Guest Post by Denise O’Malley
About 15 years ago I had what I shall call a ‘debate’ with my next-door neighbor who, like me, was a health insurance agent. I boldly told him I know how to solve the medical insurance crisis (yes, it was going on back then); of course he wanted to know my miraculous remedy and rather poo-poo’d my suggestion that ‘wellness’ was the solution.
In theory, it’s really a very simple concept… medical claim cost is the only big-item variable in an insurance contract. If that number goes down, premiums have the capability to go down. Right?
How do you reduce medical claims?
Don’t have them… or at least reduce the frequency of them.
Fast forward to last night. I was sharing my theory with someone who was very intrigued and she asked,
Whose responsibility is it to get medical claim costs down?
I looked at her, rather surprised by the question, and said “It’s your responsibility, and hers and his (pointing at others in the room), and it’s mine.”
Another woman in the discussion exclaimed “Some medical expenses are unavoidable! You can’t ignore medical care when you need it.”
Of course not”, said I. “But it is still our responsibility.”
There are many articles on the Internet about how you can oversee, manage, and reduce the medical bills you DO incur and I will let you discover those for yourself. My passion – and what my company is all about – is about knowing when to use western medical care and avoiding the need for expensive medical care through healthy habits and living a healthy lifestyle.
YOU / WE HAVE BEEN TRAINED TO INCUR MEDICAL CLAIMS
Yes, it’s true. As a society, you’ve been trained that when you feel bad, pick a provider out of your medical insurance plan directory and go… usually for a low co-payment.
We’ve been trained to believe the medical plan should cover everything from the sniffly nose to the big illnesses. Fact is, that’s not what it was originally intended to do.
I define insurance as the transfer of a perceived financial risk… and it was intended to cover illnesses that could financially devastate a family with expensive treatments and hospitalization. I am a firm believer that is what it SHOULD do… not cover the expenses that are not financially devastating.
And the latter are frequently avoidable by living a healthy lifestyle. In other words, embracing ‘wellness’.
WHAT DO I MEAN BY ‘WELLNESS’?
We all probably have a different definition, but there are commonalities: eat right, drink water, move your body, find balance and peace, reduce your stress, and don’t put things into your body that are bad for you.
Many of us hire professionals to help us on the journey to wellness: nutrition experts, personal trainers, coaches and counselors of all types, massage therapists, and the list goes on and on.
Unfortunately, services related to attaining or maintaining optimal health can’t be paid with tax favored dollars from Health Savings Accounts or Flexible Spending Accounts, or even on your income tax return. According to Internal Revenue Code Section 213, where medical care is defined, qualified expenses must be specific to illness or injury. Get a note from your doctor and it might be covered, for a year… but why should you have to go see a doctor and get a prescription just to be well?
IT’S TIME TO CHANGE WHAT CONSTITUTES QUALIFIED MEDICAL EXPENSES
According to the National Center for Complementary and Integrative Health (a division of the Centers for Disease Control/CDC), 59 million Americans spend money out-of-pocket on health services for both illness and wellness that are not covered by medical insurance… to the tune of $30.2 BILLION dollars a year!
I’m on a mission to change the definition of what a qualified medical expense is and have proposed my Congressman introduce legislation to read in part:
To amend Internal Revenue Code Section 213(d) to expand the definition of qualified medical expenses to improve expansion and utilization of Health Savings Accounts, and other purposes.
SEC. 213. Amend Paragraph (d)(1)(A) to read “for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body, or services for the purpose of attaining and maintaining optimal wellness.”
Quite frankly, I surprised myself in getting an appointment with my Congressman’s office to present my proposal. I hate politics and, in fact, I feel very naive dipping my toes into this pond. What I have discovered is an openness to SOLUTIONS to fit their agenda, which goes hand-in-hand with my personal philosophy of ‘Don’t Complain Unless You Also Propose a Solution.’
Granted, I had to find the hot button to get his attention, and that was the magical words “Health Savings Account (HSA)”… what many of our legislators believe to be the solution to the medical insurance crisis. I’m just taking a different approach than attacking the Internal Revenue Code specific to HSA’s… I’m going directly to the root cause – a concept all good medical practitioners employ to heal you instead of treating your symptoms. My solution is in a different part of the Code and defines qualified medical expenses used for the HSA rules. Follow me?
WE ALL HAVE THE POWER TO CREATE CHANGE… EVEN LITTLE ‘OLE ME!
I harbor no false illusions that this little change in the tax code will solve the medical insurance crisis… but it’s a start. The lesson here is…
- I saw a need but didn’t know how to go about creating the solution.
- Eventually (albeit 15 years later), the solution came to me.
- I did my homework… I researched, and researched, and researched.
- I spoke up.
My proposal may never go anywhere or it may get introduced but whither away and die.
Or it may make it all the way and change the law so millions of American’s can save money while pursuing activities to attain and maintain optimum wellness… and maybe, just maybe, reduce medical claim costs in the process so insurance premiums can go down.
Want to join me in this journey? Contact me!
Denise O’Malley is the Founder of You Define Wellness! in Centennial, CO. You Define Wellness! is a unique employee benefit program that bridges the gap between what medical insurance lacks, and where corporate wellness programs crack. Utilizing a provider network with more than 100 modalities, employees define wellness based on their personal needs, wants, and values while adopting healthy habits and lifestyles through regular usage.