Author Topic: Here's what you get with private/for profit Health Insurance  (Read 1259 times)

Straw Man

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http://www.latimes.com/business/la-fi-rescind17-2009jun17,0,3508020,full.story

From the Los Angeles Times
HEALTHCARE: ROADS TO REFORM
Health insurers refuse to limit rescission of coverage
Lawmakers ask three executives if they'll stop dropping customers except where they can show "intentional fraud." All say no.

By Lisa Girion

June 17, 2009

Executives of three of the nation's largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation's healthcare system.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

.......

A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.
The sister of an Illinois man who died of lymphoma said his policy was rescinded for the failure to report a possible aneurysm and gallstones that his physician noted in his chart but did not discuss with him.

The committee's investigation found that WellPoint's Blue Cross targeted individuals with more than 1,400 conditions, including breast cancer, lymphoma, pregnancy and high blood pressure. And the committee obtained documents that showed Blue Cross supervisors praised employees in performance reviews for rescinding policies.

.......

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."

SAMSON123

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Re: Here's what you get with private/for profit Health Insurance
« Reply #1 on: June 24, 2009, 11:45:28 AM »
Maybe once all of congress gets cancer, AIDS, Diabetes, Alzheimers, Breast Cancer, Congestive Heart Failure etc etc they will see the importance of proper coverage for EVERYONE. So far as the heads of these insurance companies goes...they too need to suffer the same ills as the patients and then they will change their view on insurance. The scene in the movie THE BUCKET LIST is priceless in this regard. The president of the company is forced to receive and be treated exactly the same as a patient covered under his company's insurance.
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shootfighter1

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Re: Here's what you get with private/for profit Health Insurance
« Reply #2 on: June 24, 2009, 12:14:20 PM »
This is where the gov could step in and lay down some rules for insurance companies (as I have posted in other messages)...it doesn't mean we need nationalized healthcare.  We do need intervention, I agree.

Bindare_Dundat

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Re: Here's what you get with private/for profit Health Insurance
« Reply #3 on: June 24, 2009, 12:19:03 PM »
It would seem that some of those cases should be considered fraud and dealt with as such.

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #4 on: June 24, 2009, 12:28:30 PM »
It would seem that some of those cases should be considered fraud and dealt with as such.

fraud by the insurance company?

SAMSON123

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Re: Here's what you get with private/for profit Health Insurance
« Reply #5 on: June 24, 2009, 01:01:13 PM »
It would seem that some of those cases should be considered fraud and dealt with as such.

Insurance companies are more crooked than a bolt of lightening
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shootfighter1

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Re: Here's what you get with private/for profit Health Insurance
« Reply #6 on: June 24, 2009, 01:20:00 PM »
Yeah, fraud by the insurance company that can be handled in court.

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #7 on: June 24, 2009, 01:54:58 PM »
Yeah, fraud by the insurance company that can be handled in court.

Yes - all you need to do is have the funds to pay a lawyer to fight the insurance company.;

I have a friend who is a teacher (still pays ~ $600 a month for insurance) who has been diagnosed by 3 doctors as having a degenerative bone disease in her jaw that requires bone graft from her hip.  Her HMO has repeatedly said this is elective and won't cover it.    Her only recourse was an state HMO board (administered by the very companies who are denying the claim).   Her only other recourse at this point is to sue.  Unfortunately she doesn't have the $$$'s to both sue and she has to borrow against her home to afford the surgery. 

tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #8 on: June 24, 2009, 02:41:41 PM »
Yes - all you need to do is have the funds to pay a lawyer to fight the insurance company.;

I have a friend who is a teacher (still pays ~ $600 a month for insurance) who has been diagnosed by 3 doctors as having a degenerative bone disease in her jaw that requires bone graft from her hip.  Her HMO has repeatedly said this is elective and won't cover it.    Her only recourse was an state HMO board (administered by the very companies who are denying the claim).   Her only other recourse at this point is to sue.  Unfortunately she doesn't have the $$$'s to both sue and she has to borrow against her home to afford the surgery. 
straw problem is you cant focus on individual cases bro, there are always going to be cases on either side to prove the points...my dad went to the doctor today had to wait a week to get an appointment showed up and waited 2 and half hours...these wait times for appointments and wait times to see doctors will only grow if you ad 46 million more ppl.

Soul Crusher

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Re: Here's what you get with private/for profit Health Insurance
« Reply #9 on: June 24, 2009, 02:46:54 PM »
Of course there are going to be abuses, but if you think that the govt is not going to do the same thing to curb costs, I have a huge bridge 10 miles south of me over the East River to sell you.

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #10 on: June 24, 2009, 06:06:09 PM »
straw problem is you cant focus on individual cases bro, there are always going to be cases on either side to prove the points...my dad went to the doctor today had to wait a week to get an appointment showed up and waited 2 and half hours...these wait times for appointments and wait times to see doctors will only grow if you ad 46 million more ppl.

why can't I focus on individual cases. 

When the discussion is about abortion all we here are the individual cases, especially from the anti-abortion crowd

That's what this boils down to - how the individual is treated.

We currently have a system that rewards insurance companies for denying people health care.

The examples in the story are real people.

My friend (neighbor) is a real person.

Everyone knows someone who has a similar story or they themselves have their own story


tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #11 on: June 24, 2009, 06:20:06 PM »
why can't I focus on individual cases. 

When the discussion is about abortion all we here are the individual cases, especially from the anti-abortion crowd

That's what this boils down to - how the individual is treated.

We currently have a system that rewards insurance companies for denying people health care.

The examples in the story are real people.

My friend (neighbor) is a real person.

Everyone knows someone who has a similar story or they themselves have their own story
ahhh noooo, what individual cases have i cited anytime we have debated abortion what individual cases do anti abortionist cite

you dont change an entire system b/c of one or two isolated cases...

everybody knows somebody who has had long waits for the doc or couldnt get in for weeks...its common sense that if a company must make a profit to survive and competes against a company that doesnt it will go out of business too...

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #12 on: June 24, 2009, 06:23:03 PM »
ahhh noooo, what individual cases have i cited anytime we have debated abortion what individual cases do anti abortionist cite

you dont change an entire system b/c of one or two isolated cases...


everybody knows somebody who has had long waits for the doc or couldnt get in for weeks...its common sense that if a company must make a profit to survive and competes against a company that doesnt it will go out of business too...

maybe you missed the alleged case of Dr. Tiller aborting a perfectly healthy fetus so that the woman could attend a concert or play sports or some other bullshit

tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #13 on: June 24, 2009, 06:25:42 PM »
maybe you missed the alleged case of Dr. Tiller aborting a perfectly healthy fetus so that the woman could attend a concert or play sports or some other bullshit
wasnt that in the context of law? as in it was against the law for him to do that in cases of law an isolated case matters b/c its breaking the law...

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #14 on: June 24, 2009, 06:28:37 PM »
wasnt that in the context of law? as in it was against the law for him to do that in cases of law it doesnt matter if its an isolated case its still breaking the law...

we don't even know if it true...personally I suspect it's bullshit

here's a question for you Tony

Do health insurance companies still exist in countries that have govt sponsored health care?

tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #15 on: June 24, 2009, 06:36:08 PM »
we don't even know if it true...personally I suspect it's bullshit

here's a question for you Tony

Do health insurance companies still exist in countries that have govt sponsored health care?
whether it was bullshit or not isnt important to your point and my rebuttle, if it was in the context of LAW isolated cases hold as much importance as others...

im sure that some survived like i already said that some probably would here but lets not pretend that a company that must turn a profit to stay alive can compete against a company that doesnt...lets not pretend that the company that must turn a profit wont have to cut shit out to compete, and lets not pretend that the quality wont decrease and the wait times wont increase...


Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #16 on: June 24, 2009, 06:44:27 PM »
whether it was bullshit or not isnt important to your point and my rebuttle, if it was in the context of LAW isolated cases hold as much importance as others...

im sure that some survived like i already said that some probably would here but lets not pretend that a company that must turn a profit to stay alive can compete against a company that doesnt...lets not pretend that the company that must turn a profit wont have to cut shit out to compete, and lets not pretend that the quality wont decrease and the wait times wont increase...

what was your rebuttal again?

I never said YOU pointed out isolated cases in the abortion debate.

I was merely giving you an example that isolated cases are used all the time in these types of arguments.

BTW - there is nothing isolated about health insurance horror stories

regarding health insurance companies - I'm not "pretending" anything. 

health services will remain a market place like anything else. 

If a private company can do it better than they will survive. 

If not, then tough shit.   I'm not going to lose any sleep over it.

If the govt plan is going to be so bad then I can guarantee you that private companies will still exist


 






tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #17 on: June 24, 2009, 07:12:27 PM »
what was your rebuttal again?

I never said YOU pointed out isolated cases in the abortion debate.

I was merely giving you an example that isolated cases are used all the time in these types of arguments.

BTW - there is nothing isolated about health insurance horror stories

regarding health insurance companies - I'm not "pretending" anything. 

health services will remain a market place like anything else. 

If a private company can do it better than they will survive. 

If not, then tough shit.   I'm not going to lose any sleep over it.

If the govt plan is going to be so bad then I can guarantee you that private companies will still exist
your doing the space thing again...

problem is straw that you took the comment out of context, that isolated case was important if it was in the context of him breaking the law that wasnt in the context of abortion being wrong that was in the context of tiller breaking the law...what isolated case do anti abortionist use was my question while im sure there are some i never hear them chant one persons name or case...

the problem is straw that the government isnt going to come out and have shitty service they will come out and compete service wise with the private companies at a lower rate before that though the quality will drop as a result of them tryint to cut cost and compete, then after the majority of private companies go out of business as you must know they will the problems will start with the government program

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #18 on: June 24, 2009, 07:34:31 PM »
your doing the space thing again...

problem is straw that you took the comment out of context, that isolated case was important if it was in the context of him breaking the law that wasnt in the context of abortion being wrong that was in the context of tiller breaking the law...what isolated case do anti abortionist use was my question while im sure there are some i never hear them chant one persons name or case...

the problem is straw that the government isnt going to come out and have shitty service they will come out and compete service wise with the private companies at a lower rate before that though the quality will drop as a result of them tryint to cut cost and compete, then after the majority of private companies go out of business as you must know they will the problems will start with the government program

the space thing is because I rattle off a response and then delete, retype, try to use less words etc... and then don't delete the left over space

so you're saying that govt sponsered/single payer, etc... whatever you want to call it is going to be cheap and really good and all private companies won't be able to compete.

eventually all private companies will go out of business

then the quality will drop and we'll all be bitching and moaning about the bad quality of our government sponsored health care?


tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #19 on: June 24, 2009, 07:47:19 PM »
the space thing is because I rattle off a response and then delete, retype, try to use less words etc... and then don't delete the left over space

so you're saying that govt sponsered/single payer, etc... whatever you want to call it is going to be cheap and really good and all private companies won't be able to compete.

eventually all private companies will go out of business

then the quality will drop and we'll all be bitching and moaning about the bad quality of our government sponsored health care?
ahhhhh i always wondered

Im saying that the FACT the govt program can and in all likelyhood will operate in the red and the fact that adding 46 million ppl to the system will drive the quality of the private coverage down. As a result the quality of the govt will be driven down...again its a business, if the government can save money as ive already said and you know it will probably operate in the red it is going to look at ways to cut costs, if no viable competition is there why wouldnt it cut costs by cutting services etc? you think the govt is going to do whats right by the people? hahahaha really? b/c that would be the only incentive after they run the private companies out of business.

gcb

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Re: Here's what you get with private/for profit Health Insurance
« Reply #20 on: June 24, 2009, 07:47:40 PM »
the space thing is because I rattle off a response and then delete, retype, try to use less words etc... and then don't delete the left over space

so you're saying that govt sponsered/single payer, etc... whatever you want to call it is going to be cheap and really good and all private companies won't be able to compete.

eventually all private companies will go out of business

then the quality will drop and we'll all be bitching and moaning about the bad quality of our government sponsored health care?



I don't think this is the case in other countries with universal health care - I just think this is just another entry in the right wing rhetoric handbook.

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #21 on: June 24, 2009, 07:54:23 PM »
ahhhhh i always wondered

Im saying that the FACT the govt program can and in all likelyhood will operate in the red and the fact that adding 46 million ppl to the system will drive the quality of the private coverage down. As a result the quality of the govt will be driven down...again its a business, if the government can save money as ive already said and you know it will probably operate in the red it is going to look at ways to cut costs, if no viable competition is there why wouldnt it cut costs by cutting services etc? you think the govt is going to do whats right by the people? hahahaha really? b/c that would be the only incentive after they run the private companies out of business.

ok so first you assume that it will and must operate in the red

but first it will be great and drive out all competition

and then it will ulitmately suck and we'll all be sad and wish we had the current system

yes/no?....or clarify where I'm missing your larger point


tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #22 on: June 24, 2009, 08:22:19 PM »
ok so first you assume that it will and must operate in the red

but first it will be great and drive out all competition

and then it will ulitmately suck and we'll all be sad and wish we had the current system

yes/no?....or clarify where I'm missing your larger point


LOL what makes you think that this program will operate in the black? i think its probable going off of just about every other govt program this will operate in the red...

no it wont be great it will be the same, apparently our system sucks in your eyes so it will simply suck along side it until private companies have to cut cost which means less coverage etc. If the govt can cut costs, you really think they wont? you think we are their first priority?

In all likelyhood the majority of private companies will close b/c they cant compete with a company that is allowed to operate in the red or with a profit margin that makes it not worth staying open.

Think of it like this its raising the bar to new lows...

Straw Man

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Re: Here's what you get with private/for profit Health Insurance
« Reply #23 on: June 24, 2009, 08:34:43 PM »
LOL what makes you think that this program will operate in the black? i think its probable going off of just about every other govt program this will operate in the red...

no it wont be great it will be the same, apparently our system sucks in your eyes so it will simply suck along side it until private companies have to cut cost which means less coverage etc. If the govt can cut costs, you really think they wont? you think we are their first priority?

In all likelyhood the majority of private companies will close b/c they cant compete with a company that is allowed to operate in the red or with a profit margin that makes it not worth staying open.

Think of it like this its raising the bar to new lows...

so I understand your ASSUMED outcome correctly?

tonymctones

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Re: Here's what you get with private/for profit Health Insurance
« Reply #24 on: June 24, 2009, 09:06:29 PM »
so I understand your ASSUMED outcome correctly?
you simplify it to much but sure you pretty much got it.