Date: 17/10/2019.
Person Interviewed: Female, African-American, and 38 years old.
The interviewee specified that she was a senior accountant at the Ernst & Young Company in New York City. Moreover, she explained that her salary ranges from $20,000 to $35,000 per annum depending on the bonuses and dividend paid in that financial year. Her position in the company, therefore, seems to allow her to enjoy various benefits such as allowances and insurances. She also added that she has Type 2 Diabetes.
During the interview, the participant indicated that she had health insurance. She clarified that when selecting the insurance plan, she opted for the Preferred Provider Organization, well known as PPO. She, therefore, chose it based on its numerous merits. The selection process was based on its multiple benefits. For instance, she gets reduced rates when acquiring services from the facilities she has subscribed. Moreover, it provides the flexibility of choosing a provider; hence, one can utilize the services of any facility offered within their network. Unfortunately, one incurs additional costs when using facilities outside their network.
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The interviewee illuminated that she was currently using a job-based insurance plan. It mainly includes when an employer offers coverage for their employees and their families. Generally, the company pays for a part of the monthly cover, and they end up paying for the rest. The worker’s portion, however, is deducted from their paycheck before tax; hence, they do not pay income tax to it. She explained that job-based insurance had worked perfectly well for her, as it reduces the burden of acquiring a personal health cover.
Various changes have occurred in health insurance. To begin with, in the last five years, the number of providers has increased, thus, expanding the scope of doctors and hospitals that one can acquire treatment. Furthermore, insurers are continually developing ways of reducing the number of restrictions placed on the insured, for instance, in seeing specialists. She pointed out that previously, the cover restricted her from acquiring services, such as endocrinology, from experts due to the costs incurred.
She also explained that she was satisfied with the health care received. Using the PPO has aided in the provision of the best healthcare services since it offers a wide range of doctors and hospitals. She added that she could subscribe to a facility that provides quality services; for instance, she ensured that she visits the best diabetes and endocrinology clinics around her location. Moreover, using a PPO allows one to access some specialists, for example, endocrinologists. Generally, due to the pooling of people in a PPO network, charges related to health care are lesser for participants. In other words, individuals will pay far less for services if they have a PPO plan than not having any insurance.
At some point in the interview, she indicated that she was not satisfied with the cost of her insurance. The PPO premiums are relatively expensive compared to other medical plans. Although some people use the job-based insurance cover, the remaining payments deducted from their income are rather high. The co-payments and co-insurance are also high. In contrast, the Health Maintenance Organization has cheaper packages.
The interviewee explained some of the numerous positive experiences with her health insurance. The primary experience was when the insurance paid for her expenses during a diabetic complication. It, typically, paid for the endocrinologist and general checkup throughout the surgery and recovery process. Moreover, the cover ensured that it was conducted in the hospital of her choice inclusive of the medication received.
She, nonetheless, detailed several negative encounters while using her coverage. For instance, when she had to wait for three months before using her insurance. She explained that it delayed her medication. In most cases, the insurer does not offer any cover before the lapse of three to six times.
From the interview, it was clear that the interviewee believed that she had good access to health care. She, for instance, explained that her insurance cover provided her with the flexibility to acquire health services from reputable and qualified physicians. She stated that, for instance, she receives her diabetes drugs by using her coverage. Moreover, it included her family, and thus, they also enjoy excellent medical facilities. Additionally, the PPO includes networks around a person’s residence, such that she could easily acquire medicine from nearby clinics.
The interview provided several insights on the various problems in the current healthcare system in the United States. First, it relies on private health insurance and traditional direct fee structures. Two, the presence of obstructive practices related to managed care, gender, and race result in inequality of healthcare delivery for diabetic patients, mainly affecting the minority groups (Wildeman & Wang, 2017). Third, there is an increase in medical fraud and errors in hospitals has led to the theft of dialysis equipment in some clinics. Fourth, some hospitals are experiencing a shortage of nurses and physicians, mainly qualified specialists dealing with diabetes.
The interviewee suggested that the government should aim to provide better health services to people who have diabetes. Moreover, the abolishment of the traditional fee systems would improve Medicare. Additionally, the government should develop policies that ensure equality in medical care, mainly Blacks suffering from chronic illnesses. The employment of more health workers will reduce the long queues in hospitals for patients receiving dialysis.
The healthcare system and, more specifically, medical insurance have gotten better over the last five years. The quality of the services has dramatically improved; for instance, the insurance covers include dialysis for diabetic patients. Additionally, the scope of facilities has also increased as the government aims to enhance the wellbeing of its citizens. Moreover, medical care consolidation has enhanced between providers and insurers. Although the shortage of medics is still present, their number has risen significantly. The need to improve patient experience has also increased as the doctors ensure that those with diabetes receive better care.
The interviewee added that; people should cease over-relying on the state to provide them with proper healthcare. They should, however, acquire medical insurances that help in paying their hospital bills. Moreover, the public should all aim to adopt healthy lifestyles hence reducing and preventing illnesses such as diabetes.
Favorite Quote from The Interview: Although access to healthcare is a right, people should also seek the best medical care for their families and themselves.
Thoughts and Observations: From the interview, I concluded that, although the PPO is expensive, it is a much better medical cover due to its flexibility. Moreover, it helps diabetic patients acquire better health services such as dialysis. It also helps in obtaining specialized treatment. The interviewee’s healthcare and insurance are, therefore, vital in ensuring that she gets the proper medical care for her diabetic condition.
References
Wildeman, C., & Wang, E. A. (2017). Mass incarceration, public health, and widening inequality in the USA. The Lancet , 389 (10077), 1464-1474.
