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Beware the Questionnaire!

Updated: Aug 16, 2018

We all know questionnaires can be used as tools to both seek input about and influence public opinion.

At a recent annual physical, I was given a questionnaire designed to assess patients’ ability to afford health care. Questions about the ability to pay for food, medication, and transportation to medical service facilities were included.

Although I can’t remember the exact wording, a question phrased something like this stopped me in my tracks: “Have you ever failed to seek medical attention because you couldn’t afford it?” “Yes,” I thought, “I have definitely failed to seek medical attention in an effort to avoid having to pay exorbitant “cost-sharing” prices for deductibles, co-pays, and co-insurance when the premiums I pay are already exorbitant.” And I know many other people who have done the same thing for the same reasons!

Hasn’t almost every US citizen put off medical attention at one time or another at some point in the past 10 to 15 years to avoid the burden of “cost-sharing” with insurance companies?  We cost-share with health insurance companies by paying deductibles, co-pays, co-insurance, and sometimes we pay with our lives by having conditions which they deem "pre-existing."  Yet despite all the additional costs consumers are required to "share," insurance companies make enough profit to buy ads, sponsor events, hold conferences, build and pay for lavishly designed and furnished buildings, pay for lobbying of legislators, and pay 7-8 figure (i.e. 1 - 10+ million dollar) yearly salaries to CEOs and other company executives.  Don’t we all realize that the cost of our medical care is driven higher and higher by insurance companies that don’t really want to ensure that we have adequate care because, in the process of “insuring” our medical care, they are absolutely intent on (and very good at) generating ever-increasing profits?

I honestly answered “yes” to this question about not seeking medical attention, and boldly put my suggestions for a societal solution to the problem next to it. I was later told by the medical assistant that if patients answered yes to even one question, they would be referred to a social worker.  I received no referral.  And yet, if I had actually been given that referral, who would have paid the cost of that consultation? Would I have been expected to do so, or would the insurance companies shoulder the cost of hundreds of thousands of such referrals out of the goodness of their little corporate hearts?  More likely, they would have passed the costs on to all other consumers of medical care in yet another devious form of "cost-sharing," while simultaneously hiking premium prices another 10% per year and lobbying ever more legislators.

If each of us who has honestly put off care answered "yes" to that question, perhaps we could help deserving social workers earn something approximating middle class salaries!  More importantly, and quite significantly, perhaps we could get a point across. This point would actually be a counterpoint, in that profit-driven healthcare interests are trying to look “proactive” in their "concern" for those who cannot afford to maintain their health.

If whatever portion of the population that is not seeking and not receiving adequate care were to state that they have, indeed, put off seeking medical care because of the prohibitive expense of providing “cost-sharing” to insurance companies within a profit-driven health care system, we could block their attempt to imply that only the poorest of the poor among us are suffering. Remember, questionnaires can be used for any number of purposes, and are often used to prove the point of those designing them. The act of showing “concern” for those "few" who are falling through the cracks of this broken system (by providing a questionnaire designed to spotlight a positive correlation between health care access and extreme poverty) might be nothing more than an act - and one designed to control the narrative. “We care” is the message being framed by this questionnaire.  It is also the preemptive answer to the question that is asked not nearly often or loudly enough by the cost-sharing public:  can profit-driven healthcare interests really care enough to make the changes necessary to ensure adequate and affordable health care for ALL?

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Eli Rubin
Eli Rubin
Aug 16, 2018

This is so true. Cost-sharing is something I grew up thinking was just a given, like breathing air. I had no idea it is unknown in other countries-- like Canada!

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