Open Enrollment Outrage
Published in the Minnesota Star Tribune 12/10/24
Outrage and snark boiled over at the news of the in-plain-sight murder of United Healthcare’s CEO last week. Shock and ashamed glee that someone had finally taken action took over our annual anger at the uniquely American ritual of open enrollment — the yearly process of deciding which healthcare plan put us at the least risk of potential financial, emotional, and bodily disaster.
There is rarely an upside to wrapping up open enrollment and sending in the paperwork, and there is often a feeling of having been the victim of an elaborate scam. I am a college graduate with a BA in thinking and writing, I am able-bodied, white, cisgendered and straight, and I was raised in the suburbs, and tended to benefit from my native status as someone who fit in, and for whom society was built to support, and I still feel like the health insurers somehow got me again every time I make my choice and hit the Send button.
I started a new job last summer and my employer does not offer healthcare insurance. I spent hours in June comparing deductibles, out of pocket maximums, formularies, coinsurance (?), limitations and exceptions, all to figure out what plan to buy. Spoiler alert — Affordable Care Act plans were not the answer.
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It’s open enrollment again, and we are performing the annual Rubik’s cube of risk — what to do about health insurance. Our coffee table is covered with clipboards and piles of paper, my laptop opens to too many spreadsheets that try to make sense of it all — monthly premium? in network/out of network? would that actually cover everything in a bad year, or would they unveil hidden rules that deny the expensive stuff?
Does the Apex plan cover the doctor I like, or should we go with Select or Peak because those are larger networks? Bronze has a higher deductible, Silver has 20% coinsurance. Is there one number we can distill this all down to so we can do a reasonable comparison?
Are you bored yet? Enraged? We are both.
Our government is supposedly one of laws made for the people, by the people. How did we get here, America, and how can we be proud of the way we manage healthcare? The game is rigged — I’m not supposed to understand the coverage, and worse, I am supposed to be a little scared, and second-guess my decision every year.
If our health insurance system is a house we live in all year, it’s time we recognize that the walls are crumbling and the roof is coming down. This is no way to live and the reality of the American health insurance mess is nothing to be proud of. I’m not asking for reform, to dither in the details and chip away at the corners, I am asking to tear the building down and build something we can actually live in. I would gladly have a clean deduction on my paycheck if I could go to the clinic when I want, see the doctor I want, and not have to spend hours every year agonizing about health insurance plans and live in fear that I’ve made a bad decision.
I have a simple solution to consider: write a law that says that health insurers have a fiduciary responsibility to their clients and members. Require that insurers have to take the client’s well-being as their first priority. Let them make money, as long as the systems they create benefit the insureds. Better yet, take them out of the picture entirely, we don’t need for-profit insurers in between us and our doctors and nurse practitioners, our therapists and nurses, our imaging technicians and kind receptionists. My healthcare should be between me and my doctor, period.
