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If you think this cannot happen to you? Think again!

I am sorry this is so long, but I feel is one of the things people against health care reform fail to see. Your thoughts?

What Happens Now, After Health Insurance Industry Refuses to Stop Cutting the Sick?
June 17, 2009 by archrone

Apparently, nothing much.

Let’s back up, a moment. Health insurers have been regularly cutting policy holders from their rolls that have been diagnosed with such diseases as breast cancer, lymphoma, and a multitude of other ailments. This act of cutting the sick from coverage rolls is called, in the industry, recission. And, some in congress have been investigating health insurers recission practices.

So, it should come as no surprise that yesterday, in congressional hearings, three main insurers told congresscritters that they have no intention of stopping their receission practices.

Executives of three of the nation’s largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation’s healthcare system.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

Now, our congresscritters are trying to get these insurers to agree to only cutting folks from their rolls when the person applying for health insurance gives fraudulent information in order to get that insurance. But, the health insurance companies are having none of that. In fact, they have every intention of continuing dropping the sick from their rolls. Why would the sick get recinded?

A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.

The sister of an Illinois man who died of lymphoma said his policy was rescinded for the failure to report a possible aneurysm and gallstones that his physician noted in his chart but did not discuss with him.

But, these actions are not just the fault of policy holders. These insurance companies praise workers that find ways to drop sick policy holders. And, not just sick policy holders, but pregnant policy holders as well.

Recission is an ugly practice, and one that the insurers agressively follow. If they didn’t follow that, why in the world would their workers be praised in preformance reviews for cancelling thousands of policies?

The committee’s investigation found that WellPoint’s Blue Cross targeted individuals with more than 1,400 conditions, including breast cancer, lymphoma, pregnancy and high blood pressure. And the committee obtained documents that showed Blue Cross supervisors praised employees in performance reviews for rescinding policies.

One employee, for instance, received a perfect 5 for “exceptional performance” on an evaluation that noted the employee’s role in dropping thousands of policyholders and avoiding nearly $10 million worth of medical care.

As it stands, the insurance companies have no incentive to stop this rescission practice, as they have no incentive to curtail costs. These are businesses where their main concern is profit, profit, and more profit. These companies are NOT in the business to help you, no matter what PR campaign they come up with to sway you to believe otherwise.

Last week, I noted a post over at Knoxviews which pointed out the president of BCBSofTN getting a salary boost, and I have a feeling recission plays a part in his salary. At the very least, a public-option must be part of the health care reform being played out in Washington as I type. Unfortunately, a public option that will be available to people that were cut from insurers, as well as the current uninsured isn’t going so well.

Perhaps most important, Obama has not yet demonstrated how hard he’s prepared to fight for the so-called “public option”—a government-run alternative to private insurance—or what such a reform might entail. At the AMA, Obama reiterated his position that one of the choices available to Americans “needs to be a public option.” But could this position be a straw man, set up only to be knocked down? The public plan has certainly served as a panacea to single-payer advocates and other critics of medicine for profit, including important Democratic constituencies like labor unions. One health care advocate told me that the speculation around town was that the administration could eventually abandon the public option in order to win bigger concessions from its opponents.

So, what plan would cover those that the greedy insurance companies have rescinded? Single payer would begin to take health care out of the so-called free market system, that has failed so miserably. It would be a stop-gap measure that would cover those that have been rescinded for some ridiculous reason by the for-profit insurance companies. As a single payer system is not even being discussed, the next best option is a public option, and as Ridgeway notes, even a public option has little chance of being affordable, equitable and available for the people that need the coverage the most. And this, folks, is one of the saddest commentaries about our current health care system.
52 Responses
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649848 tn?1534633700
I'm not sure where all of this information came from, but if it's true, then I would charge the government with the responsibility of finding coverage for those that have been rescinded -- notice I say "finding" coverage, not "providing" coverage, because the government is the entity that's insisting that everyone be covered.  If they insist that everyone be covered, they must find the coverage.

I am one that is against the health care bill --- I totally agree that health care is too expensive and something needs to be done. I think it's totally wrong that people with pre-existing conditions are dropped, denied or whatever (btw -- *I* have pre-existing conditions, so if I were to lose my current insurance, I'd be up a creek without a paddle).  

I have said it before and I will say it again -- first off, I don't believe the federal government should be in the business of selling health insurance, mortgage loans, car manufacturing or any number of other things they've decided to get into.  I believe it's just another way for them to take away some more of our rights by deciding our medical care.  

Here's the deal -- when the whole health care thing started when Obama was running for Prez....it was "Health CARE Reform" because health CARE was expensive, people could not afford it, etc, etc......Almost as soon as the election was over, it became "Health INSURANCE Reform".  Let's all keep in mind that there's a huge difference between heath CARE and health INSURANCE, even though they are tied together........

Health CARE is what you get when you go to the doctor and s/he treats what ails you, you pay and go your merry way.  Costs a lot to do that.             Health INSURANCE is when you go to the doctor and s/he treats what ails you, then sends the bill to someone else.........Costs even more to do THAT and when someone else is paying your bills, they have a say in what treatments you get/don't get, whether it be an insurance company or the government.  

If the cost of health CARE were brought in line, then the INSURANCE wouldn't be so important.  I'd much rather pay for my own care than submit a claim to my insurance, but they won't even let us do that anymore.  I mean, if I go to the doc for a cold and he hands me a script for antibiotics -- it usually costs around $300 and the bill is sent to my insurance company, who pays what they are going to pay, I take care of the co-pay and that's the end of the story.  Just think -- if the cost of that visit, which we all know is not WORTH $300, were less -- just say it cost $50 -- then I could pay the $50 and it would cost my insurance company nothing, so if they don't have to pay out so much, they shouldn't need to charge so much for coverage.

Here's where we have to "split hairs" between health CARE and health INSURANCE.  That's something the government isn't doing.  Nothing is being done to limit the amount of frivolous lawsuits that force doctors to have the horrendous malpractice insurance and everything else that drives up the cost of CARE so much, including greedy doctors who charge high prices just because they can and they know insurance will pay for it.  

I, personally, would prefer quality health CARE at price I can afford to pay, over insurance that I can't afford.  If I don't get sick or need a doctor, it doesn't cost me anything -- that's why so many people don't have insurance -- they don't feel that they need to spend that much of their income for insurance that they may not need to use.  I understand that -- I was there once and I totally resent the idea of someone/anyone, but especially the government telling me that I HAVE to pay for insurance.......

I read just this morning, that the average cost for a family of 4 for health insurance under the health care bill, will be approximately $6500 --- how many young families have that kind of $ laying around??  Then the cost goes up from there because the older we get, the more illnesses we tend to get and the more it costs to treat us, so the more it's going to cost to insure us.........

The bottom line is -- there's big bucks in health care, whether it be from insurance premiums or the actual cost of care, meds, equipment, etc.  Even if the government were to have a "public option" or single payer system -- what's to say that THEY won't deny your care or rescind your coverage because you're too expensive or they think your care is unnecessary?? Then they can turn around and fine you for not being covered - the government wins either way and we still pay.  

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Avatar universal
Teko, Where did you find this information?
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306867 tn?1299249709
Our family experienced this first hand. My sister was pregnant with twins and put in the hospital. They were doing everything possible to save these babies. Her specialist doctor came in and said he would no longer be treating her because her insurance was rejected.  She immediatley called her insurance company from her hospital bed and tried to deal with this. Can you imagine being flat on your back trying to save your babies lives and dealing with this. Grrrrrrrrr The insurance company said she was xcled for lack of disclosure or some such crap.  My sister was dropped and had such undue stress put on her at such a serious time.
Good news........bad news.
She later sued the insurance company and won. Although at that point the damage is done.

She lost one of the twins shortley after birth.

Insurance companies have a license to steal. Nothing boils my blood more than these theives.
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306867 tn?1299249709
PS   This really does go on. They have had insurance workers testify on Capital Hill in front of Congress. ...........and still nothing gets done about it.  
Ok gotta go get my blood pressure down. grrrrrrrrr
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306455 tn?1288862071
Barb, If yo don't want the government controlling things, why would you want them to control what Doctors charge and earn? Now that's true socialism. A much better idea is for the government to set regulations that doctors, hospitals and insurance companies can't rip people off. That is not socialism, that's common sense.
I have no doubt anyone who is against the Health Reform Bill, would change their mind in a heart beat, if their spouse or their children were put in a life threatening position and they loose their insurance.
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306455 tn?1288862071
I also want to say that I consider myself a true,good Christian woman because I care about people. I care that people aren't going to the doctors for mammograms, pap smears, heart problems etc because they can't afford insurance or the doctors bills. I care that people are left untreated.Even those people that are against Health Care for all their fellow Americans.......I would never want to see them untreated for an illness, just for the sake of the almighty dollar.
Why not a universal health Care system for Americans? And make it the best health care system in the world? Who says we have to be just like England or Canada? We're Americans....we're suppose to be the best! And we're suppose to take care of each other.....and that's what God wants.
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306867 tn?1299249709
I have a problem with people that say they don't want government run health care. They don't want the government making those decisions........but you want money grubbing CEO's with million dollar bonus's deciding what kind of health care you get. Makes no sence to me.  At the very least,we get to vote for our government officials. When was the last time you voted for who ran your insurance co.  Profit needs to be taken completely out of our medical decisions.  The number of people that die every year fighting insurance companies to pay on life saving claims (that are just) is sickening.
I also hate to hear that people are afraid they might have to wait for services.  I would gladly wait an extra 2 months for a hip replacement so that my neighbors could even see a doctor when sick.  No one would lose life saving treatments. That's just what the insurance companies have filled your heads with.......and it worked.
Oh boy I could go on for hours.lol
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535822 tn?1443976780
Government does not and has not run anything successfully so why would it be the best health care system in the world, tell me one success,that government has run ? and as for being untreated thats simply not true each area has 'free clinics , google if you want , the uninsured get free pap smears, Mammograms ,and shots and very good healthcare they contribute about $20 if they have it, they are not asked their status they are treated ,I have known 2-3 Doctors who give their time in the clinics ,most larger towns have them ,there is one in Santa Monica it is one of 3 in the area , Mexican folks  all go there and other uninsured they take their babies for their shots and check ups . They are founded mostly by Rich' folks leaving their money in trust for the clinics, the US has always been a generous Nation ..
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Avatar universal
Not necessarily true margy. I checked into a clinic here in my neighborhood because my regular doctor will not see me without insurance or cash up front. It is a based on what you earn program and I do not qualify. The only option for me is to pay regular cash fee or go to the ER. Since it is only myself and my husband and he works, we fall thru the cracks. However, anyone who is not employed gets free care that is true. As I said before, if yer rich, your taken care of and if your poor your taken care of, its the ones in the middle and the old that suffer. I put this up as I found it informative in the sense that Insurance companies can dump the sick and find loopholes to legally get away with it. I put this up to inform that even if you pay the big premiums, you are not safe. It doesnt matter if you agree or not on the healthcare reform bill being put together right now, but it does send out a big red alert and warning to us all, no matter what our circumstance. These are things that, unless you are on the recieving end, you may not be aware of. This was simply meant to enlighten, not start arguments on health care reform. This is more widespread than anyone realizes Im afraid. It is an ugly reality.
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458072 tn?1291415186
if the government pays your way, they own you. They will have the say as to where we can go the dr, which dr we can see, how often we can see him......

This is so true in the other areas that the government pays for people too.

And nothing is free, someone somewhere is paying.....the taxpayer, with our money being taxed. And if the government starts "owning" the healthcare, the taxpayers will have to pay for that as well.  What gets me, is the government uses taxpayer money, then have the gall to take the credit for it.

Kid yourself if you want to, but this is true.
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Avatar universal
Over the past few weeks, my sil who lives in Tenn, went to the ER twice and was diagnosed with an ear infection. He was put on antibiotics and sent home. The antibiotics did not work and he was having terrible headaches. On Christmas Eve, around 11:30 pm my daughter called me and said he had a stiff neck and she took him back to the ER for a third time. They did a cat scan and 3 neurosurgeons decided he had a brain aneurism and immediately transported him to a major hospital in Knoxville. I talked to her a little while ago and they still have not seen a doctor. He is in icu going on 3 days. A neurosurgion did call an order for an mri to be done and says he does not see anything abnormal. These are the notes from the doctor that the nurse read on his chart. Then today he ordered a ct scan. Still no doctor has talked to the family, however he is still in icu, nor has anyone read the results of the scan.  I talked to his mom and now she is sick with a fever and is restricted from seeing him. They are beside themselves. The nurse told them that the doctor probably would not come in until Monday because of the Holiday weekend.  In the meantime they all sit and wait and worry. I guess maybe this is because he does not have insurance, or maybe it speaks to the quality of todays healthcare, I am not sure and he is only 20. Now say what ya want, but any way you cut it this is just wrong! period.
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Avatar universal
I also do not feel that it is the government that is abusing the programs already in place. I believe it is doctors and your and my neighbors that are on them. We cannot blame everything on someone else.  Everyone these days seems to only care for themselves and not society as a whole. I have seen many a time, someone on medicaid in the ER because it was not convenient to wait a day or two to see the doc for something non emergent. You walk in the ER, it is 350.00 once you walk in the door, and that is before being seen. If you sign in and see a nurse who fills out paperwork, that is the fee whether you hang around or not. IMO...

I see programs designed for the poor, yet people who do not need it . I know of two families that got Toys for Tots this year for their children, when those children got bundles of stuff without it. Just one or two examples.
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535822 tn?1443976780
Well folks getting toys for tots when they didnt need it is plain dishonest ,I guess with the clinics I am thinking mostly of very low paid folks who havent got any money to pay and they are mainly the Illegal people come through from other countries.,and the unemployed , the story about your son in law does sound awful I hope they get him the tests soon  I cant believe that there is no one on call even over a Christmas holiday it doesnt make sense ,you are right it is plain wrong , so what happens if God forbid he took a turn for the worse .Darn crummy Hospital; if you ask me .
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306867 tn?1299249709
Living in Florida I know many elderly people that are on Medicare ( including my mother).  She gets excellent care and see's the doctors she wants, as do the others I know on it. It's a wonderful goverment program and thank God for it.
Now as far as your free clinics.  Yes we have them and I have first hand experience with them. I have been going to one for a year. I'm on a list to have a colonoscopy and should have it in another 2 months.  That makes it 14 months. It's not the clinics fault all these wonderful people donate their time, but they can only schedule so many free-bee procedures per month.  So what might have been a polp a year ago could now be colon cancer.  I've tried the local Health Dept., also tried to get on Medicaid to get this taken care of , no luck there.   I could go to the emergency room and fake that I am in serious pain, but I'm a terrible lier.   I know, terrible speller too.lol  
I've worked hard all my life and out of my 49 years on this planet I had health insurance 46 years.  Being self employed it became completely out of my reach. Not to mention that I have 90% less business now.  
People need to realize how quickly it all can fall apart. How you can lose everything over one illness. The material things aren't even that important. It's the people that are losing their lives because they aren't getting treated. The sad thing is some of those people have insurance but claims are denied or their cancelled.
Teko's right......everyone just cares about themselves.  Without some government intervention the banks and insurance companies will, and have robbed us blind.
Yes, I might pay a little more in taxes, but myself, family, friends & neighbors would be able to see a doctor when their sick.
I'm also a firm believer in "what goes around comes around". I believe the people against the public option, that have good insurance right now.......will be pleading for help in a few years. It's sad that sometimes people must walk in others shoes before seeing light.  I have learned this lesson myself a few times.  
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306867 tn?1299249709
A few sucessful government run programs......Department of Defense( our military)
The IRS seems to run a pretty tight ship.lol     Medicare is a life saver for so many.  Even the National Weather Service does a pretty good job.(they didn't know the levies in New Orleans would break)  Our police & most fire dept's.  Social security ( my mom's check is always on time) Actually, Social Security also runs a tight ship. They come looking for a refund if you die in the middle of the month. lol
Yes, many of these could use some work and there will always be some abuses but could you imagine any of these for profit. OMG would we be getting the shaft. Our government is far from perfect, but they do a darn good job.
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306455 tn?1288862071
I also think it's a shame that so many think our government, the US Government, does such a bad job running things.  I can't think of another countries Government I would want to replace it. Like it or not, we the people of the US are responsible for those that run the Gov. We did not import all the Gov.leaders (past & present) from Iran or Russia or China. All those people in our Gov.are home grown,. They were once small American children raised by their American parents. They represent the people Americans raise. So when to say ALL our Gov.people are corrupt, you are saying all of our children are corrupt....the children  WE all raised and put in the Gov. Yes, there are always some that have lost their way and succumbed to the almighty dollar, just like any other business or situation..even churches, but as for me, it's the only Gov. I'd want running this country. The programs our Gov have put in place are pretty darn good, especially if you compare them to a lot of for-profit businesses. When our Americans health is the issue, I'd much rather see it placed in the Gov.hands than the life sucking insurance companies.When was the last time you voted for people to run your insurance company? They don't care about your votes, or your health....only their profit margin.
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535822 tn?1443976780
You know guys with respect to you, I think we are living on differant planets altogether so I have'nt much response .......This government and all of his 'weird czars' and crazy programmes ,and the horrendous debt they have placed on us for generations to come,their extreme radical views, are ruining America .. I do believe it is all wilfully done  .
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458072 tn?1291415186
Our government is really doing a great job. you want proof? look at our school systems, wow! our medicare system that is about to be non existent, just to mention 2.

If the new healthcare insurance reform, is so great, then I please tell me why the government officials have signed to not have to partake of such a wonderful scheme?

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535822 tn?1443976780
Thats a good point peg ..theyalso want a redistribution of wealth but they dont want to redistribute their wealth, and do you honestly believe this President and his big spending wife is going to share the ton on money they have or use the heathcare they want for everyone else .,we pay for the jetting around ,we the people the trips to Copenhagen by a whole bunch of them ..for what ...Does money grow on trees who is paying for it all , there are only so many wealthy that will pay , its us guys the middle classes....
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306867 tn?1299249709
The reason government is not getting healthcare insurance reform is because of the billions of dollars the insurance industry has spent scaring the crap out of people. Feeding them bullcrap like death panels etc.
Our Medicare system works great the problem is a shift in babyboomers recieving it and people paying in.  I agree we have to solve this problem and congress and the president are suppose to have a solution.  First is to stop the duplicate testing. Lord they could save a fortune on my mother alone if the 10 specialists she see's would share the info or even read the chart.
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306867 tn?1299249709
Also remember this president is picking up the pieces from the worst president ever. Most the problems that people complain of were there before he took office. Talk about destroying our Constitution. Pres. Bush walked all over it. He nearly had this country in complete colapse.
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306455 tn?1288862071
Crazy Programs? What crazy programs? Horrendous debt? Yeah, which Obama got from Busch, now Obama has to try to fix things and yes, it's gonna cost some money. Extreme radical views? What extreme radical views...ruining this country? And willfully done? The President is trying to fix some issues that need fixing in this country, and you may not agree with it, but it doesn't mean he's ruining the country or turning it into a socialist country. A lot of paranoid people around here.
Obama got elected because the majority of Americans agreed with his views.
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535822 tn?1443976780
He got elected because most of us didnt know about his veiws he ran a good campaign, we believed him , we didnt know how left wing he was, most thought he would at least be a moderate Democrat .You honestly dont know about the trillions of debt ..what extreme views...Wow I suggest you get reading or at least watch CNN now ,there are many questioning what he stands for I dont care if you dont believe me you need to get informed what is happening here ...actually maybe you dont .....its possible you dont want to know .
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306867 tn?1299249709
You still haven't named one extreme view.  Actually the far left is upset with him because he has been more moderate.  Watch CNN everyday.
Can I ask how you felt about the prior president ?
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