in Uncategorized

What’s So Awesome About American Healthcare

is that when you get sick, the insurance company can just drop you and refuse to pay.

The practice is known as “rescission,” and the Washington Post reported today on the experiences of several patients. This is my favorite:

For Teresa Dietrich, it was fibroids. The Northern California real estate agent was left to pay $19,000 after Blue Cross said she did not disclose a diagnosis of the benign uterine tumors. But Dietrich said the doctor who had written “fibroids” on her medical record never mentioned his suspicions to her. The bills destroyed her credit and cost her her home — and, in a comically cruel twist, the surgery proved the doctor was wrong.

“They said I had a condition I didn’t even have,” Dietrich said. “And they canceled me.” (Emphasis mine)

How bad is the problem of insurance companies not wanting to pay? California Attorney general Jerry Brown is investigating incredibly high rates of denial by HMOs:

Los Angeles – Attorney General Edmund G. Brown Jr. today announced that deputies in his office are launching an independent inquiry into how Health Maintenance Organizations review and pay insurance claims submitted by doctors, hospitals and other medical providers.

This investigation is prompted by reports that California’s five largest health-insurance providers are denying insurance claims at rates of up to 39.6 percent.

“These high denial rates suggest a system that is dysfunctional, and the public is entitled to know whether wrongful business practices are involved,” Brown said.

If a number close to forty percent sounds too high, consider these statistics from the California Nurses Association:

Claims denial rates by leading California insurers, first six months of 2009:

• PacifiCare — 39.6 percent
• Cigna — 32.7 percent
• HealthNet — 30 percent
• Kaiser Permanente — 28.3 percent
• Blue Cross — 27.9 percent
• Aetna — 6.4 percent

Health insurance companies are blaming everyone but themselves as they scramble to perform damage control over this story. Which reminds me: insurance companies are raising their rates.

In the past few days, 114,000 Michigan households have received bad-news letters from Blue Cross Blue Shield of Michigan, socking individual health insurance subscribers with premium increases averaging 22%, effective Oct. 1.

Blue Cross could have said, “Hey, things could have been worse. We asked for a 56% rate hike first and dialed it back to 22%” — but that probably would have just made folks angrier. (Emphasis mine)

Blue Cross is what remains of an American experiment with so-called “co-ops” — an experiment that failed.

Remind me again: why is private insurance necessary?

Socialize this!
  • Paul

    We are all adults here, and as adults we know there are consequences for are actions, so if you do not agree with his views on healthcare, you can a) do nothing, b) vote for him, c) not vote for him, d) protest and picket, its your choice, live the dream!

    It all comes down to what you believe, either you are your brother’s keeper or are not. The healthcare system is broken, even when you play by the rules, because even when you are working and come down with something serious the insurance company can deny your claim and you are stuck using you own funds and filing for bankruptcy when these same insurance companies are paying out bonuses to those employees that deny claims and on top of that the same companies show record profits. We are already paying for emergency room care anyway for those without healthcare, it makes sense to me to cover everyone and not pay 10-20 times more for emergency room care.

  • Paul

    We are all adults here, and as adults we know there are consequences for are actions, so if you do not agree with his views on healthcare, you can a) do nothing, b) vote for him, c) not vote for him, d) protest and picket, its your choice, live the dream!

    It all comes down to what you believe, either you are your brother’s keeper or are not. The healthcare system is broken, even when you play by the rules, because even when you are working and come down with something serious the insurance company can deny your claim and you are stuck using you own funds and filing for bankruptcy when these same insurance companies are paying out bonuses to those employees that deny claims and on top of that the same companies show record profits. We are already paying for emergency room care anyway for those without healthcare, it makes sense to me to cover everyone and not pay 10-20 times more for emergency room care.

  • Marvin Music

    This, to me, is the #1 reason why we must have a public option – I just do not trust the private insurance companies – at all. And it's also such a huge point that should be being made all the time by those in support of health care reform. If those with private health insurance realized the truth about how it doesn't really provide true security then there would be overwhelming support for healt care reform.

  • Anonymous

    Last I heard, of the something like 1300 insurance companies nationwide, the average californian is allowed to choose from only 6 different providers.
    I for one will NEVER buy a policy which is allowed to be cancelled without receiving a FULL refund.
    Right up there with car insurance. You are forced to buy it and then when you actually need to use it they raise your rates.