What Do People Think About When Choosing Health Insurance Plans?
Here is a discussion I had with Tess Vigeland of Los Angeles Public Radio about the psychology of choosing health plans.
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With its expansion of Medicaid eligibility, the Affordable Care Act (a.k.a. Obamacare) was supposed to go a long way towards providing healthcare coverage to millions of uninsured Americans. That accomplishment was dealt a large blow by the Supreme Court, when it forbade the federal government from requiring states to expand Medicaid coverage. Nevertheless, many states…

Since purchasing the Walt Disney Company six months ago, the Church of Scientologyhas been slowly remaking that venerable institution, in an effort to promote their ambitious religious mission. In the pipeline are an unprecedented number of science fiction films and John Travolta/Tom Cruise buddy movies, changes that have been surprisingly popular among movie fans.
But now the church is making a change that is not so popular. It has decided that Disney employees will no longer receive insurance coverage for psychiatric care or any medications used to treat mental illness: “Psychiatrists are the enemy of the people,” stated Church spokesperson Walter McGee. “The church opposes their brutal, inhumane treatments and refuses to pay for such services because they collide with our religious beliefs.”
Many Disney employees are up in arms over this decision. But the church is unrelenting in its position: “If people want to receive devil-care, they can either pay their own money or find a job somewhere else,” said McGee.
Critics blame the situation on a decision made by President Obama in February of 2012. Early that month, he had announced regulations that would require health insurance companies to cover contraception, with exceptions for churches that oppose birth control but not for larger church run organizations such as hospitals or universities. The Roman Catholic Church cried foul, claiming that their religious freedom was being violated. In response to pressure, the Obama administration quickly backed off on its policy, broadening the religious exception to any church owned business that was run as part of the church’s broader religious mission.
That shift in policy opened an opportunity for religious organizations to carve a broader set of services out of their health insurance plans. The Jehovah’s Witnesses had gained ownership of Wal-Mart in late 2013, and soon employees of that company (at least the ones who get health insurance) no longer received coverage for blood transfusions. An Orthodox Jewish organization became majority owners of Ace Hardware in early 2014, and now employees of that company no longer receive insurance coverage for insulin products that are derived from pork.
The Church of Scientology is undeterred by critics who claim that treatments like antipsychotic medications and antidepressants ought to be part of any basic health insurance plan. “America is the land of religious freedom,” he explains “a place where the government has no right to stand between a church and its employees.”
Who could argue with that logic?
Many companies are large enough they self-insure—they take on the financial risk of paying for their employees’ health expenses. In these cases, there is no insurance company around to negotiate prices. Instead, your employer must bring itself to the negotiating table (or maybe, these days, to the negotiation-Zoom-room?). That might mean that your costs, including…
On October 10, 1952, President Dwight Eisenhower gave a speech in Salt Lake City in which he reiterated his opposition to socialized medicine. In fact, he had long asserted that he would “use every single attribute and influence of the Presidential office to defeat any move toward socialized medicine.” But Ike also recognized that all…
Here is an excellent picture from the New England Journal of Medicine, illustrating which states have chosen to run their own exchanges, which are relying on the federal government, and which are following some kind of hybrid approach. Unsurprisingly, the distribution of states pretty closely mirrors the outcome of the most recent presidential election. (Click…
In health policy circles (yes, those exist!), experts often refer to three aims for a modern healthcare system – to offer (1) universal access to (2) high quality medical care at (3) an affordable cost. Access, quality, and cost: a possibly unachievable set of goals, certainly in the U.S., where the quality of our care…