Barbara O’Brien has a superb post explaining why relying on private insurers to provide anything like universal, affordable, accessible healthcare is a fool’s game:
The must-read new story today is by Lisa Girion of the Los Angeles Times. In “Health insurers refuse to limit rescission of coverage,” we find the clearest case yet why the private health care industry will never, ever, not in a million years, come even close to solving the health care crisis.
In a nutshell — yesterday three big insurance company executives — WellPoint Inc., UnitedHealth Group and Assurant Inc. — told the House Subcommittee on Oversight and Investigations that their business models depended on being able to cancel the health insurance policies of customers who cost them too much money. An investigation by the Committee had found that over a five-year period, these companies had canceled the coverage of more than 20,000 people in order to avoid paying more than $300 million in medical claims.
One of the execs claimed the rescissions — industry jargon for canceling coverage — were necessary to protect the companies from fraud. People lie about preexisting conditions on their applications, he said, and this drove up the cost of insurance for everyone else. I’ll come back to this point in a moment.
In practice, this means insurers target people with high-cost conditions such as breast cancer and lymphoma and direct employees to examine patients’ paperwork for any pretense to cancel coverage. People with innocent mistakes and inadvertent omissions; people who were unaware of a preexisting condition at the time they filled out the application because the symptoms hadn’t developed yet; people whose preexisting conditions were minor and had nothing whatsoever to do with the disease costing the insurer money — such people found themselves dumped out of the health care system at their time of greatest need.
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Of course, you might remember that Michael Moore documented this practice quite nicely in Sicko. We all knew this was going on. Members of the House Committee feigned surprise.
But I want to go back to the part about rejecting people with preexisting conditions. Who above the age of 40 does not have a preexisting condition? For that matter, what percentage of young adults freshly cut loose from their parents’ policies find they cannot obtain insurance because they failed to get through childhood without a preexisting condition?
The insurance companies are saying they can’t make a profit unless they deny coverage to people with preexisting conditions. How is this not an admission the private health insurance industry is a big, fat FAIL?
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My next question is, how obvious does this have to get before people see it?
I’m sure some people do lie on their insurance applications in order to obtain coverage. But in most industrialized democracies, this wouldn’t even be an issue. You’re a citizen, you get health care. Whether you once had acne treatments or took Lipitor or had a gallstone or even had a life-threatening disease, you get health care. Because the purpose of the health care system in most countries is delivering health care, not making a profit.
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