Slate: Why You Can't Trust Your Health Insurer

[marmar]

Why You Can't Trust Your Health Insurer
Private insurance companies dump very sick claimants based on stupid technicalities. That's reason enough to support health reform.

By Timothy Noah
Posted Monday, July 27, 2009, at 6:02 PM ET


Blue Dog Democrats are (for reasons Steven Pearlstein of the Washington Post and Paul Krugman of the New York Times correctly label "muddled") obstructing House passage of health care reform. The Congressional Budget Office says the White House's "game-changing" proposal to create a Fed-like body to control Medicare costs will save only $2 billion over 10 years and may not save a dime. The Senate finance committee is still groping for a way to raise taxes to pay for a health reform bill it has yet to introduce. The Washington Post's editorial page is chiding the president for neglecting to tell the elderly and infirm that they have a duty to die, as Colorado Gov. Dick Lamm famously suggested back in 1984. (Lamm—naughty fellow!—turns 74 next week.) In the New York Times, David Leonhardt poses the health-reform question of the hour: What's in it for me?

A comprehensive answer may be found in this excellent New York Times editorial. I'll focus here more narrowly with a three-word answer: No more rescissions.

Rescission (also known as "post-claims underwriting") is the process whereby health insurers avoid paying out benefits to treat cancer and other serious illnesses by seeking and often finding chickenshit errors in the policyholder's paperwork that can justify canceling the policy. In one job evaluation, the health insurer WellPoint actually scored a director of group underwriting on a scale of 1 to 5 based on the dollar amount she had managed to deny through rescission. (The director had saved the company nearly $10 million, earning a score of 3. WellPoint's president, Brian A. Sassi, insists this is not routine company practice.) Rescission's victims tend typically to be less-educated people who are more likely to make an error in filling out their insurance forms and lack the means to challenge a rescission in court—a path in which success is, at any rate, not guaranteed, because under state law the practice is perfectly legal if done within the allowable time frame (typically up to two years after a policy is issued).

The health crisis doesn't get more gothic than this. Robin Beaton, a retired nurse in Texas, was rescinded last year by Blue Cross and Blue Shield after she was diagnosed with an aggressive form of breast cancer. Blue Cross said this was because she had neglected to state on her forms that she had been treated previously … for acne. Beaton eventually persuaded her congressman, Rep. Joe Barton, to twist Blue Cross' arm, but the delay meant it was five months before she could receive her operation. Otto Raddatz, a restaurant owner in Illinois, was rescinded in 2004 by Fortis Insurance Co. after he was diagnosed with non-Hodgkins lymphoma. Fortis said this was because Raddatz had failed to disclose that a CT scan four years earlier had revealed that he had an aneurism and gall stones. Raddatz replied—and his doctor confirmed—that he had never been told about these conditions (the doctor said they were "very minor" and didn't require treatment), but Fortis nonetheless refused a payout until the state attorney general intervened. The delay in treatment eliminated Raddatz's chances of recovery, and he died. .............(more)

The complete piece is at: http://www.slate.com/id/2223680/

[foginthemorn]

1. So, why is the WH and congress willing to kinck for $$ to these greedy creeps??

[irislake]

2. Because they are CROOKED!

[Vinnie From Indy]

3. This practice is one that so many "I got mine so screw you" folks just don't understand

I know many right wingers that are against healthcare reform in the belief that they will NEVER be on the receiving end of a rescission.

[PA Democrat]

4. Fortis Health has changed their name to Assurant Health, but they are still the same filthy scumbags

involved in the same despicable activities. They've been successfully sued, fined, warned, but it is still more profitable to cheat as many people as possible out of the health care they promised their subscribers.

I know first hand of how Assurant will lie, cheat, and KILL people to make a profit. I consider myself lucky because my husband and I did extensive research on them when they rescinded my policy and claimed my cancer was a "preexisting condition". Funny how involving the state attorney general's office, the state's insurance commissioner and threatening a lawsuit made them change their minds and pay my claim in less than 48 hours. But I have to wonder how many people die fighting. I was fortunate in that my cancer was caught so early that I needed no further treatment other than annual testing.

I've seen Assurant advertising on MSNBC. Stay away from them. They are crooks.

http://www.ct.gov/ag/cwp/view.asp?A=2341&Q=333840

http://www.ct.gov/ag/cwp/view.asp?A=2341&Q=335742

http://www.ct.gov/ag/cwp/view.asp?A=2341&Q=415828

http://www.medicalnewstoday.com/articles/72261.php

[valerief]

5. Are there any--ANY--insurers who don't play the Recission Game? nt

[localroger]

6. No, they can't.

The problem is that once one company got this bright idea, none of the others could compete with them on rates unless they developed equally aggressive "cost-cutting" policies. If there was an ethical health insurance company their premiums would have to be higher than those of a company unwilling to insure actual sick people, so the ethical company would get all the sick people and all the young healthy "immortals" would go to the much cheaper competition not realizing what they're in for in the relatively unlikely even that they personally get badly sick. So eventually the ethical company either becomes unethical too or folds. They all became unethical too.

The problem is that it used to just be expensive to be one of the fucked-over; now it's become impossible to get health care at all. It's become impossible to get insurance at all, and it's impossible to get many kinds of treatment at all if you don't have insurance -- this is true even if you're rich enough to pay cash for the procedures, because the providers simply don't accept cash, they only accept insurance.