Makes me both angry and sad.....

[Luvkitty33]

I just heard that there is a health insurance company that actually paid a bonus to someone to go through the policies, look for the sick people, and then cancel their insurance! How do these people LIVE with themselves??!!! It makes me want to puke when I hear or read crap like that!!!!!!

The woman in the story was fighting breast cancer and after her policy was cancelled, in the middle of treatment mind you, she was left with over $200,000 in medical bills. Stress makes pain worse and makes sick people sicker.....are they trying to kill this poor woman? What a disgrace!!

 

[HB1965]

It's called GREED

 

[Luvkitty33]

It's called GREED

Yep! And heartless, disgusting........maddening...

 

[myinnerslut]

Yep! And heartless, disgusting........maddening...

and sickening and revolting and evil

 

[CutieMouse]

*****

 

[Master_of_Pupets]

That is sick. It's crooked insurance companies like that that make me happy to live in Canada with government funded health care, despite some of it's short comings.

 

[wayfarm]

I just heard that there is a health insurance company that actually paid a bonus to someone to go through the policies, look for the sick people, and then cancel their insurance! How do these people LIVE with themselves??!!! It makes me want to puke when I hear or read crap like that!!!!!!

The woman in the story was fighting breast cancer and after her policy was cancelled, in the middle of treatment mind you, she was left with over $200,000 in medical bills. Stress makes pain worse and makes sick people sicker.....are they trying to kill this poor woman? What a disgrace!!

The name of the company that did this was called:

HEALTH NET

I think that is the important name to know. If this makes you angry, your best bet is to send them a note at:

https://www.healthnet.com/portal/member/viewContactUsForm.sdo

I don't expect a reply to the letter that I sent, but it lets them know, the public is expecting a response.

WF

 

[Homburg]

It's called business.

Exactly, and it is endemic to both the public trading of stocks and the law of the land. Insurance is a MASSIVELY regulated field. I don't work in the health side, but I've been involved in it, and you can't take a crap in the woods without having to comply with some sort of regulation.

To use an example, Walmart can set their prices whenever they want, and people will pay or not. Insurance companies don't have that option. Rate changes go through vetting processes regulated by the state corporation commissions. Walmart can decide which products to carry. Insurance companies can't. If they change their catalogue of services, again, there's a vetting process.

Insofar as cancellations are concerned, it is business pressure. Insurance companies exists to shuffle money around. They don't actually tend to make any profit off of you, the customer. They use your premiums to invest, and make their profits off their investments. Most companies shoot for a fairly even or slightly negative ratio insofar as premiums taken in versus settlement paid out are concerned. Combined Loss Ratios and all that refer to how much money the company loses on payouts and admin costs, and, again, it is watched VERY closely by state corporation commissions. If the carrier makes too much profit off of premiums, they can get heat for it. Luckily it doesn't happen often.

That said, carriers do regular policy reviews. Accepting the fact that the carrier will only allow a certain amount of loss on each policy, each policy is looked at in that light. When risk exceeds return, the carrier has a legal obligation to it's owners/shareholders to remove that risk. It sucks because the carrier is talking money, while the customer is talking life and death, but the insurance company isn't a charity, it's a business. And the law literally prevents ascent into charity. Hell, I've personally caught heat for (accidentally) overpaying a claim. Charity is not allowed. Admittedly, underpaying is actually worse legally, but both will land you in hot water.

At the end of the day, look at the insurance carrier as a casino, and the premiums you pay as money being put into the slot machines. Are you likely to get anything out of it? Not necessarily. But, just like the casino says 98% payout, the insurance company does the same, except with higher percentages usually. In the end though, it is all gambling. You are gambling that you will have a loss at some point while the policy is in force, and that the insurance company will then have to pay out to help protect you from the impact of that loss. The carrier is betting that you will either not have a loss, or that the loss will not necessarily be heavier than the premiums you pay in on a yearly basis. Casino's will eventually eject someone that is winning too much, and so will insurance companies. Make sense?

In the end, I would bet that the company had hard-coded requirements to drop policies like that, and would have actually faced possible legal action had it not. Yeah, it sucked, and I bet that the poor son of a bitch that made that decision probably earned sleepless nights for it. Insurance is not a fun field to work in...

 

[graceanne]

Laws might be different in other states, but I KNOW (at least here in Oregon) that they can't cancel you for being sick. They can, however, cancel you if you are even one day late on paying your premiums. So if you're sick be careful and pay on time, every day, cause as CM said - it's business. Health insurance isn't cause they give a damn about the person they're insuring, it's about making money. That's why they won't insure people who've got pre-existing conditions - they won't make money on them.

 

[graceanne]

http://www.signonsandiego.com/news/state/20071109-0529-ca-healthnet-policies.html

Here's a news article on what happened. They say that she lied about a heart problem and her actual weight. This is another lesson - don't lie to health insurance people because they will be looking for reasons to cancel you if you get really sick. Obviously they cancelled her cause of how much she was costing them, but she gave them a foothold to cancel her by lying on her application.

 

[Netzach]

For those of us sitting here going "it's just business" and acting like it was always like this:

how come a basic MD's visit in the 70's was about 35 bucks? How come everyone seemed to have some form of access? How come my pediatrician made house calls?

This is not some halcyon days of yore farm doctor scenario. Something got horribly horribly fucked up, and it's not the doctors.

 

[Puman]

Sad, but true. the medical field, in general, has moved from being a caring health service, to being a business...and it's the same everywhere.

 

[CutieMouse]

*****

 

[kimbernee]

According to the inflation calculator, $35 in 1970 is about $185 today.

 

[Netzach]

According to the inflation calculator, $35 in 1970 is about $185 today.

Well, it's funny how the take home pay of a clerical worker totally failed to do that trick, neat...

 

[Homburg]

For those of us sitting here going "it's just business" and acting like it was always like this:

how come a basic MD's visit in the 70's was about 35 bucks? How come everyone seemed to have some form of access? How come my pediatrician made house calls?

This is not some halcyon days of yore farm doctor scenario. Something got horribly horribly fucked up, and it's not the doctors.

Yes, everything got more fucked, and, no, the doctors got fucked up right along with it. It is a sick combination of tort law and the popularity of malpractice suits, the cost of malpractice insurance, insurance companies setting 'pre-negotiated' rates, climbing incidence of deliquent medical accounts, etc. It's not any one thing.

And, to be frank, it cost me $50 for a doctor's visit last year (haven't gone this year). $50 today is a helluva lot less than $35 in the 70's. I spent 5 years with no medical insurance, had no problems getting access.

As to home visits, those have gone away for a number of reasons. Population density, mobility of society as a whole, avalability of care, liability, etc have all conspired to make house calls a thing of the past.

And, a the end of the day, it is still just a business. Show me a doctor that is doctoring for some volunteer organisation, or working at a free clinic sans remuneration, and I will say that person is not doing it for business reasons. Otherwise, that doc is putting food on the table, as is his malpractice insurer, the company that he pays lease to for his office, the carrer for the patient, etc. All business, all involed in the cost of health care.

 

[somberReality]

Unreal.

Karma will get them. It always does.

 

[Netzach]

Yes, everything got more fucked, and, no, the doctors got fucked up right along with it. It is a sick combination of tort law and the popularity of malpractice suits, the cost of malpractice insurance, insurance companies setting 'pre-negotiated' rates, climbing incidence of deliquent medical accounts, etc. It's not any one thing.

And, to be frank, it cost me $50 for a doctor's visit last year (haven't gone this year). $50 today is a helluva lot less than $35 in the 70's. I spent 5 years with no medical insurance, had no problems getting access.

As to home visits, those have gone away for a number of reasons. Population density, mobility of society as a whole, avalability of care, liability, etc have all conspired to make house calls a thing of the past.

And, a the end of the day, it is still just a business. Show me a doctor that is doctoring for some volunteer organisation, or working at a free clinic sans remuneration, and I will say that person is not doing it for business reasons. Otherwise, that doc is putting food on the table, as is his malpractice insurer, the company that he pays lease to for his office, the carrer for the patient, etc. All business, all involed in the cost of health care.

I am very close, shall we say, to someone in the health field.

He said he would make more money, with less insanity, in a heartbeat, billing directly to people what they could pay. He could treat people instead of literally having to fight with medicaid every day. (He does treat underserved people.) Problem is, it's not legal, it's not possible. It's not the MD's even. They could make a decent living, and they know they could and they are frustrated beyond belief that they are pushed into becoming extortionists. They would really rather not be stuck fighting your insurance company for their payment, and while you are left to do it half the time, they're on the phone with them just as much.

"We're extortionists, we're not murderers" said an anti-coagulation specialist I expressed worry about heparin to. Heparin - 1500 for 4 weeks. I don't have that lying around, most people don't. He said if it meant admitting me so I got it, that was what they'd have to do. I imagine that beats the lawsuit brought by the family of a 32 year old woman who died of a diagnosed blood clot because no one would cover her meds. Absurd.

However, you are right about one thing, a lot of people are not aware of the fact that MD's will continue to treat, hospitals will continue to treat - there is usually a non-profit or the hospital's own insurance, people are generally not left dying out front, but you kind of have to be dying before you will be treated when you can't pay. It's still unacceptable. There's more at stake than business and there's more in the balance of the economy to have people who cannot get treated and cannot have their health maintained when minor illnesses become major and the public system has to step in only then.

I'll be in debt the rest of my adult life because I was diagnosed with an illness at the wrong time. Period. I'm a responsible person. I'd just paid the last of my undergrad loans *shrug* Do I deserve to have my future completely overtaken by something I have no control over? Do I deserve to have all the wealth I generate sucked from my hands before I can generate it because I got unlucky, or is a certain standard of health care something I should be able to gain for paying a reasonable percentage of my income and participating in society in positive ways?

I just choose not to stress over that, because my health is more important. I'll pay them when I'm good and able, and there's nothing for them to come and take from me.

 

[graceanne]

I am very close, shall we say, to someone in the health field.

He said he would make more money, with less insanity, in a heartbeat, billing directly to people what they could pay. He could treat people instead of literally having to fight with medicaid every day. (He does treat underserved people.) Problem is, it's not legal, it's not possible. It's not the MD's even. They could make a decent living, and they know they could and they are frustrated beyond belief that they are pushed into becoming extortionists. They would really rather not be stuck fighting your insurance company for their payment, and while you are left to do it half the time, they're on the phone with them just as much.

"We're extortionists, we're not murderers" said an anti-coagulation specialist I expressed worry about heparin to. Heparin - 1500 for 4 weeks. I don't have that lying around, most people don't. He said if it meant admitting me so I got it, that was what they'd have to do. I imagine that beats the lawsuit brought by the family of a 32 year old woman who died of a diagnosed blood clot because no one would cover her meds. Absurd.

However, you are right about one thing, a lot of people are not aware of the fact that MD's will continue to treat, hospitals will continue to treat - there is usually a non-profit or the hospital's own insurance, people are generally not left dying out front, but you kind of have to be dying before you will be treated when you can't pay. It's still unacceptable. There's more at stake than business and there's more in the balance of the economy to have people who cannot get treated and cannot have their health maintained when minor illnesses become major and the public system has to step in only then.

I'll be in debt the rest of my adult life because I was diagnosed with an illness at the wrong time. Period. I'm a responsible person. I'd just paid the last of my undergrad loans *shrug* Do I deserve to have my future completely overtaken by something I have no control over? Do I deserve to have all the wealth I generate sucked from my hands before I can generate it because I got unlucky, or is a certain standard of health care something I should be able to gain for paying a reasonable percentage of my income and participating in society in positive ways?

I just choose not to stress over that, because my health is more important. I'll pay them when I'm good and able, and there's nothing for them to come and take from me.

Preach it, sister. As many know I can't get insurance cause of my health problems. Consequently I owe over 60,000 dollars in doctors bills. That's about three times our YEARLY income. I am never gonna be able to pay it. Luckily I get most of my meds free. Remicade: $3,000 a pop received every 6 - 8 weeks. Humira: $6,000 (I think) a pop recieved every two to four weeks. Thank god I got on as a test subject.

 

[Homburg]

I am very close, shall we say, to someone in the health field.

He said he would make more money, with less insanity, in a heartbeat, billing directly to people what they could pay. He could treat people instead of literally having to fight with medicaid every day. (He does treat underserved people.) Problem is, it's not legal, it's not possible. It's not the MD's even. They could make a decent living, and they know they could and they are frustrated beyond belief that they are pushed into becoming extortionists. They would really rather not be stuck fighting your insurance company for their payment, and while you are left to do it half the time, they're on the phone with them just as much.

A) It's not my insurance company.
B) I'm not defending the insurance industry.

Every time anyone tries to inject reality into a discussion about healthcare, tempers get flared and people talk about how so and so got screwed over, or how they get screwed over. I have sympathies for this. Really. I work in the industry, but not in that part of the industry. I look at wrecked cars, for fuck's sake.

"We're extortionists, we're not murderers" said an anti-coagulation specialist I expressed worry about heparin to. Heparin - 1500 for 4 weeks. I don't have that lying around, most people don't. He said if it meant admitting me so I got it, that was what they'd have to do. I imagine that beats the lawsuit brought by the family of a 32 year old woman who died of a diagnosed blood clot because no one would cover her meds. Absurd.

Yes, and fifteen years ago, that drug would not have been available, and the person that needs it may well have died from lack of that drug. Debt, or death, it sucks, but it is a choice that would not have been even possible a few years back for many conditions.

But does that somehow mean that an insurance company has an obligation to cover that treatment, or any other treatment, in excess of their contractually agreed upon obligations? Again, it's a business, not a charity.

I'm NOT being heartless. I'm NOT denigrating your condition or anyone else's. I'm NOT defending MY insurance company.

I'm just trying to make clear that it is business, and business exists to do one thing - make money.

However, you are right about one thing, a lot of people are not aware of the fact that MD's will continue to treat, hospitals will continue to treat - there is usually a non-profit or the hospital's own insurance, people are generally not left dying out front, but you kind of have to be dying before you will be treated when you can't pay. It's still unacceptable. There's more at stake than business and there's more in the balance of the economy to have people who cannot get treated and cannot have their health maintained when minor illnesses become major and the public system has to step in only then.

I'm right about one thing? Okay, where's the other stuff I'm wrong about? =P

Sure, it's unnacceptable. But why waste time griping about insurance companies when it won't do anything? Contact you congressman and demand some sort of movement towards socialised medicine. If you don't like the way the market handles something, the next option is to petition god and/or government.

I'll be in debt the rest of my adult life because I was diagnosed with an illness at the wrong time. Period. I'm a responsible person. I'd just paid the last of my undergrad loans *shrug* Do I deserve to have my future completely overtaken by something I have no control over? Do I deserve to have all the wealth I generate sucked from my hands before I can generate it because I got unlucky, or is a certain standard of health care something I should be able to gain for paying a reasonable percentage of my income and participating in society in positive ways?

I just choose not to stress over that, because my health is more important. I'll pay them when I'm good and able, and there's nothing for them to come and take from me.

You have my sympathies, Netzach. I've spent quite a bit of the past decade uninsured (I think I said 5 years, but it has been more like 7 I think), and am sitting under a mound of medical debt too.

If you really want to point blame at someone, we need to take a gander at ourselves. A significant chunk of the revenue generated by a given's doctor's practice gets put into malpractice insurance. Why? Because we, as a culture, like to sue the shit out of people, and doctors, as a significant cause of wrongful death in this nation, are prime targets for lawsuits. If we as a culture weren't so damned tort-happy, we'd pay less at the doctor's office.

And that doesn't even get into the deep, hard fucking we get on a daily basis by Big Pharm. Oh, wow, they are cocksmen par extraordinaire.

 

[Netzach]

A) It's not my insurance company.
B) I'm not defending the insurance industry.

Every time anyone tries to inject reality into a discussion about healthcare, tempers get flared and people talk about how so and so got screwed over, or how they get screwed over. I have sympathies for this. Really. I work in the industry, but not in that part of the industry. I look at wrecked cars, for fuck's sake.

Yours as in "whatever sick person's insurer they are billing and it's been 3 months." One's if you want to be more grammatical, not yours in particular. I'm hardly aligning you mentally with Blue Cross, don't worry.

If you really want to point blame at someone, we need to take a gander at ourselves. A significant chunk of the revenue generated by a given's doctor's practice gets put into malpractice insurance. Why? Because we, as a culture, like to sue the shit out of people, and doctors, as a significant cause of wrongful death in this nation, are prime targets for lawsuits. If we as a culture weren't so damned tort-happy, we'd pay less at the doctor's office.

Yes we're tort happy. And still horrible and egregious license-removal scale wrongs happen all the time and nothing happens to those MD's. It goes both ways.

And that doesn't even get into the deep, hard fucking we get on a daily basis by Big Pharm. Oh, wow, they are cocksmen par extraordinaire.

Yes. And they are turning MD's into little cocksmen the minute they get into med school, but that's another level of debate. The obscene overprescription of certain meds and the side effects of same are a whole industry in themselves.

 

[Homburg]

Yours as in "whatever sick person's insurer they are billing and it's been 3 months." One's if you want to be more grammatical, not yours in particular. I'm hardly aligning you mentally with Blue Cross, don't worry.

Thank you. I may be 76% evil, but those motherfuckers scare even me.

The Underwriting offices are kept colder and at lower air pressure so their miasma won't escape...

Yes we're tort happy. And still horrible and egregious license-removal scale wrongs happen all the time and nothing happens to those MD's. It goes both ways.

I agree, and unfortunately there is no way to prevent the bullshit claims that are much a drain on resources as the legitimate ones. It still makes us, as a society, a distinct and heavy-handed part of the problem.

Yes. And they are turning MD's into little cocksmen the minute they get into med school, but that's another level of debate. The obscene overprescription of certain meds and the side effects of same are a whole industry in themselves.

I buggered if I can see a way out, aside from the looming spectre of socialised medicine. And I have so many core political issues with that concept that it makes me twitch.

That said, wow, countries with socialised medicine (Canada and the UK being good examples of countries with similar enough cultures and tech to make comparison possible) spend WAY less of the GDP on healthcare, and still see equivalent or better performance from said healthcare. Infant mortality rates and other markers show favourably, and, holy crap, their percentage of GDP put into healthcare is significantly less. That's a strong enough argument on its' own for me to contemplate socialised medicine.

 

[JMohegan]

The Presidential Candidates on Health Care.

No wonder Guiliani only ever wants to talk about 9/11.

On topics like this one, he's pathetic.

 

[Homburg]

The Presidential Candidates on Health Care.

No wonder Guiliani only ever wants to talk about 9/11.

On topics like this one, he's pathetic.

Eh, a lot of the language used by the various democrat candidates hurts my head. It bothers me to see phrases like "required to get healthcare insurance". Pardon me? I'm going to be required to purchase coverage? That bothers me. I'd rather see a purely governmental system than that. Telling me what to do with my money beyond taxes pisses me off.

Then you have republicans largely blathering on saying nothing much at all, with no real results anywhere. Tax credits? Yay, thanks, Rudy. At least Ron Paul looks at it critically and has a different idea on how to handle the issue.

The only race that would really make me smile would be Kucinich vs Paul (general issues, not specifically healthcare).

 

[kimbernee]

Well, it's funny how the take home pay of a clerical worker totally failed to do that trick, neat...

Minimum wage in 1970 was $1.45. It's now $5.85. So you're right that minimum wage hasn't quite kept up with inflation (400% increase compared to 500%) but it is scheduled to go up again in each of the next two years.