How health insurers secretly blacklist those with certain ailments.
What is a little collusion among friends? Remember when insurance companies like our local health insurer Excellus, undercompensated patients by using a rigged database. That went on for years - millions of dollars.
Check out this McClatchy article - from the Miami Herald.
Trying to buy health insurance on your own and have gallstones? You’ll automatically be denied coverage. Rheumatoid arthritis? Automatic denial. Severe acne? Probably denied. Do you take metformin, a popular drug for diabetes? Denied. Use the anti-clotting drug Plavix or Seroquel, prescribed for anti-psychotic or sleep problems? Forget about it.
This confidential information on some insurers’ practices is available on the Web — if you know where to look.
Blacklisted for a preexisting condition. Denied coverage based on meds you take. Like I said what is a little collusion among companies -
Let’s not forget insurance companies make their money by denying coverage so they can take that money and invest it.
Ultimately, the question is are they in the health business or the death business.
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The more government gets involved in health care, the worse this situation will get. Our choices get smaller and smaller as government involvement increases. In a free market you would be able to choose among hundreds of insurers and have the clout necessary to keep costs in line.
Damn - Mike- can it get much worse? I mean what passes for a free market and all got us here - coupled with no oversight. I get that you want a reduced government and good for you - I don’t buy your arguments for a weaker central government and shifting resources elsewhere. Government reflects our society dare I say community - we are stronger together rather than separate. Interdependency as opposed independence.
OK - I’ll dip my toe in the water on this one.
At the end of the day, whether it’s a for-profit insurer, non-profit insurer or a public sector entity like Medicare/Medicaid you need to bring in more revenue in premium funding than you spend each year in claims. If you don’t, it’s not a sustainable enterprise.
Love them or hate them, pre-existing condition restrictions are a tool to spread risk and protect the long term viability of an insurance system. They are found in private insurance as well as in public sector programs like Medicare. The analogy often used is that you can’t buy homeowners insurance for your house when its on fire. In the same vein, under our current system, you can’t purchase individual health insurance when you have a serious health condition. The claims paid to cover that known condition will far outstrip premium revenue coming in from the member.
The only solution I see, is if everyone is covered - single payer is certainly one method of achieving this. Another is an individual mandate like Massachusetts has instituted. Once everyone is covered and paying premiums it takes away the risk to the system of pre-ex.
Interestingly, health insurers as a group have been willing to discuss doing away with pre-ex in return for a universal health plan in America. I haven’t noticed a blog post here on that topic, but perhaps I missed it.
Maybe it’s just me, but your comment about insurance companies making their money by denying claims just seems a bit inflamatory. I’m no Excellus fanboy, but there’s a process in New York for appealing denied claims through the NYS Insurance Department. If it’s legitimate and for a service covered under the health plan, there shouldn’t be a problem with getting a claim paid.
Cheers, Matt
Thanks for stopping by. Yes cover everyone. My preference is a single payer system.
re health care v death care - well to each its own. I’ll admit to painting with a wide brush. Conceptually - insurance, HMOs etc ultimately profit by taking in more than paying out and the money they take in using as an investment vehicle. So, serving a pool of people that may not need or use thier services is a good thing to them. As a Private enterprise they don’t have to serve everyone.
Isn’t there something called the, “80/20 rule”, where 80% pay for what the other 20% use? Meaning the percentage of the people who actually use their medical insurance for some sort of catastrophic illness is 20% which is more than compensated by the 80% and that’s how insurance stays in business.
Calling what we had a free market is completely erroneous. There were myriad regulations in effect for many, many years. Real competition and choice weeds out the bad actors, government regulation doesn’t.
Mike - so we don’t have a free market now? We have too much government regulation that that is what is causing our health care (and other)) woes?
How would you propose we have “real” competition?
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