DYSON COLUMN: Are we all working just for health insurance?

OK, I started it. My primary care provider, who is wonderfully thorough, asked me if there had been any changes in my family medical history over the past year. I mentioned that a relative had both knees replaced due to deterioration from arthritis, a problem that unfortunately runs in our family.

(I’m not naming the relative because my family has been complaining about my tell-all columns.) Anyway, this person turned 65 last year and hadn’t planned to retire, but was going to use Medicare as the primary insurance for the operation and let work insurance pick up the difference.

That’s not possible, the insurance lords said.

I didn’t have all the details, but basically, work insurance would be the main payer. In this equation, the patient would be responsible for approximately $8,000.

Not wanting to pay that, my relative retired and let Medicare, along with supplemental insurance acquired later, foot the bill.

In other words, insurance was the biggest factor in determining when my loved one stopped working. And that just doesn’t seem right.

My doctor agreed. Years ago, when my annual deductible was around $3,000, she mentioned hers was $10,000, and I almost fell off the exam table. At my recent appointment, she said her insurance superiors had decided her family’s plan had been grandfathered in for too long and would no longer be offered.

Starting later this year, the doctor may have to self-medicate because she won’t have health insurance, at least from her current company. She’s married to a doctor, so I guess between the two of them they can diagnose routine germs and strep, but need insurance for more serious issues.

The patient she saw in front of me was the granddaughter of the family doctor, with the old house calls and the little black bags. When commercial insurance came along, along with federal government coverage for seniors, the doctor warned his fellow practitioners that they would be sorry in the long run because the paperwork and procedures for pre-authorizations and billing codes appropriate would take over their lives.

His gaze into the crystal ball seemed right on the ball.

Insurance dictates when we can see health care providers or if we can have surgery to treat conditions that patients and doctors deem necessary. Recent surveys suggest that at least half of employees keep their jobs, even if they are not necessarily happy in their jobs, because of their health coverage.

When people reach their 60s and are eligible for Social Security or an occupational pension, they tend to continue working, not only for their immense satisfaction, but also because they wait until they are 65 and eligible for Medicare.

A number of colleagues walked through the door once they got their golden ticket, that is, their Medicare card. I don’t blame them for anything. Someone asked me the other day how long I had until I was eligible for a pension, and I said the same thing my slightly older colleagues probably said before me: I’m just working for health insurance.