You are currently viewing The Sick State of Health Insurance

The Sick State of Health Insurance

Health insurance can be a great safety net if you find yourself in a catastrophic situation that requires extensive care. But it falls woefully short when it comes to helping you maintain a healthy lifestyle. Which begs the question, “Is it really your insurer’s responsibility to keep you healthy anyway?”

When things go sideways and we need some crisis management, it’s nice to know that our exorbitant monthly premiums are buying us some peace of mind. Maybe.

But in all fairness, each of us should be doing our absolute best to live as healthy a life as we can on a daily basis. That comes on your own dime.

No matter the scenario, I would never leave my health in the hands of my insurer. That’s kind of like relying on Social Security to fund your retirement. It’s probably more appropriate to start thinking of your health insurance more along the lines of your car insurance. It’s there in case of an accident, but it doesn’t pay out for routine maintenance. Your oil changes, wiper blades, new tires, bulbs, fuses, etc. are all paid for out of pocket. Likewise for clean food, exercise equipment, yoga class, water filters, air purifiers, and bed pillows. And in more and more cases nowadays, your chiropractic adjustments either fall outside the allowance of your insurance coverage or, more likely, your coinsurance is so high that it renders the coverage irrelevant.

Let me point out two important things here.

First of all, the fact that insurance does or doesn’t cover a certain service doesn’t reflect on the validity or efficacy of that service. Your insurance company isn’t in the business of getting you well. It’s in the business of making money. Have you ever been in the unfortunate position of fighting with your insurance company over lack of coverage for a procedure that you deemed necessary? It is not pleasant.

Gibsonia chiropractor

It’s really pretty crazy that your insurance company has such incredible influence over how you take care of yourself. I know far too many people who decide on a course of action based strictly on whether or not their insurance company approves it.

Have you ever considered the absurdity of choosing your doctors based on whether or not they are in your insurance network? The truth is that participation in an insurance network has no bearing on the competency of the doctor. I’m always intrigued when people find us through their health insurance plan. I’m compelled to dig a little deeper to see if they did some additional research before choosing us, or if they simply based their decision on the fact that we accept their insurance. I understand the financial implications of choosing an in-network doctor, especially given the outrageous inflation of health care fees. But in an ideal world your doctor would be chosen because he is the most qualified and reputable, not because he is the cheapest or is in this or that network.

Secondly, while most major insurers do provide some coverage for chiropractic care, it’s usually not what it’s cracked up to be when you start kicking the tires.

For example, chiropractic coverage is usually limited to a relatively small number of visits, and crisis visits at that – acute injuries for which you’ve never before been treated. If your insurance deems your visits chronic in nature, or routine wellness adjustments, they will not contribute to your care.

In addition, chiropractors are considered “specialists” by insurance companies – a designation that usually comes with a higher copay than that which you would pay your PCP. In fact, it’s not uncommon nowadays for patient copays to be so high that they exceed the cost of paying outright for a cash visit. And in case you think this is just a chiropractic issue, consider the fact that there is a growing trend among primary care physicians to break free of the confines of insurance and instead establish self-pay clinics that allow them to keep the cost of services lower.  

chiropractors Gibsonia

The bottom line is that health insurance is not a prerequisite for a healthy life. In fact, none of the foundational building blocks of health – good food, clean air, exercise, a positive attitude, etc. – requires insurance.

So remember that while health insurance offers some security should you be dealt an unfortunate blow, it is every individual’s personal responsibility to keep himself healthy. What you eat for breakfast everyday has a far greater impact on your long term state of health than your insurance plan ever will.

Making your health your top priority is always your best insurance against illness.

Dr. Joe Tsai is a chiropractor and health coach dedicated to helping you live up to your maximum potential. You can contact him directly at