You undoubtedly already know what medical insurance aka health insurance is, but do you know how it got started? Well, accident insurance was the precursor for modern medical insurance way back in the 19th century. It was similar to what we now call disability insurance and continued to be the only option for consumers until insurance coverage for illnesses was introduced around 1890. Until then, of course, medical bills were all paid out-of-pocket. Disability insurance didn’t totally evolve into medical insurance until late in the 20th century and coverage for hospitals and expenses came a short time later. Modern-day HMO’s were introduced in 1929.
The entire health insurance issue was probably simpler back then because it certainly has become complicated as the years have gone by. Between premiums, co-pays, co-insurance, deductibles, coverage limits, exclusions, capitations, and now the murky Obamacare debate, health and medical insurance has indeed become a battleground.
Now, there’s a new dirty word on the medical insurance battlefield and it is called “rationing”. The concept involves high-priced treatments, such as for cancer, which could cause a rise in insurance rates for everybody. There has been a great deal of in-fighting going on about this controversial terminology, one that the president has actually been urging everyone not to use. This could be due to the fact that this particular insurance term helped to sink an attempt by Clinton to bring about health insurance reform recently amid some fairly hostile reactions.
Inflammatory articles regarding rationing have been popping up everywhere from the Wall Street Journal to the New York Times. One of the issues that is the basis of those arguments is whether an expensive treatment should be capped based upon its efficacy in number of months or years of life it could provide. In other words, should we all pay higher premiums so that a terminal cancer patient can receive a pricey treatment that could add six months to his or her life? Would it be different for a younger patient as opposed to an older patient? For a man rather than a woman? Would the cap be higher or lower based upon the amount of time added and the quality of life that could be expected? And, then again, who ultimately gets to decide?
As the tension mounts and the question still goes unanswered, we all seem to struggle to just understand our own insurance coverage, whether it is private, Medicare, Medicaid, or whatever. Yes, it would definitely appear that the entire medical insurance issue was much easier to understand during that simpler time when it first began.