As an employee of one of Mission Hospitals’ two Emergency Departments for over three-and-a-half years now, I’d have to say that I greatly value my position and have tremendous esteem for my co-workers. It’s a wondrous thing when you can help aid a wound, comfort a distressed family member, or help save a life.
It’s less wondrous when you realize that the patients who enter the doors of our department either have much better health insurance than we employees do, or have no coverage at all, and they do not have to field calls from collection agencies trying to extract money on behalf of their own employer.
Two years ago, Mission changed from a more universal/general employee health plan with co-pays and no itemization, to a plan that allows a set amount of dollars per calendar year. Under the new plan, the deductible for an individual employee is $3,000 dollars. Once the individual has reached $2,000 dollars of that deductible (through co-payments etc.), he or she must then pay $1,000 out of pocket with no contribution from the insurer before “insurance” begins to pay for health services again. The deductible for a family plan (employee, spouse and children) is $5,000 dollars. Once $4,000 dollars is used, the family must pay $1,000 dollars out of pocket—and then coverage payment is resumed.
A further, extremely confusing detail is that the company that manages this plan requires that the users save and potentially send them every single receipt for every single usage. If you fail to act as your own certified public accountant and itemize as desired, you may be audited and your benefits immediately suspended. In addition, if money is still owed to Mission as the health-care provider, it will be your own employer’s billing department providing you with collection phone calls, and before the day is done you could be turned over to a collection agency. My family’s coverage was abruptly cancelled (and I know of other such families) for discrepancies of less then $5! Approximately $3,600 dollars a year comes out of my paycheck in the form of premiums for such a hideous plan. And the neurology blood work alone for our 5-year-old son was $2,100 dollars because—we were told—we did not “ask” first.
No plan is perfect, and it is indeed a blessing to have a job and any medical coverage at all. I wanted a place to grow with, and as action goes, Mission is by far one of the most interesting and busy places in town.
Mission is the region’s largest corporation, continually touting itself for its accreditations, and employees wear badges carrying the slogan of “Merit”—mercy, excellence, respect, integrity, trust/teamwork. Yet I feel Mission is not meritorious regarding the health and happiness of its own people and their families.
— Radix Y. Faruq
Janet Moore, director, Community Relations, Mission Hospitals responds: Four years ago Mission Hospital switched from a traditional insurance plan to a consumer-driven health plan. Consumer-driven health plans are being used by organizations nationwide as a way to provide competitive health-care benefits and involve employees more in managing their care. It’s a new model, and many employees have found the plan difficult to use. Mission’s leaders, all of whom are covered under the same plan, recognized this challenge. After conducting staff focus groups earlier this year, the problems are clear. Using this information, Mission is modifying the current plan to make it more user-friendly. Along with the frustrations, however, are some excellent benefits. Mission contributes to the deductible for each employee, according to their individual plan. Mission’s plan covers preventive care like annual physicals, mammograms and other services that prevent disease or diagnose diseases in their early stages. For many employees, this has enabled them to enroll in disease-management programs through which they receive services and medications at no cost. The writer is correct: No health plan is perfect. The challenge is to develop an “easy button” when it comes to using the plan. We’re working hard to develop one that minimizes frustration and allows all of us who work at Mission to utilize our health-care benefits for ourselves and our families.