Help protect insurance companies

[snuffy]

http://www.funnyordie.com/videos/041b5acaf5/protect-insurance-companies-psa

[Lewis the Pike]

Excellent video.

I'm not a national healthcare supporter, but even less about insurance CEOs.

and Snuffy you beat me to posting this!

[Vulgar Display of Orange]

"with his allowance."

[Poke John I]

Many Insurance Companies have gotten way from what most people feel is their purpose which is to pool risk and spread expenses so than nobody gets hit with catistrophic expenses. The management of most insurance companies has decided to "Cherry Pick" and insure the healthyist people while knocking the high-risk people off their rolls. I'm sure the management incentives of basing management bonuses on only this year has had a lot to do with it. Too much of U.S. industry has gotton away from looking at things long term. It's all about maximizing this year even if it's to the detriment of next year.

Private Insurance need to be either, very heavily regulated, or they need to be out of the health insurance industry.

[WyomingOSUAlum]

Isn't insurance pretty much a contractual situation between the company and the customer? If one party to the contract breaches, then the other party is no longer obligated to fulfill its obligation, right?

Is there really a problem with companies "knocking the high-risk people off the rolls" without cause?

[wood911]

I don't support a public health plan until they get spending under control. I also find it a little amusing that Will Ferrell, who made $31,000,000 last year making bad movies, is concerned about what somebody else makes.
Having said that, executive compensation in America is broken and needs fixed. The CEO and the board of directors have figured out how to cook the books and, as PJI points out, use short-term results to justify huge bonuses. There is definitely an incestial relationship between some boards and the executives. I have no idea how to fix the problem.

[Vulgar Display of Orange]

Isn't insurance pretty much a contractual situation between the company and the customer? If one party to the contract breaches, then the other party is no longer obligated to fulfill its obligation, right?

Is there really a problem with companies "knocking the high-risk people off the rolls" without cause?

It's immoral.

[WyomingOSUAlum]

Is it immoral when a person misses several payments and their car is repossessed?

[FalseGod]

Wood, so you would prefer that he just sit back and count his dough and not even worry about the little guys? I find that amusing.

[ARPoke]

Wood, so you would prefer that he just sit back and count his dough and not even worry about the little guys? I find that amusing.

I would prefer he stick with things he knows about, and he certainly does not know about (and has never known about) the little guys.

[Vulgar Display of Orange]

Is it immoral when a person misses several payments and their car is repossessed?

No. It's immoral when some asshole in a cubicle in Milwaukee decides that Franky Familyhistory doesn't deserve health insurance any more because it makes his spreadsheet pretty.

[WyomingOSUAlum]

You can't get dumped by an insurance company because you're high-risk. I agree that doing so would be immoral. But it would also be a breach of the contract.

I'm also not a big fan of billion dollar salaries for CEO's. But unless I'm a shareholder in the company, I can't see that it's any of my business. If I don't agree with a person's salary, then as a customer, I'll probably take my business elsewhere.

[wood911]

Wood, so you would prefer that he just sit back and count his dough and not even worry about the little guys? I find that amusing.
I prefer he show his commitment by sacrificing some of his wealth for the little guy since he wants others to do that. There is nothing about the clip that suggests that he is protecting the little guy as much as attacking the big guy, which he is one, just a different career field. If he is so concerned about the little guy, he needs to be pounding the politicians on the eradication of the national debt. The risk to our country is far greater due to the national debt than it would be if we had no healthcare. The ad is like talking about what a bad job a seamstress did sewing the sails when the ship is sinking.
BTW, moveon.org funded the ad.

[Lewis the Pike]

You can't get dumped by an insurance company because you're high-risk. I agree that doing so would be immoral. But it would also be a breach of the contract.


I would disagree with you 100% on that point. I know from personal history.

and I would agree with you 100% that it is not my business.

However, I do believe health of the citizens should be a concern of government, which is a flaw in my Libertarian ideals.

I am concerned about to what extent they should be involved, considering their role in mortgages/ defense contracting/ and immigration.

I would prefer it be handled on a state level with more accountability and direct oversight.

[Poke John I]

Wyoming, the health insurance companies don't directly terminate you but they get the same results by jacking up your insurance costs where you can't afford the insurance anymore. My wife has had double breast cancer plus colon cancer while I've had prostate cancer. We had an individual family policy and they jacked the price up where it exceded our income. Thus two cancer survivors were left without health insurance. Had we been insured in a large company plan, we would have been able to keep the insurance because the risk in shared in a much larger pool.

Insurance company regulation needs to include a country wide price (fixed for one year) for all individuals plus families and include policies through employers, family policies, and individual policy. That is the only way risk can be fairly shared for the small person or individual family.

Something also needs to be done about executive bonuses having some requirement for longer term company success.

[Vulgar Display of Orange]

Haha. "They need to make big profits, so they can afford to give their employees health insurance."

[WyomingOSUAlum]

I would disagree with you 100% on that point. I know from personal history.

and I would agree with you 100% that it is not my business.

However, I do believe health of the citizens should be a concern of government, which is a flaw in my Libertarian ideals.

I am concerned about to what extent they should be involved, considering their role in mortgages/ defense contracting/ and immigration.

I would prefer it be handled on a state level with more accountability and direct oversight.



You lost me on the first paragraph, Lewis.

PJ1, aren't you guys on Medicare now? If not, what about AARP? That would represent a HUGE pool of contributors to spread the risk.

VDoO, I agree there's humor there!

[Lewis the Pike]

After My stepfather had to have a pacemaker inserted, he was dropped from Blue Cross Blue Shield. He is 2 years away from Medicare.

-------------
I have been dropped from HealthNet Insurance after my first claim, 2 months after paying premiums for a condition I disclosed initally.

[WyomingOSUAlum]

There had to be something else going on there (?). Did he reach his maximum lifetime benefit cap?

[BigBadBen]

I have been dropped from HealthNet Insurance after my first claim, 2 months after paying premiums for a condition I disclosed initally.



Hey, at least they insured you after you told them where you head was.

They probably just dropped you when they found out exactly how far it was in there.


:D

[WyomingOSUAlum]

After My stepfather had to have a pacemaker inserted, he was dropped from Blue Cross Blue Shield. He is 2 years away from Medicare.

-------------
I have been dropped from HealthNet Insurance after my first claim, 2 months after paying premiums for a condition I disclosed initally.


Lewis,

I had initially missed the second part of your post above. Did they breach their contract with you by doing that?

[FalseGod]

I prefer he show his commitment by sacrificing some of his wealth for the little guy since he wants others to do that. There is nothing about the clip that suggests that he is protecting the little guy as much as attacking the big guy, which he is one, just a different career field. If he is so concerned about the little guy, he needs to be pounding the politicians on the eradication of the national debt. The risk to our country is far greater due to the national debt than it would be if we had no healthcare. The ad is like talking about what a bad job a seamstress did sewing the sails when the ship is sinking.
BTW, moveon.org funded the ad.

Right, I am sure he has never donated a cent to charity.

[FloridaPoke]

I think the solution is quite a simple one. We should convert all health insurance companies to investor owned regulated utilities much like our electric and gas utilities, who's rates are regulated based on a rate of return (say 7%) set and arbitrated by the utility commission. Then, all underwriting and claims payments would be fair and equitable, salaries and bonuses negotiated as reasonable. It would leave healthcare in the hands of private enterprise (versus the government) and eliminate all doubt about motives or fairness.

What is not being talked about in Obama's plan that astounds me is this. Democrats constantly opine about the rich people not paying their fair share and protecting the poor and middle class. However, a key component of the Obama plan is to legally "require" all people to have health insurance (which is necessary to offset the adverse selection risk that would be caused by the new proposed rule that there is no such thing as a pre-existing condition). However, this will amount to a direct flat tax to all citizens of approximately $3,500 per year, clearly a regressive tax effecting the poor and middle class much harder than the wealthy.

And, by levying heavy new taxes on insurance companies and drug companies, it will also cause a direct flat tax on citizens, again regressively effecting the poor and middle class much harder. Why? There is no way those taxes won't be passed down to the consumers.

Obama doesn't want to call these new taxes on individual citizens, but by any definition they are. And he is trying to tax the very people he said he wanted to protect.

[Lewis the Pike]

Lewis,

I had initially missed the second part of your post above. Did they breach their contract with you by doing that?

I don't know if it was a breach of contract.

I was not strong enough to advocate for myself, and the insurance companies could push paper at me forever. They would always win by outwaiting me.

It discouraged me from getting medical treatment.

It opened my eyes how much my health and well-being is worth.

I seriously couldn't care less if insurance if those claims adjustors live or die. It's not right that I feel this way, and I know I should forgive them, but they have made my heart cold, and I really don't feel my quality of life is worth anything.

I am terrified of putting myself in an unsurmountable financial burden, because I will get claims denied. And therefore, don't seek medical attention that I need.

I have gotten by with a few very generous doctors, but they have bills to pay as well.

I have given up on ever being cured.

[WyomingOSUAlum]

I think all 57 states (sorry, couldn't resist!) have a state insurance commission. If an insurance company screws up and denies coverage when it shouldn't or refuses to pay a claim, I think I would contact the state government.

The state has authority to regulate insurance companies and they do. Threatening to remove a company's authority to do business in a state is a powerful tool, I think.

[Ostreak]

A very cool response:

http://www.youtube.com/watch?v=AJ9Te1XP8RM

[Verb]

You can't get dumped by an insurance company because you're high-risk. I agree that doing so would be immoral. But it would also be a breach of the contract.


My sister, a self-employed single mother who works her butt off and can barely afford any insurance at all just got dropped by her company.

She was dropped because she had an out-patient surgery to remove a benign uterine polyp--an extremely common mid-life problem that is not in any way life-threatening but causes a lot of pain and bleeding.

Now what's she supposed to do?

[Verb]

Sorry folks--we don't know how this thread got locked, but as soon as I figure out how to unlock it, you can continue your discussion! Oops!

[WyomingOSUAlum]

My sister, a self-employed single mother who works her butt off and can barely afford any insurance at all just got dropped by her company.

She was dropped because she had an out-patient surgery to remove a benign uterine polyp--an extremely common mid-life problem that is not in any way life-threatening but causes a lot of pain and bleeding.

Now what's she supposed to do?



If the company violated the contract, then I'd contact the state regulatory agency. Their website is http://www.ok.gov/oid/ . There's a toll-free number listed on the front page of the website.

I'd start shopping for another company in the meantime.

(She's OK, right? I mean, no complications or anything?)

[AnniePokely]

I didn't lock this thread, but wondered why it was locked. Someone clicked on a button..lol

[Verb]

If the company violated the contract, then I'd contact the state regulatory agency. Their website is http://www.ok.gov/oid/ . There's a toll-free number listed on the front page of the website.

I'd start shopping for another company in the meantime.

(She's OK, right? I mean, no complications or anything?)

Thanks for this, seriously. I'm going to pass that info along to her.

And thank goodness, she's just fine!

[Lewis the Pike]

If the company violated the contract, then I'd contact the state regulatory agency. Their website is http://www.ok.gov/oid/ . There's a toll-free number listed on the front page of the website.

I'd start shopping for another company in the meantime.

(She's OK, right? I mean, no complications or anything?)

Wyoming, you are kidding right?

Do you know how long an insurance company can strech out the proceedings?

In addition, with the now pre-existing conditions, any new insurance company will consider her uninsurable.

Do you know why every insurance company retains so much legal counsel??

Because they do shady shi+

It's the same reason Al Capone carried guns, because he was up to some faulty behavior....Ironicly that's their insurance.

your solution works very well in a vaccuum, but I can tell you, insurance companies act that way for two reasons.

1. It's profitable

2. They'll get away with it.

[WyomingOSUAlum]

Lewis,

I can't speak for anybody else, but I'm a patient guy. I don't get worn down easily. I'm used to courts taking years to decide something. That's part of the reason why I would start shopping for a new company right now.

I see a public attitude that is intolerent towards insurance companies right now. My guess is that same attitude will be reflected in the state regulatory agency. If the company did something they shouldn't have, I think they will get smacked for it.

It costs nothing to complain except your time. Even the phone call is paid for.

Now my guess is that the company has a clause within the policy that would allow them to do what they did. But she will never know unless she reads the fine print or contacts the state. She's probably not a lawyer, so reading that crap can be burdensome. That's why I'd start with the state. But that's just me!

Now as far as pre-existing conditions go, I honestly don't know. Maybe they look at a tonsilectomy as being pre-existing. Doesn't make much sense to me, but maybe that's how they look at it.

We'll see how it goes.

Sure there are some things I'd like to see fixed in our current system. I just hate to see the federal government screw this up like they have with social security, medicare and medicaid. Each of those programs is broke and go deeper into the hole every year, right? Maybe there's a better answer than what we have now, but I can guarantee you that the federal government is not the better answer based upon their past performance in similar programs.

[Lewis the Pike]

Wyo, I agree a state solution would not be better.

I do believe an insurance company that paid claims as timely as they take premiums would be the utopian pipe dream.