Losing Your Insurance for Getting Sick
Word of the day: rescission. That’s what they call it when you apply for health insurance, they accept you, you pay your premiums month after month and year after year, and then you get really sick. And they yank your coverage, because it’s expensive for them all of a sudden.
In 2006, Blue Cross was faced with lawsuits from 10 former Blue Cross members and five nonprofit hospitals for this sort of activity. The former members said their coverage was rescinded when they needed it most:
In each case, the suits allege, Blue Cross didn’t look into the member’s medical history until an expensive claim came in. Then, the plaintiffs contend, Blue Cross extensively scrutinized their records looking for something that had not been disclosed and seized on whatever discrepancies they found to justify revocation of the policy, even if the inconsistencies were inadvertent or irrelevant to the claim.
Yenny Shu of Los Angeles, for instance, says her coverage was canceled after she was diagnosed with breast cancer at 46. In its letter rescinding her coverage, Blue Cross allegedly told her that she failed to disclose her exposure to the hepatitis B virus when she was a child.
Other patients say they had, in fact, disclosed the information Blue Cross accused them of omitting.
And the hospitals sued saying Blue Cross refused to pay for treatment it had already authorized.
Echoing the patients’ allegations, the hospitals contend that Blue Cross doesn’t bother to investigate the information on an application until after it receives a bill. The hospitals allege the investigations — an illegal practice known as “post-claims underwriting” — are triggered by bills that reach a threshold cost.
Whether or not the rescissions are proper, the hospitals contend, state law requires health plans to pay them for treatment they authorize in advance.
Well, rescission is back in the news. That’s because insurance executives went before Congress this week and:
Late in the hearing, Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show “intentional fraud.”
The answer from all three executives:
“No.”
No. No coverage for the Texas nurse whose coverage was taken away when she had breast cancer, with the excuse that she hadn’t told them she had gone to a dermatologist for acne. No to more than 20,000 people who were dropped from coverage because they came down with one of more than 1,000 different conditions. No because those 20,000 people’s lives were apparently not worth the $300 million in claims saved over five years.
But insurance company employees have gotten glowing performance reviews for dropping those people from coverage. And the insurance company executives who testified before Congress? They “were courteous and matter-of-fact in their testimony,” but to the people they’re rescinding coverage from, even the ones who filled out their medical histories in good faith? Apparently all they have to say is “no.”
It’s inhuman. And now, as we enter a battle for health care reform, they’re showing what they’re made of. Which may be a good thing—as one consumer advocate said,
“When insurance companies go under oath and admit they are canceling innocent patients when they get sick, it makes it very difficult for lawmakers to pass a law that requires every American to buy a policy or face a tax fine. It opens the way for a public option to hold the companies in check.”
The best way to cure what ails our wealth care, not really health care system in to rid us of the virus that is the corpoRATe wealth care insurers!
Shame on the unions for not supporting the single payer (HR 676) bill that would cure all the ills in one fell swoop! statusQUObama’s “down payment” plan is a farce!
SINGLE PAYER NATIONAL HEALTH CARE OR BUST!
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The scientifically impossible I do right away
The spiritually miraculous takes a bit longer
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One way or another, we need to figure out how to stop paying insurance companies to figure out how to deny us coverage. It’s absurd.
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If we only had the benefits that our goverment officials have. I have worked as a critical care nurse for years and have wittness the “worse care scenerio”. It is time to get this fixed!
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Our politicians need to stop working for the health insurance, pharma, and life sciences companies and lobbyists they think elected them. We the people should be about expanding healthcare for all - everybody in, everybody pays, and everybody covered. Why shouldn’t all of us have minimum the choices that every Federal employee has, including our members of Congress?
This is the way to fix the economy. Having a single payer such as the government would allow the individual more free choice, not the stilted choices today made by my employer, my insurance company, my employment situation, my sex, or my pre-existing conditions. This would allow more competition - today we don’t know the value of our health insurance company vs. another, one drug vs another, one physician vs. another, one hospital vs. another, or one provider vs. another. Think of the size of the negotiating public - today we have small groups or individuals who don’t have a chance of success in the negotiating game. This would allow more competition as health insurance companies would have to actually compete across markets, populations, and against public options. This would create more jobs in healthcare as more people would seek more healthcare, especially preventative care. More people educated in more valuable jobs around healthcare. More areas of the country with more access. More companies would hire people as they wouldn’t be worried about paying the cost of employee healthcare or the loss of employee downtime due to sickness.
Think taxes will go up? - maybe, but imagine if you weren’t paying for health insurance or for high healthcare costs. Make it about healthcare not about bloating the bottom lines of publicly traded health insurance companies. Insurance is for property, not the human body.
Our bodies are not profit centers.
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Heath Insurance is possibly the truly big issue here.
It is robbing those who have insurance just to give that money paid to the greedy companies who then look for more ways to deny you the insurance you paid for.
Even then the coverage is more about treating symptoms than health.
On an even broader picture companies like Ford, Dodge, GM whom we all are helping now. Have to compete against companies based in countries that have some form of universal health care. In those countries that cost is spread over all the group instead the company, Union, and person that provide that insurance. That added cost or saving is added into the cost of the product and that adds to our difficulty in competing.
Yes Unions have not supported a one stop one group approach. Most of them are struggling just to keep their programs solvent and in decent shape. I can say it is at least better having representatives on the insurance trust boards that have an obligation to represent the rank & file members instead of the cooperate board. At least the Union based insurances are there to care first for their membership.
We do need a nationalized coverage of some sort so everyone has at least a basic form of health care.
We need to make the Big Business interest realize that we as citizens and consumers have to be respected as more than just a cash cow.
Capitalism is re- distribution of wealth also, from the many to the few!!! or in other words GREED.
Our heath care, big Pharmacy, and to some extent the food industry. With cheep products that make massive profits that treat symptoms. If they cure the disease or stop the symptoms then we stop buying the product so it is more important to just treat symptoms so we keep spending. The cure is the disease in the system they care about.
For the Big Business of health care the patient is important to the extent of how much money they can generate for the system, not how the system can improve the life of the patient.
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