Another Modest Proposal

In my May 2019 blog, I presented three modest proposals for national elections, sports championships and ending wars. To date none have been adopted, but I have confidence that they will surface for active consideration in the future as the sound logic behind them commands attention. I now have another modest proposal to offer for your consideration. It is my Christmas present to you. Be sure to savor it.
Like many of you, I have studied the resounding financial success of our medical insurance program. It has successfully channeled a substantial percentage of our national wealth to the coffers of the medical community and related service industries. Medical expense used to be of concern to the general public, but it somehow managed to be covered out of the family income. You went to the doctor or the hospital and paid them directly for the service provided. It could be a burden, but it did not financially break the family. Now with medical insurance, the family no longer directly pays for services; instead, that burden is handed over to the insurance industry, which, for a very generous fee, handles those expenses for us. In addition, they have removed from the doctor the need to determine essential services. If you cannot pay the extremely high premium, the associated copays, and out of network costs for uncovered services, they assist further by forcing you into bankruptcy. You no longer have any money worries because you no longer have any money. It is a well-designed system that functions efficiently under the umbrella of consumer confusion.
I got to thinking – why not use this successful model to benefit the restaurant industry? With the cost of eating out constantly rising, it makes sense to add an insurance program to assist consumers who need help in this area of their lives. It used to be that my wife and I could go out and dine for about fifty dollars or less; this included a tip for service. By purchasing a dining insurance policy, we might be able to dine out more often even at today’s elevated prices.
Using medical and even dental insurance experience, I became an early adopter of a plan that works like this: I pay a fixed premium per month, which is deducted from my checking account. For people still employed, the employer can make an in-kind contribution. Under regulation from the government, a set of dining out rules is established, and a code system set up for reimbursement of the restaurant.
Last Sunday I presented the insurance card when I entered the restaurant, and we were seated in the area prescribed under my policy. The menu looks conventional, but there are codes associated with all the menu items that establishes the price as set by each restaurant and agreed to by the insurance company. I do not have to worry about the prices because I have absolutely no control over them. Unless I have access to the code program, I have no idea of the price, but I do get a list of codes used in my monthly report that lets me check that the restaurant did not cheat the insurance company.
This past Sunday morning, I ordered Eggs Benedict for brunch, but my profile, which is on file when I logged in, indicated that all the melted butter in this dish could be bad for my health according to my profile, so the order was denied and automatically changed to a healthy alternative by the dining review consultant employed by the insurance company. In addition, the expensive Canadian bacon was replaced by the cheaper but equivalent generic SPAM. I now have the benefit of a healthier, more cost effective brunch that is within the insurance company guidelines, and only requiring the standard copay. However, I was charged an extra out-of-network fee because the waiter is not part of my insurance company network, but I did get a bonus glass of fruit juice.
The next weekend I thought it would be a treat to use the insurance card and take my wife out to dinner. We choose the Lakeside Steak House as the view of the lake is lovely this time of year. Unfortunately, we did not get a window view as our basic plan only allows interior seating. That was disappointing; however, we could hear the piano being played in the room with the view.
We both ordered the full cut ribeye steak, but we were informed that our profile recommended the petite cut, so that is what we were served. It was generic grass fed beef, which, while quite tough and chewy, is much healthier than the prime steak rich in cholesterol. Once again the insurance consultant intervened to approve the choice. For dessert, I ordered the Bavarian chocolate layer cake with whipped cream topping, but I was served corn bread with honey, which is the approved generic version of that menu item. The good part is that I only had to make a co-pay of $25 when I got the bill.
I am still concerned about the substitution of corn bread for the Bavarian chocolate cake and the extra fee for using the out-of-network waiter. When I raised my objection using the insurance company’s dispute procedure, they informed me that I should add the new supplemental plan that covers out-of-network expenses and will pay for non-generic menu items. When I checked on the cost of this plan by selecting the “D” version, I discovered that the premium was so high that we could no longer afford to eat out. I really need to think hard about this type of insurance and the benefit that accrues to me. I may just go back to paying out of pocket at non-network restaurants.
Take my word for it – this is the wave of the future!

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