What Still Needs To Change

Regardless of the uncertainty regarding the Affordable Care Act and the Republican’s “repeal and replace” cry, there’s something that has been missing in health care.


I’ve written about this in the past and it continues to be an issue.

The ACA, passed with the support of the Democratic party, moved us down the path of universal coverage. Health and Human Services (HHS) stated in early 2016 that 20 million people now had coverage under the ACA. This doesn’t include the 2017 open enrollment numbers as we’re still in open enrollment. Having more people covered is a good thing.  Yes, there’s a question about adding people to a system that can’t control costs, but from a health standpoint, having insurance is arguably better than not having it (especially if you have a medical condition of some sort).

The Republican party has not yet agreed upon one approach, but they have options.  One item I’ve noticed is the push for transparency – the ability to know what you are paying for when you consume health care.  This is also an area that needs a kick in the pants.  It’s maddening to go to a health care provider and, while at the registration desk, agree to pay for any out-of-pocket expenses – WITHOUT KNOWING WHAT THEY WILL BE.

As maddening as this is, I still say that getting covered and having transparency doesn’t do anything without…say it with me…engagement.

I can have health insurance coverage. I  can have tools that let me see what things cost.  But if I don’t actively engage in my health – and I’m talking all facets of health – then problems remain.

So how would I define engagement?  I suppose there are many ways, but let me start with this:

Knowing how to choose the right health plan for you and your family, eating healthy, staying on a medication regimen when prescribed, questioning treatments prescribed by your doctor to prevent over-treatment, exercising, arming yourself with information before seeking care, utilizing all the great tools that employers offer to their employees to manage their health, understanding your chronic condition and actively managing it, knowing when to go to ER vs. urgent care vs. telemedicine visit, etc. etc. etc.

Yes, there’s a lot here.  But it’s our duty as consumers of health care to engage in our own health.  That’s not a small order, I know.  And sadly, a great deal of engagement is missing.