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A retired orthopaedic surgeon criticizes health insurance plans that restrict coverage for routine procedures performed in high-tech hospitals, arguing that premiums and copayments should reflect the complexity of the procedure rather than the hospital designation.
Sir, – I read with a lot of sympathy Julian McCormick’s letter . To call the way health insurers operate obfuscation is quite generous.
Being currently in the process of renewing my own health insurance , it is a nightmare. What is particularly galling is the so-called “High-Tech Hospitals” access, which requires a significantly higher premium. As with many other patients, it is difficult when one attends a consultant only to find out that they only work in a private hospital not covered by your plan, despite the fact that you are having a relatively simple procedure carried out.
Surely it makes no difference where non-high-tech procedures are carried out, as the cost should not differ? I do not understand what a high-tech hospital actually means. The concept of a high-tech procedure is obviously straightforward and would include such procedures as spinal surgery and cardiac surgery. It seems ridiculous that a hospital is designated as high-tech but carries out simple procedures that are not covered by a lower plan.
Surely a copay for a high-tech procedure would be accepted by most people, but to designate a hospital as such seems at best ridiculous. The fact that even day case procedures are not covered in high-tech hospitals on a lower plan is even more egregious due to the lack of necessity for any high-tech requirements. Perhaps someday the Health Insurance Authority will actually regulate the healthcare insurance industry.
– Yours, etc, PETER O’ROURKE FRCS, Retired consultant orthopaedic surgeon, Ramelton, Co Donegal.
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