Illness as the primary cause of bankruptcies...

[LRAO]

Pretty damn scary...

double check your insurance coverages!

http://story.news.yahoo.com/news?tm.../ap/20050202/ap_on_bi_ge/medical_bankruptcies

 

[Marshac]

Re: Illness as the primary cause of bankruptcies..

I heard that on NPR this morning on the drive to work. What really hit me was the statement that most of the people declared bankruptcies for medical debts under $12k. Just shows you how close to the margin most Americans are living these days.

 

[John Galt]

Re: Illness as the primary cause of bankruptcies..

I am often shocked when I hear stats like that. It does
illustrate my point on another thread that for millions in
this country, $50.00 a day would be "livin'large".

JG

 

[Hyperborea]

Re: Illness as the primary cause of bankruptcies..

I am often shocked when I hear stats like that.  It does
illustrate my point on another thread that for millions in
this country, $50.00 a day would be "livin'large".

Only because they'd either have company provided health coverage (which they would lose when they lost their job due to illness as per the study) or they'd run without it.

 

[Bob_Smith]

Re: Illness as the primary cause of bankruptcies..

Even wealthy folks can lose everything from health problems... even if they purchased insurance.  All it takes is one long term health problem.  You have insurance now, but your healthcare insurance company can drop you like yesterday's news if you get sick and they know you will be sick going forward.

I would still be working if there hadn't been an early retirement offer that included lifetime access to my employer's group plan, which transfers to my wife if I die. I must pay the premium, but they can't drop me, and they can't raise my rates without raising the entire group. There's no lifetime max either. It's expensive though.

 

[Marshac]

Re: Illness as the primary cause of bankruptcies..

but they can't drop me

As long as they stay in business

 

[Bob_Smith]

Re: Illness as the primary cause of bankruptcies..

As long as they stay in business

Going out of business isn't likely - it's the State.

 

[Jarhead*]

Re: Illness as the primary cause of bankruptcies..

Even wealthy folks can lose everything from health problems... even if they purchased insurance.  All it takes is one long term health problem.  You have insurance now, but your healthcare insurance company can drop you like yesterday's news if you get sick and they know you will be sick going forward.  Then you can't get coverage elsewhere.  They can bump your premiums sky high.  You can meet the upper limits of what they will pay and then it's out of your own money.

Healthcare in the US leaves a lot to be desired.

Davew894: Well, hard to argue with your last sentence, but you are wrong about a couple of major points in the main text.
An insurance company, on initial underwriting, can, of course refuse to accept you.
Once you have been accepted, they cannot drop you individually as a risk, regardless of your future health problems.
They can also not single you out for a rate increase.
I know this because I'm old.

 

[REWahoo]

Re: Illness as the primary cause of bankruptcies..

Once you have been accepted, they cannot drop you individually as a risk, regardless of your future health problems.
They can also not single you out for a rate increase.
I know this because I'm old.

Jarhead, thankfully you are correct. Err...I'm thankful insurance co's can't drop you or raise individual rates if you get sick, not that you are 'old'.


REW

 

[maddythebeagle]

I hear this stuff from the "left" while the "right" says that it is people being irresponsible. I would suspect that the truth is in the middle somewhere. From what I see this new bankruptcy law seems reasonable.

 

[OldAgePensioner]

My health insurance experience is 35 years in the US and 20 years overseas? It's a mixed bag as to which system is more effective. But one thing is clear, here in the US we can get to a specialist without the stop to a General Pratisioner like in the UK. There you could wake up blind but you had to go to the GP and be "referred" to a eye specialist in a few weeks. Don't condem our system till you've lived thru some others.

In Australia 1990-1997, the technology was about 5 years behind the US. To get an MRI was like asking for vacation on the moon. No antibiotics, the country is fanatical that antibiotics are the worst evil on the earth.

In UK 1997-2005, their system cost you nothing for visits with at GP and only a few GBPs for a perscription. But any of us who need any surgery were advised to head back to the US. Hospitals varied but just read the papers, major problems with cleanliness. Superbugs are killing many. Waiting lines are huge, even for major problems like cancer, organ replacement.

I like the US model.

 

[Martha]

Jarhead and REW, federal law (HIPAA) does require guaranteed renewability of individual health plans (though the insurer can cancel the plan for everyone). However, HIPAA is silent on premium increases. A number of states do not prohibit insurers in the individual market from increasing rates based on claims or age of covered individuals. Some states require community rating of health insurance premiums. No policyholder can be charged more than any other based on health status, health history, or other risk factors. Other states require modified community rating with adjustments permitted for age, but not health status. Yet other states impose rating bands that limit how much premiums can vary based on health status, age, and other factors.

Because there are no national rules on rates, the guaranteed renewal may or may not be helpful to a particular individual because they could be priced out of the market due to age or illness.

 

[REWahoo]

...HIPAA is silent on premium increases. A number of states do not prohibit insurers in the individual market from increasing rates based on claims or age of covered individuals.

As usual, you are correct Martha. Rate change regulations do vary by state. A good place to review state health insurance information is http://www.healthinsuranceinfo.net/ In my case (TX), an individual cannot be singled out for premium increases based on claims:

"...[W]hen you renew your individual health coverage, an insurer can increase your premiums. However, premium increases must be applied to all persons in your class and not on an individual basis. A class may be grouped by age, sex, or by each individual health plan product."

REW

 

[astromeria]

My current and previous 2 US PPOs as well as my last HMO (in 3 different states) all require(d) me to get a referral to a specialist from my primary care dr. In fact, a couple of years ago I was referred to a specialist from another specialist. When I showed up for the appointment, they refused to see me unless I paid $50 upfront instead of my nomal $15 copay, as if I came in off the street. No referral from primary care doc, no $15 copay. And this was in the same building as the referring specialist! Man, was I ticked--I refused to pay, the doc refused to see me, I never went back. I personally don't think our system could be much worse.

 

[Brat]

Speaking of HIPPA.. My mother had a broken hip a couple years ago which was fixed by an ortho associated with a local hospital.  Mom lives in a nursing home.  Recently a person from the ortho office called my brother (the appointed contact person) to inquire about her current ADLs (activities of daily living).  So far so good, until the person mentioned that she could see that Mom had a recent bladder infection.  SAY WHAT

It appears that the ortho office could look at her medical record at the local hospital (who does her lab work).

I don't object to health practioners having access to health history when they are treating a patient, but this surgeon hadn't seen Mom in years. What gives

 

[Martha]

Brat, HIPAA doesn't give as much privacy rights as people often think. Consent to the use of your mother's medical information is not required if it is used or disclosed for treatment, payment, or health care operations.

Most of the privacy protections have to do with sharing medical information with employers and for marketing purposes.

 

[haha]

Malcolm Gladwell on Health Insurance

http://www.newyorker.com/fact/content/articles/050829fa_fact

IMO, an excellent article which goes to the center of our weird American obsession with individual independence. Even the healthiest person in the world is nuts to want to shoulder his own health costs, because they could suddenly go from 0 to $250,000. Who gets Hodgkin's disease? Melanoma? Testicular cancer? Lots of young healthy people do, along with the older folks.

Risk sharing is not only humane, it is prudent.

Also, often we mistakenly think the waits in other countries, when they in fact do exist, result from the organization of care. More likely, they result from the fact that those systems are being operated on many fewer $s per capita. Nothing to prevent the USA from using the greater efficiency and good sense of a social insurance system, but funding it more highly.

Haha

 

[Martha]

Excellent article. Interesting info on per capita spending:

Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average.

The point about bad teeth as a class divider is well made.

 

[maddythebeagle]

martha: how do you know all of this so well?

 

[Martha]

My high IQ?

I am very interested in health insurance and in a national solution to health insurance issues. I also have participated in lobbying efforts to eliminate cuts to MinnesotaCare, a subsidized health insurance program for otherwise uninsured poor in Minnesota.

 

[SteveL]

Most governments in the world are struggling with this problem. All are faced with aging populations who need more care, greater availability of more expensive medical technology, the drug industry, rising expectations of better health by people, and increased life spans.
In the US, these problems are made worse by a system that pays the persons who deliver the service on a piece rate. This would be similar to paying a carpenter by the nail.
Where I live in Wa. State, if you move here and are 65 you can't get a doctor, because Medicare reimbursements are so low.
The bankruptcy issue has not been helped by hospitals who charge the poor much higher rates than they charge the insurance companies. There are several law suits now underway on this issue. Hospitals will lose, and this obscene cost shifting to the poor will end. The rest of us will have to pay more.....

 

[maddythebeagle]

The bankruptcy issue has not been helped by hospitals who charge the poor much higher rates than they charge the insurance companies. There are several law suits now underway on this issue. Hospitals will lose, and this obscene cost shifting to the poor will end. The rest of us will have to pay more.....

I think this is a very good point and I also believe there is a lot of cost shifting. I noticed that a lot of local working class arent paying medical bills and notice several small claims court actions (as if that will get payments). Seems like everybody's bills should be the same.

 

[Martha]

The bankruptcy issue has not been helped by hospitals who charge the poor much higher rates than they charge the insurance companies. There are several law suits now underway on this issue. Hospitals will lose, and this obscene cost shifting to the poor will end. The rest of us will have to pay more.....

I think one of the arguments in these suits is that many hospitals were created as charitable organizations and to charge the highest rates to the unisured poor conflicts with their mission.

Some hospitals have said that they were essentially forced to charge the highest rates to the unisured because all discounts work off of these rates. Another rationale of hospital is that they had to charge market rates to the uninsured or they would get into trouble on medicare and medicaid reimbursement. Some months ago HHS issued a letter that lower charges could be made to the indigent without jeopardizing medicare and medicaid reimbursement. Of course, this won't help if you are not indigent and are simply soaked for big charges because you are unisured.

 

[tozz]

Socialized medicine, pay as you go, fee for service, HMO, PPO: all are different ways of rationing health care. You can ration by long waits, by high costs, by hassling the individual until he goes away, by using "gate-keepers" with a financial incentive to keep costs down.

I personally think that some minimum level of health care should be a right in this country. If you want above the minimum level, you can pay for it. Evidently, I'm in the minority.

I personally don't think our system could be much worse.

 

[justin]

If I could pay medical care providers at their insurance negotiated rates, I wouldn't care to have insurance except maybe a $10,000 deductible policy or something.