Understanding risk and insurance: Is healthcare a right?
There is an incredible, nearly unbelievable amount said and written about healthcare reform. As a member of the Society of Hospital Medicine Public Policy Committee, I am flooded with more required reading than I have had since graduate school! I try to keep up with some of the articles on this topic that are flooding the Internet.
On occasion, one will come across some remarkably profound, yet incredibly simple concepts that we have all known but seem to get lost in the massive amount of white noise. One of those is the concept of insuring against risk. In an article by C. Edmund Wright, we are reminded of what health insurance is, or more appropriately what it was. Consider this quote from the article.
The problem begins with the almost universal misapplication of the terms. Health insurance does not insure your health, nor was it ever intended to. Healthcare insurance, formerly called “medical insurance,” is merely an instrument of neutralizing risk. Financial risk, that is. It was brought about by a need to insure a family’s assets against a dread disease requiring care so expensive it would wipe that family out financially.
Don’t get me wrong. I do not necessarily agree with everything Mr. Wright states in this article, but he raises an interesting point. A point well-defined in a different article published by The McKinsey Quarterly (through their premium subscription service) titled, “Why understanding medical risk is key to US health reform” by Adigozel, Pellathy and Singhal. This article details the necessity to understand how our nation’s healthcare risk has shifted over the years . . . away from “random, infrequent, and catastrophic events driven by accidents, genetic predisposition, or contagious disease and toward behavior–and lifestyle-induced chronic conditions.” This article stratifies healthcare risk over several categories of care and advocates minimal need to insure against routine treatments. It also makes a case for inexpensive or perhaps even free preventive care. Assuming the supply side of the equation could be met (enough providers, etc.) this would seem to provide for maximum access and help minimize the catastrophic episodes that cost so much . . . risk that merits insurance.
These discussions will ultimately lead to the question, “Is health insurance a right to which all are entitled?” What do you think?
About the Author: Kirk Mathews is the CEO, principal, and founder of Inpatient Management, Inc., a national hospitalist management company in St. Louis. Prior to cofounding Inpatient Management in 1997, he was senior vice president of Cejka & Company, responsible for managing one of the nation's largest physician recruiting enterprises with a search portfolio of over 300 clients. His experience includes management, sales, operations, recruiting strategy, physician compensation and benefits planning and design, and employment contract design and negotiations. In 1989, he served as vice president of Clayton Medical Associates after serving as senior recruiting consultant with Jackson & Coker, the nation's largest physician recruiting firm at the time. Mathews received his B.S. in accounting and MBA from Northwest Missouri State University. Mathews is a member of the the Society of Hospital Medicine.
