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Insurance for what?” “Life insurance?” “Which life?” “Medical coverage?” “I heal myself.” “Never mind.

(It’s sad—but not surprising—that teeth have become a status symbol in a country where more than one in three citizens lack dental coverage, which isn’t included with standard medical insurance.)

A Harris/Harvard School of Public Health poll of 1989 showed that most Americans (61 percent) favored a Canadian-type health system, in which the government was the single payer to doctors and hospitals, bypassing the insurance companies, and offering universal medical coverage to everyone. Neither the Democratic nor the Republican party adopted that as its program, although both insisted they wanted to “reform” the health system.

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If companies want to benefit from the advantages of social norms, they need to do a better job of cultivating those norms. Medical benefits, and in particular comprehensive medical coverage, are among the best ways a company can express its side of the social exchange. But what are many companies doing? They are demanding high deductibles in their insurance plans, and at the same time are reducing the scope of benefits. Simply put, they are undermining the social contract between the company and the employees and replacing it with market norms. As companies tilt the board, and employees slide from social norms to the realm of market norms, can we blame them for jumping ship when a better offer appears? It's really no surprise that "corporate loyalty," in terms of the loyalty of employees to their companies, has become an oxymoron.

In March 2002, the National Academy of Sciences, a private, nonprofit society of scholars, released a high-profile report documenting the unequivocal existence of racial bias in medical care, which many thought would mark a real turning point. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care was so brutal and damning that it would seem impossible to turn away. The report, authored by a committee of mostly white medical educators, nurses, behavioral scientists, economists, health lawyers, sociologists, and policy experts, took an exhaustive plunge into more than 480 previous studies. Because of the knee-jerk tendency to assume that health disparities were the end result of differences in class, not race, they were careful to compare subjects with similar income and insurance coverage. The report found rampant, widespread racial bias, including that people of color were less likely to be given appropriate heart medications or to undergo bypass surgery or receive kidney dialysis or transplants. Several studies revealed significant racial differences in who receives appropriate cancer diagnostic tests and treatments, and people of color were also less likely to receive the most sophisticated treatments for HIV/AIDS. These inequities, the report concluded, contribute to higher death rates overall for Black people and other people of color and lower survival rates compared with whites suffering from comparable illnesses of similar severity.

What American Healthcare Can Learn from Italy: Three Lessons It’s easy. First, learn to live like Italians. Eat their famous Mediterranean diet, drink alcohol regularly but in moderation, use feet instead of cars, stop packing pistols and dropping drugs. Second, flatten out the class structure. Shrink the gap between high and low incomes, raise pensions and minimum wages to subsistence level, fix the tax structure to favor the ninety-nine percent. And why not redistribute lifestyle too? Give working stiffs the same freedom to have kids (maternity leave), convalesce (sick leave), and relax (proper vacations) as the rich. Finally, give everybody access to health care. Not just insurance, but actual doctors, medications, and hospitals. As I write, the future of the Affordable Care Act is uncertain, but surely the country will not fall into the abyss that came before. Once they’ve had a taste of what it’s like not to be one heart attack away from bankruptcy, Americans won’t turn back the clock. Even what is lately being called Medicare for All, considered to be on the fringe left a decade ago and slammed as “socialized medicine,” is now supported by a majority of Americans, according to some polls. In practice, there’s little hope for Italian lessons one and two—the United States is making only baby steps toward improving its lifestyle, and its income inequality is worse every year. But the third lesson is more feasible. Like Italy, we can provide universal access to treatment and medications with minimal point-of-service payments and with prices kept down by government negotiation. Financial arrangements could be single-payer like Medicare or use private insurance companies as intermediaries like Switzerland, without copying the full Italian model of doctors on government salaries. Despite the death by a thousand cuts currently being inflicted on the Affordable Care Act, I am convinced that Americans will no longer stand for leaving vast numbers of the population uninsured, or denying medical coverage to people whose only sin is to be sick. The health care genie can’t be put back in the bottle.

Netherlands, which has a restrictive immigration policy compared to the United States. Most European nations, including the Netherlands, after all, have universal health insurance coverage, which makes drug treatment and psychiatric treatment more available, and the Dutch government subsidizes more housing. Finally, the Netherlands’ big success was with heroin, which has effective pharmacological substitutes, methadone and Suboxone, not with meth, which lacks anything similar. But there may be fewer obstacles than appear. The Netherlands has a private health-care insurance system similar to that of the United States and covered the people who needed health care in ways similar to Medicaid and the Affordable Care Act, which significantly expanded access to drug treatment, including medically assisted treatment, in the United States.4 San Francisco subsidizes a significant quantity of housing, as we have seen. While California is larger than the Netherlands, the population of Amsterdam (872,000) is nearly identical to San Francisco’s (882,000).5 And while California’s population and geographic area are larger and more difficult to manage than those of the Netherlands, California also has significantly greater wealth and resources, constituting in 2019 the fifth-largest economy in the world.6 And the approach to breaking up open drug scenes, treating addiction, and providing psychiatric care is fundamentally the same whether in five European cities, Philadelphia, New York, or Phoenix.

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Global Insurance Travel Medical Coverage GeoBlueAffiliate Available for PrestigeCare Private Health Advisory Members GeoBlue Voyager Global Insurance for Single-Trip International Travel travel insurance Global insurance health coverage may be the last thought we have when planning a trip to another country. Most people do not even realize that while traveling, your current medical insurance can be useless in some countries or that your usual over-the-counter medications are prohibited in many locations. Protect Your Health Around the World. What is GeoBlue VoyagerSM? Short-term travel medical insurance for U.S. residents traveling abroad. Why Choose GeoBlue? Strength of a U.S. Insurer Underwritten by 4 Ever Life Insurance Company, rated A- (Excellent) by A.M. Best. 4 Ever Life is an independent licensee of the Blue Cross and Blue Shield Association. Better Coverage: Our plans are U.S. licensed and feature coverage more generous than plans sold as “surplus coverage.” Our plans do not restrict illnesses or injuries resulting from a terrorist act. We do not impose precertification penalties for hospitalization. We provide coverage for pre-existing conditions for medical evacuation. Pre-existing conditions are also covered in all instances by our Choice plan. A Better Kind of Care: International travelers can leave home feeling confident that a trusted source of care is available at a moment’s notice - no matter what town, country or time zone, with global insurance. Travel anywhere knowing that if your health is a concern, getting good care is not. Global insurance coverage is available through PrestigeCare Private Health Advisory's affiliate partner, GeoBlue. You will have access to short-term global insurance health coverage options that best suit your needs while traveling. Just another way PrestigeCare Private Health Advisory looks out for all your health and wellness needs.* At PrestigeCare, we provide health solution services. *Up to $250,000 of coverage available through our affiliated partner for an unlimited number of trips of a maximum of 30 days in duration.

The only way to have a truly integrated medical model in this country is for ALL medical disciplines to have equal protection under the law, equal rates of insurance coverage, and equal amounts of research dollars, more or less. Then the marketplace would naturally sort itself out.

the head of innovation of an international French insurance company. I was supporting a HealthTech start-up providing remote chats with GPs in South Asian emerging countries. As data is the new oil, the start-up was also capturing analytics in the process on key trends for main pathologies. Patients in those countries miss affordable access to medical consultations. Equally, insurance companies miss useful data of the healthcare market and the patient requirements. People in this part of the world cannot pay for yearly insurances with large coverage but they could afford some level of insurance addressing specific diseases, pregnancy or partial coverage for their children. Hence insurance companies are keen to better understand this population and tap into a huge market. As the win/win was obvious the founder of the start-up had engaged with several insurance companies in view of developing an open innovation program. I was following up the engagement bringing the professional experience of working with a major healthcare innovative company in the US. The conversation started very well with an innovation manager genuinely supportive of integrating start-up creativity in the enterprise. Knowing the corporate world, I was not surprised to uncover two obstacles:

In 2008 when George W. Bush signed the Mental Health Parity Act into law, it required all insurers to cover behavioral health the same way plans covered any other type of medical treatment; but insurance companies found loopholes and ways to circumvent coverage. Years later, when Obamacare was implemented, in a significant move toward parity, it forbade health plans from rejecting people with preexisting conditions—including mental illness and addiction. “We have made progress expanding mental health coverage and elevating the conversation about mental health,” President Barack Obama said in a statement. “But too many people still do not get the help they need.

No other developed country in the world has such an outdated, fragile health insurance system. Health insurance in many such countries is considered a right and is provided by their government, paid by taxes. It is like Medicare without an age limit. Other countries offer insurance through private options also, but there is universal coverage. In our country, the most common cause of personal bankruptcy is medical bills.

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