Our health insurance system sucks

[ramapo]

I posted this in GD but of course it sunk like a rock. This is just one of the stories I'm sending along to President Obama in response to his request yesterday for personal stories.
(I did clean it up a bit for him.)

If you've been watching TV the past couple of days, you should be very afraid of the proposals being discussed to reform health insurance. After all, what could be worse than a system that at the every least provides for guaranteed-issue insurance through a federal program?

My blood pressure soars each time I see one of our "representatives" spewing bullshit about how Americans are going to sacrifice cost, choice, and availability under a "government" plan. They've been out in force this week. Never mind we have no choice today and that patient and doctor alike are at the mercy of the insurance companies.

Here's my reality and it has my blood pressure through the roof.

My 22-year-old son is graduating college. Wonderful, except now he cannot be covered under my health plan.

He's been going to school in Chicago and wants to stay there. He is an aspiring musician so, for right now anyway, he's not looking into corporate employment. Not that there's much out there now for a liberal art graduate anyway.

So he needs individual insurance. Unfortunately (in the eyes of the insurance companies), he is the survivor of a benign brain tumor. Today, seven years later, he is as healthy as anybody. The chances of recurrence are about nil and he hasn't even been sick in two years.

Yet this bit of medical history is enough to deny him insurance without even a thought. It doesn't matter that he's perfectly healthy today. Now he could get guaranteed-issue insurance in NJ (for a price of course) but he doesn't want to live here. He has worked hard to build a life in Chicago. Do you just throw that away because you need insurance?

So here we are in this wonderful country of ours. Need insurance? Well to start off, it depends what state you happen to live in. In NJ, you can always get insurance, as long as you can afford it. In most of the states the answer is if you've EVER had something wrong with you is, "Sorry can't have it. Hope you don't get sick or injured. Good luck".

I hate every one of those f***ing, sick bastard politicians and lobbyists who have done everything in their power these past 16 years to make sure that the insurance companies get to retain the power to decide who is fortunate enough to get insurance, which providers you can visit, and what treatments get covered. I won't even talk about rates, co-pays, and deductibles.

I like to think this gets fixed this year but it looks like we'll be lucky to get some watered down BS solution. I hope I'm wrong.

I've written my letters and made my calls. A lot of good that'll do my son if he winds up sick.

[RaleighNCDUer]

1. That is EXACTLY the kind of story that needs to go to Obama -

properly bowdlerized for presidential consumption, of course.

[uppityperson]

2. k&r

[REACTIVATED IN CT]

3. Several states have passed laws requiring insurers to keep kids

on their parents employer's plan even if they are not in school. It was effective here in CT as of 1/1/09 and I know MN, MA and IA have enacted same legislation. The only hitch is that the value of the coverage is taxable to the parent which will cost them about $100/month in taxes (Federal, Soc Sec & Medicare)

Is this sort of plan on the table in NJ legislature?

I'm sure you know that he would be eligible for 36 months of COBRA although the cost would be a lot more than $100 per month.

[ramapo]

5. NJ is enlightened, IL is not

Yes NJ enacted that legislation a couple of years ago.

The problem is my son will not be living in NJ, which is a requirement. Our insurance coverage area does not include Illinois so he cannot COBRA. A little known gotcha is that you must live within the service area of the insurance company in order to COBRA.

He can COBRA the not-very-good school policy for one year only. After that, he is screwed.

[ramapo]

10. Correction & an expensive solution

I found out today that my son is eligible for 36 months of COBRA coverage. The only problem is since he will be out of the coverage area, he can only use the out-of-network benefit. This basically equals no benefit at all, barring something pretty serious.

So for now I will be paying about $500 a month to make sure he is covered in case something bad happens. Our out-of-network deductible is $5000 with maximum out-of-pocket per year of $10,000.

Bottom line is $11,000/year before the insurance company needs to pay out a penny.

Well I exaggerate just a bit. If he needs a prescription, he can have it filled at CVS or Walgreens for $30-$50. Or he can come back to NJ and find a network provider if he is sick.

As bad as this is, I am relieved. At least he won't lose his insurance.

[YewNork]

4. That happened to me too

My job sent me to work in Canada for about 7 years. Three months after arriving in Canada I received my health insurance
card in the mail. It covered me from that point until I left Canada to return to the US to live. While I was in Canada I
was even treated for cancer. I had a tumor removed, and was successfully treated, and I am now happily cancer free for
five years.

Well, I returned to the US to live last year, and guess what. Despite being cancer free and despite the fact that the cancer
was caught early, I cannot get any insurance that will cover me for treatment of any cancer in the future.

Where I live, insurance companies are allowed to indefinitely exclude a pre-existing condition. It is asinine that the
state you live in should control what insurance you will have.

[eridani]

11. Tell this story far and wide. Congress, Obama's email contact forms

--write LTEs, share with every single payer group out there. Never shut up about it!

[WillYourVoteBCounted]

6. Sen Baucus is the gatekeeper protecting insurance co's profits

and he and they want single payer to fail.

There is NO reason to subsidize insurance cos, they are middle men and it is too expensive
to pay them to waste our tax dollars.

Private ins has far more red tape and it takes them more resources to process than
does govt /medicare.

[Wednesdays]

7. K&R

:kick:

[raccoon]

8. K&R. nt

[PHIMG]

9. Private Health Insurers = THE PROBLEM

Bloody Hands. Private Insurers make self-interested and arbitrary claim and coverage denials relegating many to premature death.

Restrict Choice. Private Insurers restrict medical consumers’ choice in medical providers, inhibiting the proper function of the free market in medical services and enabling bad providers to thrive.

Adds Complexity. Over 1,200 Private Insurance bureaucracies complicate and impede the practice of medicine with differing and often conflicting billing and administrative policies.

Drains Resources. Nearly 30% of the healthcare spending funneled through health insurance middlemen is wasted on profit taking, underwriting, executive compensation and other unnecessary expense and waste.

Squanders Expertise. Our current health care model diverts providers' attention from "how to heal" to "how to get compensated" by the shameless insurers.

Manipulates the Media. Private Insurers exert a level of editorial control over the media via advertising purchases.

Corrupts Our Politics. Private Insurers manipulate elected officials with campaign donations, plum corporate jobs, and an army of lobbyists.

Brainwashes the Populace. Private Insurers use paid media to lie directly to the populace, leveraging fear tactics and other highly sophisticated propaganda campaigns in order to evade accountability for the consequences of their actions and protect the status quo.

Restricts Debate. Private Insurers’ media and political operatives dishonestly malign genuine reform as “politically infeasible” in order to limit the debate to industry-blessed half measures.

Private Health Insurance Must Go! Reform proposals that do not remove private insurers from our healthcare system are morally unacceptable, fiscally irresponsible, and unsustainable even in the near term. These “mandate and subsidize” proposals are not well meaning attempts at realism by so-called centrists. They are a sinister attempt to marginalize the opportunity our country has at this defining moment to sideline the private insurers and move to a healthcare system that works – publicly funded and privately provided Medicare for all, as implemented in HR 676 – The United States National Health Care Act.