Health Reform: What Doctors Can Learn from Life Insurers

I recently applied for a million-dollar life-insurance policy with The Hartford (shhh, don't tell my wife). I expected a lot of paperwork, but what I didn't anticipate was a health assessment so thorough and convenient that it got me wondering if I should make my underwriter my doctor.

Here's what happened: After completing a few basic forms, a Hartford rep called and questioned me for 40 minutes about my health, activity level and lifestyle. Then she asked when a medical professional could stop by to collect blood and urine samples and take some other health measures.

"You mean I don't have to make an appointment with my doctor or go to a lab for testing?" I asked.

"No," she replied. "We come to you."

Wait, things get better. When forecasters predicted a snowstorm the day of my exam, a nurse from Portamedic called the afternoon beforehand to apologize and reschedule. But since I was about to leave on a month-long trip, I told her it would have to wait until I got back. One day after my return, The Hartford called to set me up again.

Eventually, a registered nurse came to my house and completed the checkup. A few weeks later, after requesting the results, I received a report with nearly 50 different health measures. These included everything from the basic cholesterol panel I get from my doctor to such things as PSA (for prostate cancer), HIV testing, and various liver-, kidney- and heart disease markers. Although no analysis or advice was provided, normal ranges for most tests were supplied so I could easily tell if anything was amiss. I was also awarded an overall risk rating of "preferred," which means I have less of a chance of dying in the next decade than those in the "standard" or "denied" class.

I showed this report to my doctor, who said it was similar to what he'd order for a guy my age (50) having a complete physical. In fact, Quest Diagnostics â€" the same lab he uses â€" did the blood and urine analysis. If he had ordered all these tests, my health-insurance provider would have been billed $259 (plus the cost of the doctor's visit). If I were uninsured that amount would have come out of my pocket.

Frankly, I was impressed. The medical report cost me nothing. I didn't have to waste time driving around and waiting in doctor offices or labs with sick people. I had an assessment of my health that my own doctor deemed trustworthy and thorough. Plus, I wasn't even obligated to purchase the life insurance.

The Hartford says it conducts 90,000 of these assessments annually. Depending on the age of the applicant and the amount of the policy, these evaluations can be less or even more intensive, including electrocardiograms, X-rays, and treadmill tests. What I experienced is pretty standard, says Robert Pokorski, M.D., a chief medical strategist with The Hartford. He adds that the industry started doing more of its own health assessments in the 1990s as it became increasingly challenging and expensive to rely on family doctors.

All of which makes me wonder whether some life-insurance companies, which may have millions riding on your mortality, might be doing a better job evaluating your health than our overburdened medical system. Considering that the average family physician now spends just 18.6 minutes with each patient, it may not be such an outlandish thought. In fact, I have a friend â€" a fabulously successful businessman â€" who discovered he had Hepatitis C during the course of applying for life insurance. Despite annual physicals and routine tests, doctors had never uncovered it. The discovery prompted him to stop drinking alcohol, and the disease has, fortunately, remained dormant.

After experiencing the life-insurance application process firsthand, I wish the medical world would consider adopting these practices:

House calls: For routine blood draws, physicals and even the diagnosis and treatment of minor illness, why not use more mobile nurses or nurse practitioners? The convenience might encourage more people, especially the elderly, doctor-phobic and super-busy, to take better care of themselves. If I can get a "pet butler" to come to my house to groom my dog, why not a medical professional?

Treatment that's predictive as well as reactive: The key to solving our health-care woes, both private and public, is better prevention. Life-insurance companies not only assess where you're at now but also look ahead. While they'll never replace doctors when it comes to giving prescriptive advice, I wish the medical system would be more forward thinking.

Mortality assessment: Instead of having your doctor tell you to lose weight and exercise more while your eyes glaze over, why not have him look you in the eye and, in his best underwriter voice, say: "Mr. Kita, unless you stop swallowing so much brisket and Budweiser you have an 83.4% chance of dying from a heart attack in the next 5 years." The actuary tables evidently exist to figure this, so why not grab people's attention with the specifics?

Shared, secure medical records: After you apply for life insurance, your most pertinent medical information is coded and kept on file with an organization called the MIB Group (not to be confused with MIB) for 7 years. Upon request, it's shared with other life-insurance companies to guard against fraud. Comparatively, when I step into a doctor's office the first thing I usually see is a wall of manila folders. What if my file gets misplaced, or if there's a fire, or if I have an accident far from home and another doctor needs it quickly? Why does it seem the only thing that's digital in most doctors' offices is the prostate exam?

Bulldoggish follow-up: I wish doctors were a little more like dentists, scheduling your next preventive check-up while you're still in the chair finishing up your last one. "So we'll see you again in a year, Mr. Kita? Remember to keep on top of that arterial plaque."

The best tests possible: With all the blood and urine components that can now be measured and analyzed, why should we settle for a rudimentary cholesterol panel and blood pressure reading? Anything that helps me glimpse my physiological future (including genetic tests once they're perfected) is something I want to utilize if practical and affordable. That's not hypochondria; it's just sound life insurance.

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