Tuesday, August 4, 2009

THIS IS WHAT'S WRONG WITH PRIVATE HEALTH INSURANCE

If you want to know what will trigger the insurance industry to drop your health coverage take a look at this Youtube clip. These insurance company CEOs make it clear that anywhere from 1,200 to 2,000 conditions and ailments (like high blood pressure and pregnancy) can trigger their cancelation review policy from their "denial specialists" (who earn postive evaluations for canceling policies that save the company money).



Several things caught my eye:

1. EXPEDIENCY OVER INFORMATION: Securing health records of potential clients are not the primary concern of the insurance industry when it comes to signing them up (this comes in handy when the industry needs to deny coverage for "unknown" and "previous" conditions).

2. HONEST MISTAKES: Unintentional mistakes on an application for health insurance can trigger investigation, interruption, or cancelation (necessary for saving money, not lives).

3. RISE OF THE MACHINE: Programmed computers, rather than people, can have final authority over what triggers investigation, interruption or cancelation of an insurance policy (so much for that "personal" touch).

Towards the end of the clip (4:50), when the CEOs are asked if they will stop denying coverage to those they cover unless they commmitted "intentional fraud" in their application - as opposed to an honest mistake - all of the CEOs said they would not make that promise. Cancelations would continue, even if applicants made an honest mistake (kind of like, "The beatings will continue until morale improves").

Put another way, you can pay for a product but in the health insurance industry there is no longer a guarantee that the provider has to provide you with the service. Does this sound like a "free market" to you? More importantly, this clip makes it clear that your insurance coverage can be dropped simply because you got sick, as this LA Times article points out.

Final thought: If you ever wanted to see the character of the "mindless bureaucrat" - that many like to complain about when it comes to government servants - this clip makes it clear who's putting up all the roadblocks, and/or hiding behind regulations.

- Mark

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