Another Insurance Scenario For You

August 2nd, 2008 | by Craig |

This one is semi-hypothetical. That is to say, the particulars have been obfuscated, but the situation is essentially as written.

There is a family who has a child with an obvious impairment. She was missing developmental milestones by the age of two, and by three she was seeing specialists, and attending a special preschool. At every turn, the diagnosis was the same: “We don’t know. She’s a puzzle.”

The parents were given strategies to cope, and to help, but most of the suggestions were just guesses, and their child made progress, but it was slow, and they still didn’t understand what was going on.

Enter serendipity. They met someone who was a professional, but not a doctor, who recognized the problem right away. Not only did the professional know what the problem was, he’d dealt with it with his own child. In the first meeting, he explained what was going on, and was able to show concrete examples. He gave the parents some “homework,” and within a week, there was visible progress. It was that fast. Armed with a diagnosis, everything fell into place. The parents were able to understand their daughter’s behaviors, and began to understand what they could do to help her along. They would need help from professionals, but just having an explanation was a quantum leap.

Unfortunately, the professional was mostly retired due to being physically unable to perform his duties, and would be unable to see their girl on any kind of regular basis, but the family could make an appointment to see a younger, less experienced professional who had limited experience.

The question was raised. Perhaps the professional could act in an advisory capacity? Unfortunately, he couldn’t, due to the narrow definition of the condition, and of his professional obligations. Besides, he lamented, how could anyone afford what he needed to charge without insurance? And what insurance company would pay for someone to be a “consultant?” No, all things considered, there really wasn’t much to do, but continue with the treatment that the insurance would cover, and hope that the inexperienced professional could figure things out on her own.

Now what do you think would best serve the patient and all involved?

I’ve said it before, and I’ll keep on saying it. Insurance isn’t the solution. Insurance is the problem.

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