The language of health insurance has changed in the decade or so since managed care has become the dominant form of health insurance for middle class Americans. No longer does "one size fit all." Patients are now consumers of health care, but do not usually have much choice of what health policy they use. Nor do consumers have much input into how policies are tailored. That privilege goes to the purchaser of health insurance: employers.
Employers who offer health care benefits to their employees are increasingly tailoring those plans to the needs of the employer/buyer, and not to the needs of the consumer/patient. That's why we are now seeing major shifts in costs to employees in the form of greater financial liability. Financial responsibility is passed on to employees in the form of greater co-payments and co-insurance, tiered drug formularies, restrictions to preferred hospitals and doctors, and reductions in services.
Even people who purchase individual policies or participate in government sponsored health insurance are finding cost shifting and greater limitations on their choices. I was counseling a Wall Street broker who wanted a policy that covered everything. He said he wanted, "the Cadillac of policies." I had to tell him that there were no Cadillacs to be found. The policy he wanted (and could pay for) wasn't being offered by anyone.
Most people can't afford a Cadillac health plan, but when they read the sales literature during their employer's enrollment period it sounds great: everything is covered! It all seems to be clearly spelled out. Unfortunately, few people actually read their policy, and those who do may find their eyes glazing over.
