This is (may be) Us
by Matt Kochanski

Excuse me for any typos but my hands are just now thawing out. The heat is finally back in my house after malfunctioning for the fourth time in the past three weeks. For several days my aging heat pump was out of commission. I had filed a claim with my home warranty after the first malfunction. The mechanic came and said the system needed to be replaced. The next day I received an email from the warranty company saying that their original vendor could not complete the service, and a new one would be out to re-evaluate. This took another few days.

The second vendor said that the system only needed refrigerant. Also, if I wanted a new system, I should not rely on the warranty and should buy one from then. Well, the system of course malfunctioned immediately after that mechanic left, On the second, third and fourth visits, this second vendor found additional minor problems and got approval to repair them – each time reminding me that the insurance could not be relied upon to actually cover what needed to be done.

So now I am sitting in a house that is being warmed by emergency auxiliary heat while waiting for another minor part to be ordered and installed – all the time knowing that it will be a temporary fix.

 

I know a battle is coming and I am girding my loins to face the leviathan that is my homeowners company. I have studied the policy, kept all the documentation and rehearsed my impending conversations with the gauntlet of service representatives, supervisors and escalation consultants with whom I will be interacting.

But in going through this, my thoughts have wandered to the tragedy in NYC, and I have to consider – is our health care system using the same play book as the after-market auto service and home warranty companies.

I have a lot of experience in dealing with the delay and deny tactics of these type of insurance carriers but my experiences relate to getting creature comfort items repaired. But even at that level, I get frustrated and sometimes opt just to cut the losses and pay out of pocket. This in no way compares to someone struggling to regain their health (or even to survive) being faced with seemingly the same tactics.

I see the similarities between the scenarios. I see the same play books seemingly being used. I have been a part of the health insurance industry for decades, but I still have to ponder -Is this what we have become? Has the mission of health care insurance programs been lost in the maelstrom of bottom lines and ROI? I hope not but can’t not think that it has and that truly leaves me cold.

By Matt Kochanski