By Jeff Keeling
A recent news release from a lobbying group for health insurance companies regarding the proposed Mountain States Health Alliance-Wellmont Health System merger brought to my mind the fable of the frog and the scorpion.
In the story, a scorpion and a frog encounter each other on a stream bank. The scorpion asks the frog to carry him across the stream on his back, since he can’t swim. The frog, its self-preservation instinct kicking in, responds with a highly appropriate question: “How do I know you won’t sting me?” The scorpion answers, quite logically, “because if I do, I will die, too.”
Convinced by such a logical response, the frog agrees and they set out. Midway across the stream, the scorpion stings the frog, who almost immediately feels paralysis setting in. With both creatures about to drown, the frog asks the scorpion, “why?” The scorpion replies, “it’s my nature.”
When it comes to the hospital systems and the lobbying group (America’s Health Insurance Plans), I can’t say who is the frog and who is the scorpion. AHIP released a report Nov. 13 “from leading economists” predicting a MSHA-Wellmont merger will increase costs and limit choices for consumers. I suppose it would consider itself the frog, being asked by the MSHA-Wellmont scorpion to help the system cross the river of health care reform.
On the other hand, the hospital systems – who quickly pooh-poohed the AHIP report – have dealt with plenty of pointed behavior from the insurance companies over the years, and particularly since the advent of Obamacare. Both systems’ financial folks told me last month that a rise in high-deductible plans among moderate and middle-income patients is driving a rise in delinquent accounts.
Those $2,500 and $3,000 deductibles, where they used to be $250 or $500, are hurting not just the hospital systems’ finances. They’re also causing financial hardship and all the stress that accompanies it for many families not just in this area but nationwide.
In fact, one could argue consumers/patients best fit the role of the frogs in this tale, with multiple scorpions piling on their backs – insurance companies, hospital systems, medical device and pharmaceutical makers and other interest groups who have profited handsomely from fee-for-service medicine and now want to reach the other side of the reform river as intact as possible.
I would suggest, however, that all the players in this game are both frogs and scorpions. By allowing health care costs to consume an ever-increasing portion of our economy and our incomes, we have created an unsustainable mess on this side of the “river.” Consumers are as much to blame as anyone, having happily come along for the ride as we created a system with little to no accountability for our own physical wellness. Wait until you’re sick, go hand the provider a piece of plastic, and let others sort out the details. That’s what insurance is for, right?
So now, we’re all tempted to respond out of our natures. The insurance companies blast the hospital systems. The medical device companies lobby for elimination of the 2.3 percent excise tax on their products. Hospital systems attempt to merge, sell out or buy smaller fry to achieve scale and leverage. Consumers pine for the good old days and keep sitting on the couch eating processed food.
The fact is, we all need to get to the other side of the river. To get there, everyone’s behavior and approach will have to change – that of doctors and hospitals, insurance companies and drug makers along with that of consumers.
Perhaps, rather than a thousand attempted journeys across the river with frogs carrying scorpions, we need to build a boat that can carry us all across. Everyone will have to give a little when it comes to the boat’s features so we can all fit in together, and everyone will have to be willing to pull on the oars – together. It’s time to start getting in shape so we’ll be able to enjoy life on the other side.