So this blogger walks into a bar…
At least that the premise of a recent post by Julie Barnes at the New America Foundation’s New Health Dialogue Blog, talking about a performance by comdian Jake Johannsen:
When we saw him, he was on a “How The Man Sticks It To The Little Guy” run when he used health insurance as an example. First, he mentioned how lucky most of us feel if we can buy insurance through our employers (unspoken subtext: because if we get health insurance at work, we don’t have to worry about being denied coverage because of preexisting conditions). But then we don’t feel so lucky if we get sick and, even with coverage, get a pretty big bill. At least then, Jake joked, we could complain about how our boss was “sticking it to us.” But some of us have to purchase our own insurance directly, so, he deadpanned: “I end up sticking it to myself! That doesn’t seem right.”
Then, in surprisingly fluent health insurance-speak, Jake went off about how he could barely keep up when his insurance broker was trying to explain his policy choices: an HMO, an HMO with a POS, a PPO, and variances between the deductible, premiums, co-pays, co-insurance and out-of-pocket maximums.
Jake asked “but which one is best” and the broker replied “it depends on the individual.” And Jake, being a comedian, said: “Let’s say, hypothetically, that the individual is me.” The broker responded: “You have to make your own decision about what’s best for you.” At which point, Jake made a funny face that meant “You’ve got to be kidding” and the audience responded with gales of laughter.
Ha ha. To be honest, the retelling doesn’t seem that funny… it just seems sad because it’s so true. Some have argued that we don’t need reforms to standardize the individual insurance market–like the pending SB1522(Steinberg)–because people have access to brokers. If you are lost (as many consumers are), it is useful to ask for directions, and it is useful to have a map. One doesn’t obviate the need for the other. Both are helpful.
The blogger from the centrist New American Foundation agrees that the humor doesn’t quite translate:
As things currently stand, no one (not even those of us who work on health policy for a living!) can make truly informed decisions about which health care policy is best for us. It is difficult to determine whether paying more up-front or taking the risk of paying more later or having more or less provider choice is the way to go. This kind of confusion is not funny, which is why transparency and consumer-friendly decision support tools (real ones, that real people can understand) must be part of any health reform.