refuse to allow them to inspect it, it should also be their right to refuse insurance.

I'm not quite sure how we ended up with the mentality that we can and should dictate medical insurance arrangements; we are trying to transfer our risk to an insurer in exchange for a premium - surely they have a right to have some conditions?

I couldn't agree more. People want to take no personal responsibility for their own well being but fully expect their medical insurance to cover everything that goes wrong with them as a result.

Sure, if you want to refuse colonoscopy because you read some nonsense on the internet, that's your right. But then the cost of treating the colon cancer that shows up later should be totally on you. Your insurer should be able to say, "Sorry, you're out of luck."

[Smallsteps]

Your DH's self insured company is trying to be responsible and identify and mitigate risk, so that they can offer this benefit to everyone while keeping a healthy bottom line so that they can continue making product and keeping folks employed. That is not only their right, but it is their responsibility.

Maybe the tough tone was to scare some into believing they will be cancelled and just running to do tests like good little sheeple.
What can they do throw me off the plan??
I think that would cost them much more in litigation then perhaps any test would save them.

Why don't we go back to the good ol' days when people had to take a physical before being hired or get any insurance?

[kork13]

Call me sheltered from having grown up in a military family, and personally being a military aviator (where this is required)... But I'm of the opinion that it's just common sense to have at least an annual checkup with your doctor. That's when I'd expect to be told "Hey tubby, you should lose 10-15 pounds. And while you're here, swing by the lab & get some blood drawn for these tests, get these immunizations, and hey, that mole looks new, can we do a quick biopsy? By the way, it's been a few years since your last eye exam, so you should make an appointment for that as well." Yes, the military does a good job of ensuring that I stay in good health (it's of mutual benefit), and I'm probably a little spoiled in that respect. But really? I just don't understand why you'd be upset being told to go see a doctor periodically... Sure, it may have come across as pushy, but come on... I don't expect top-notch "people skills" from folks writing letters for an insurance company.

How often do you guys typically do a normal check-up with a doctor? And on similar lines, how often do you see the dentist? 1-2x per year is typically recommended for both, and that's what's covered by most insurance for nothing but a visit copay. But hey... it's your health...


(ETA: I don't mean to sound argumentative, though that tone might come across. I honestly just don't understand being upset by such a letter -- the intent is to help you proactively manage your health)