What if we paid for our water the way we pay for healthcare?
Say, for example, that you went to the bathroom and flushed the toilet. The water company would supply the water. They would then submit a bill to your water insurance company. If your water company is in-network with your water insurance company, the insurance company will knock thirty percent off the bill your water company submitted and pay that, assuming your deductible was met, then send you an explanation of payment for the flushed toilet.
But if your water company was out-of-network with your water insurance company, they might refuse payment all together or make your deductible twice as high as your in-network deductible.
But your water insurance company might need more information before they can pay the claim. They send you a form to fill out. Was that you who flushed the toilet or was that someone else? Do you have any other water insurance? Was that toilet flushed on the job? Then they deny your claim. Based on the information you submitted, they determined that you really didn’t need to flush right then. Or perhaps you’ve exceeded the allowed number of flushes this calendar year.
You call them and wait on hold for 40 minutes. Once you get a live person to talk to, they tell you that you have to talk to this other person. They transfer you and you sit on hold for another 40 minutes. This person tells you that you filled out the wrong form and that they really needed the information from the water provider. “Just have them write a note for you stating that you really did need to flush then,” they tell you.
You call your water company. They write a letter to your water insurance company. The water insurance company reviews all the records and determines that you did need to flush then but that you didn’t need five gallons so they are only going to pay for three. And to avoid all this confusion in the future, the next time you need to flush, just have your water company call and get prior authorization.
Then you go to take a shower. Your water provider asks you, “what part of your body do you want to wash today?” They inform you that if you wash your whole body in one shower, the insurance company won’t pay for it. And so on it goes.