The Price on Your Life

Unfortunately, the title is not referring to a skilled sniper waiting on the top of a building targeting you because your own government leaked your CIA ‘secret’ identity to get to your husband; that would have been a really cool story if it could have ever happened in real life…I am referring to guys sitting at the top of tall buildings wearing fancy suits and sitting around board room tables talking about how to save their company big bucks, putting more money in their own wallets, and denying you healthcare coverage, all at the same time. At the moment, everyone is focusing on what they think is wrong with the new healthcare reform bill so I thought I would take some time to focus on what is totally faked up with the current private insurance business.

If you are fortunate enough to live under the current private healthcare system in America, you enjoy many benefits and options that those of us living under a public healthcare system do not enjoy. For example, you have the benefit of worrying about being dropped for medical coverage if you contract a serious illness. You have the added benefit of going bankrupt from those medical bills. Seriously though, let’s review the facts of the situation and try to figure out if private health care run by insurance companies and pharmaceutical companies is the best solution.

The reality is that you are only valuable to an insurance company until you get sick. The private insurance company’s objective is to turn a profit. It is not profitable for them to pay claims but it is profitable for them to charge premiums to healthy people. To predict actions by people or companies (run by people), look no further than the main incentive. In this case, big bucks are the incentive. Somehow these fakheads are so greedy their thirst for money has outweighed their morality. They don’t give a flying fak about you, your sweet daughter, Suzie-Q, or your husband, Joe the Plumber if it involves them spending hundreds of thousands of dollars to treat your/her/his illness. Unfortunately, I did not have to look very long to find the following typical story of the current health care system:

“In November 2007, Patsy Bates sued Health Net Inc. , a California based health insurance company, alleging the insurer unlawfully canceled her health insurance policy retroactively. Health Net rescinded Bates' policy after she was diagnosed with cancer, had begun chemotherapy treatment, and incurred $ 200,000 in medical bills. Health Net based the cancellation on its belief that Bates knowingly lied about her medical history when filling out her application. Under California law, policies can be canceled if an individual knowingly commits fraud (Cal. Health and Safety § 1365(a)(2)).

Further investigation by a California judge revealed that Health Net reportedly paid the executive in charge of the cancellation more than $ 20,000 in bonuses. The California Department of Managed Health Care (DMHC) subsequently fined Health Net $ 1 million for failing to disclose information (when asked by DMHC investigators) about bonuses paid to employees.” (Source here)

I wonder how many times those greedy faks pulled the same trick in the past and ‘save’ millions of company money.

It is not all insurance companies that have these incentives-based policy cancellations and some states even have laws prohibiting these incentives. The faked up part is that I have to say “some states”, it should be federal law! We are talking about people’s lives that are being ruined or cut short because of the greed in the private insurance industry! The top 18 insurance companies turned a total profit of $15.9 billion in 2008. Can you please enlighten me, how much is that faking worth in human lives?

Just for fun, some generic reasons people’s policies are retroactively cancelled (as stated by the Department of Health and Human Services):

Failing to disclose a condition when originally applying for insurance, even if that condition is unrelated to the current claim and EVEN if the person is unaware of the condition when filling out the original paperwork. Jeez, I hope they don’t find out about that flu I had back in ‘94! (Source here)

If the insurance company doesn’t retroactively cancel your policy, maybe they will just deny your claim based on some pre-existing condition or a procedure being outside the offered coverage. Why on earth did I have my appendix removed when I was 12?

“The United States remains the only country in the industrialized world where human lives are sacrificed for private profit, a national disgrace that seems on the verge of perpetuation." -Deborah Burger, RN, CNA/NNOC Co-President.  (Source here)

According to the California Nurses Association, 1 out of every 5 claims were denied by private insurers in the state of California. Why would insurers deny coverage to a patient needing treatment? If you are a woman and you have been the victim of domestic violence… you might be classified as having a pre-existing condition therefore an insurer might deny you coverage. If an insurance company feels your operation is “experimental” even though it is doctor recommended and a life-saving procedure, you can be denied coverage. This was the case in the 2008 death of Nataline Sarkisyan of Northridge, California. And, unfortunately, this is not an isolated event.

Insurers look at people as medical “losses”, their term! Is this how sick people should be seen? Most big insurers are publicly traded which means they have pressure to turn a profit. The best way to do this is to deny care or revoke existing medical coverage in order to get out of paying a medical bill. The problem with private insurance is that it is for profit. If we get rid of the monetary incentive in both the insurance and the pharmaceutical industries it will create a better healthcare system automatically. One way to take the competition and big profits out of the industry is for the government to regulate pricing for medical procedures, drugs, and insurance premiums. Bottom line is our current healthcare system is in need of major reform, the current system is leaving millions uninsured, bankrupting those of us that are insured, and letting people die because of a pre-existing condition. Is this the best the most powerful and ‘most’ democratic country on this planet can do?