COMMENTARY: Don’t Blame Patients for Unaffordable Health Care
Response to KFF Health News piece on Mary Lou Retton
Reader responses to the recent piece published by KFF Health News were published today by the news service. As someone who is uninsured and tries to keep up on the health industry, I found the response from Kimberly J. Soenen consistent with my research, interesting and informative. A link to the original piece is included in Soenen’s response below. It is reprinted in its entirety.
This op-ed (not article) by KFF Health News reporter Julie Appleby shames the former Olympic athlete for her financial distress and for being unable to manage her finances and health — while ill, injured, or chronically disabled (“Mary Lou Retton’s Explanation of Health Insurance Takes Some Somersaults,” Jan. 12).
The writing implies that an American consumer or citizen can be a very “successful person in your other life” but “not understand American health care” and that financial distress could have been prevented if only Mary Lou Retton had been more assertive, informed, and intelligent.
Appleby states that “Retton excelled in landing difficult moves as a gymnast, but she may have missed the bar when it came to buying insurance coverage.”
This notion — especially among health journalists and newsrooms covering the health care model in the U.S. — that commercial health insurance guarantees access to health care, or that the Affordable Care Act is affordable and guarantees access — is a false one. ACA plans are largely managed by private commercial health insurance companies. The industry business model is “Denial of Care.” That is how insurers deliver returns on investment to shareholders year after year, quarter after quarter, and profit from illness, injury, disability, and death. This model as of today is still legal. And, with PxDx software and artificial intelligence, companies are now denying medical care claims at a rate of 100 per 1.2 seconds.
To suggest paying for commercial health insurance promises medical care is editorially irresponsible. To suggest a citizen was not intelligent enough to navigate the barbaric and cruel commercial health insurance industry’s non-system of health care is reprehensible and repugnant. The only one who “missed the bar” was Appleby and her misinformed editors.
KFF Health News has been partnering with NPR and CBS for nearly seven years on the “Bill of the Month” series. During that time, physician suicide has reached record highs, medical worker strikes have hit record highs, medical bill bankruptcies have reached record highs, medical residents across the country are unionizing to protect patients’ rights and patient safety, and yet, all the while, commercial health insurance industry profits have reached record highs. And their financial product divisions continue to invest in portfolios that have nothing to do with health care.
By every measurement and metric, over the past 40 years, the commercial health insurance industry has caused preventable harm and death — intentionally, for profit. And still, Appleby suggests it’s the fault of patients that they cannot afford medical care? What, specifically, does Appleby suggest patients like Retton “do better?”
It’s time to begin reporting responsibly and accurately about statewide single-payer resolutions and legislation across the United States and the national (improved) Medicare for All Act of 2023-24 at the federal level.
Commercial health insurance is not health care.
— Kimberly J. Soenen, executive director of Some People and managing editor of The Fine Print, Grand Marais, Minnesota
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
Neither of these points is valid or honest. First, the patient, (unless under stress, duress, or impairment of some kind), has a responsibility to do their diligence. An excuse of: "I didn't understand", or: "No one explained the details", is hollow, and an excuse to become a 'victim' of the heartless insurance companies. Understand what you're signing, understand what you're paying for, and if you can't, then beforehand, get help. Secondly, the insurance companies are exactly that, heartless. They have a metric, they have an actuarial scale, and the agent's house payment or kid's tuition depends of how the agent or representative, gets the customer to sign off. So, we have a customer/patient who is a victim due to their own lack of homework, and an insurance company mid-level worker, whose livelihood depends on getting their monthly numbers. And, both those individuals don't care a wit about anything other than what benefits them.