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Old 09-29-2009, 09:43 AM   #21
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You've cited instances and anecdotes (which are, as you promised, "data.") I think what would be useful is actual refined statistics and information that allows us to determine if the insurance companies are abusing these retrospective determinations of eligibility.
Did you actually read the link that was provided?
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Old 09-29-2009, 09:49 AM   #22
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Originally Posted by toofrugalformycat View Post
We do have real data on this.

Here's the link:
http://energycommerce.house.gov/Pres...pplemental.pdf
Thanks for the link. It was interesting, but there really was not much in the form of (useful) data that I was looking for (unless I missed it, I read most of it, skimmed some). They report that "they rescinded at least 19,776 policies from 2003 to 2007.", but we have no denominator, and we have no idea how many of those were clearly fraudulent applications. So somewhere around 5,000 per year; need to subtract actual fraudulent applicants, then divide by the number insured by those cos and we start to get a picture. Sure, one is too many, but we need to be realistic.

I never had a doubt that these practices take place. I'm not defending the ins cos here, but under the current system they need to do much of this or they won't stay in business (look at my welding example below for one reason why) and then none of us will have ins. And I'm not even surprised (though I am horrified) that in some cases the system is abused by the ins cos. But that hearing reads mostly like a string of anecdotes, "In this case this, In that case that".

The data I was looking for was something to tell me the % of cases where abuse took place. Abuse by the ins cos, and abuse by the insured. The latter is important, because if a high % of applicants are lying it does show that the ins cos need to be more aggressive in weeding those out. And when you deal with big numbers, I'm sure that some cases of abuse will occur - some simply by error, some from over-achieving, misguided individuals.

For a bit of balance, I also would not be surprised if someone could post a string of horrifying cases of abuse from the large list of Medicare/Medicaid cases. Do we throw the baby out with the bath water?

This is why I keep offering up the voucher system. With nationalized competition for the ins cos (yes, with some important regulations), and a public option that had to play under the same rules (take one take all), you eliminate the problems with underwriting.

-ERD50
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Old 09-29-2009, 10:22 AM   #23
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12 years 1993 to 2005. age 49 to 61. I would not recommend it for someone else.

Remember the line from 'Star Wars' -"never tell me the odds."



heh heh heh - now moving from LA to MO post Katrina and high deductible got me to a place where I could afford it and stay ER'd - that and time in the market in the 90's.

I just got back from New Orleans - friend passed at age 58 with health insurance out the whazooo - luckily he ER'd at 53 and got a lot of good licks in.

Like the man say's - never tell me the odds. And don't sniff rocket fuel.
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Old 09-29-2009, 10:58 AM   #24
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I agree with ERD, we need a better picture of the data.
I also agree with frugal, that link shows a 'systematic' issue and should be taken more seriously than 'last night uncle joe told me of a story about a co-worker's friend's insurance company denying....' type of anecdote.
The full data is the next step, hopefully we will see it soon.
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Old 09-29-2009, 12:27 PM   #25
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Originally Posted by samclem View Post
You've cited instances and anecdotes (which are, as you promised, "data.") I think what would be useful is actual refined statistics and information that allows us to determine if the insurance companies are abusing these retrospective determinations of eligibility.
You're right, it is frustrating that the information is not available to consumers. It's not even available to Congress!

Quoting from the same document:
"In October 2008, the Oversight Committee requested information from 50 state insurance regulators about the size of the individual insurance market in each state, legal standards governing rescissions, and investigations relating to rescissions. Most states were unable to answer basic questions about rescissions and the individual health insurance markets in their states. For example:
Only four states, Hawaii, Kansas, Texas, and Washington, were able to provide the total number of rescissions that occurred within their jurisdictions.
Only ten states were able to provide the number of individual health insurance policies in effect in their jurisdictions.
Over one-third of state commissioners were unable to supply a complete list of the companies within their jurisdictions that offer individual health insurance policies."

I did find in this document, a few numbers about California (but admittedly not enough on which to generate a probability of rescission there).

"But WellPoint has been forced to reverse thousands of rescissions and pay millions of dollars for improperly terminating health insurance coverage in recent years. In July 2008, a subsidiary of WellPoint, Anthem Blue Cross, entered into a settlement with the California Department of Managed Health Care under which the company reversed 1,770 rescissions and
paid a $10 million fine. 6s This year, in February 2009, the company entered into an additional settlement with the California Department of Insurance under which it reversed 2,300 more rescissions and paid an additional $15 million penalty. The practice does not appear to be an isolated incident. In 2008, a judge ruled that another health insurance company, Health Net, had rescinded a California woman undergoing
chemotherapy in bad faith and awarded $9 million in damages. It was revealed that Health Net paid bonuses in part based on meeting or exceeding annual targets for rescinding policies."
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Old 09-29-2009, 12:39 PM   #26
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You're right, it is frustrating that the information is not available to consumers. It's not even available to Congress!
Agreed. It would sure be nice to be able to have a fact-based discussion, but the facts, let alone a fair analysis of them, appear to be lacking.

Of course, all this becomes irrelevant if we go to a "must issue, no underwriting" system.
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Old 10-04-2009, 09:52 PM   #27
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Had an interesting conversation with a store employee today. We got onto the topic of health insurance somehow. These folks are American citizens, not illegals (who get free care). He said he and his wife have plenty of money but choose not to have health insurance because they have found ways to work the system. They tell the provider they cannot pay due to poverty ( a lie) and get a minimum payment per month, forever. $40 a month was the number he mentioned.


Another of his tricks : If you want to get the debt off your back, stop paying completely for 6 months, after which the debt will be sold to a third party for a fraction of it's total, and the third party will write of the entire debt as an expense, getting a tax break, and allow you the debtor to pay off your liability with a fraction of the remaining debt, say 20%. The third party apparently makes a profit doing this.

Yes, this is pretty sleazy, but I bet a lot of folks who are "street smart" and willing to lie, are doing it. Driving up the cost for the honest folks.

Apparently hospitals, doctors, etc are not allowed to check your net worth?

This guy said he had house and a mortgage too, and never had a lien against it for health care debt.

Yeah, he could have been making up a story, but I think he was serious.
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Old 10-06-2009, 01:27 PM   #28
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I'd only go uninsured if I had no assets to protect.
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Old 10-06-2009, 03:55 PM   #29
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They tell the provider they cannot pay due to poverty ( a lie) and get a minimum payment per month, forever. $40 a month was the number he mentioned.

Another of his tricks : If you want to get the debt off your back, stop paying completely for 6 months, after which the debt will be sold to a third party for a fraction of it's total, and the third party will write of the entire debt as an expense, getting a tax break, and allow you the debtor to pay off your liability with a fraction of the remaining debt, say 20%. The third party apparently makes a profit doing this.
He better hope he doesn't need a loan of any kind, or applies for job
that does a background check. Depending on where he goes (state run hosipital for example) they may get supplemented by tax payers (ie. you), so they don't bother to follow up on dead beats.

I think he is BSing somewhat, 1. except for this year, that debt they
writeoff is considered income to you, so you end up paying more in taxes,
2.What debt could he possibly have after do that more than once? His
credit score must be nil.
TJ
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Old 10-07-2009, 10:35 AM   #30
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He better hope he doesn't need a loan of any kind, or applies for job
that does a background check. Depending on where he goes (state run hosipital for example) they may get supplemented by tax payers (ie. you), so they don't bother to follow up on dead beats.

I think he is BSing somewhat, 1. except for this year, that debt they
writeoff is considered income to you, so you end up paying more in taxes,
2.What debt could he possibly have after do that more than once? His
credit score must be nil.
TJ
These last few posts beg the question... if the health care system, including insurance companies, are all using unethical techniques to make a big profit and screw the little guy, isn't it fair to use every available technique to cheat the system?

The author of the original link stated that he could survive financially without health insurance. The other option is to make yourself look so poor that no debt collection agency could ever collect a dollar from you for a visit to the emergency room. That's what I did - and I don't carry health insurance either.

How is it possible to look that poor and yet not really be poor? There are many strategies, but here are a few examples:
1. Sell your house to your kids.
2. Move all your cash to a foreign bank - simple wire transfer and no credit collection agency can ever find where you keep your cash.
3. Get a false name or use a poor friend to buy and hold your investments (real estate investment is easy to hold this way, nobody to send in 1099s)
4. Many more similar tricks.

If you don't like going to the emergency room, pre-arrange a hospital in someplace in Mexico or Asia. For elective or non-emergency health care, the total cost of travel and treatment is far less than a few days in the hospital - and the quality of care is just as good as the US.

And, as far as something really serious, I choose not to have it treated. Let's call it a message from God that your time on earth is over. Instead of suffering through endless, expensive operations, I keep a shotgun under my bed... my form of euthanasia. If my time has come, why fight it? Everyone has got to die sometime, just a question of when. I don't mind dying if my quality of life is gone. I just don't want to suffer.
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Old 10-07-2009, 10:44 AM   #31
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...if the health care system, including insurance companies, are all using unethical techniques to make a big profit and screw the little guy, isn't it fair to use every available technique to cheat the system?
You are advocating that two wrongs make a right? That we should stoop to their level and wallow in the mud with the slimy b@stards rather than go after them and make them pay for and change their unethical practices?

Sounds too much like a 'third world' approach to doing business...
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Old 10-07-2009, 10:57 AM   #32
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These last few posts beg the question... if the health care system, including insurance companies, are all using unethical techniques to make a big profit and screw the little guy, isn't it fair to use every available technique to cheat the system?
What if it is some individuals high up in the health care system as a whole?
Basically, by making that decision, you are definitiely contributing to the downfall/added cost based on a possibility of a the actions of a few?

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And, as far as something really serious, I choose not to have it treated. Let's call it a message from God that your time on earth is over. Instead of suffering through endless, expensive operations, I keep a shotgun under my bed... my form of euthanasia. If my time has come, why fight it? Everyone has got to die sometime, just a question of when. I don't mind dying if my quality of life is gone. I just don't want to suffer.
I sure am glad I don't think like you, I would have died over 40 years ago.
Yes, it has been expensive and yes, my quality of life would be better without diabetes. But having 40-90 years of life I truely enjoy cut short at my own hand? That just seems stupid.

Oh, and thank you for making health care more expensive for the rest of us:P
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Old 10-07-2009, 01:19 PM   #33
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These last few posts beg the question... if the health care system, including insurance companies, are all using unethical techniques to make a big profit and screw the little guy, isn't it fair to use every available technique to cheat the system?

The author of the original link stated that he could survive financially without health insurance. The other option is to make yourself look so poor that no debt collection agency could ever collect a dollar from you for a visit to the emergency room. That's what I did - and I don't carry health insurance either.

How is it possible to look that poor and yet not really be poor? There are many strategies, but here are a few examples:
1. Sell your house to your kids.
2. Move all your cash to a foreign bank - simple wire transfer and no credit collection agency can ever find where you keep your cash.
3. Get a false name or use a poor friend to buy and hold your investments (real estate investment is easy to hold this way, nobody to send in 1099s)
4. Many more similar tricks.

If you don't like going to the emergency room, pre-arrange a hospital in someplace in Mexico or Asia. For elective or non-emergency health care, the total cost of travel and treatment is far less than a few days in the hospital - and the quality of care is just as good as the US.

And, as far as something really serious, I choose not to have it treated. Let's call it a message from God that your time on earth is over. Instead of suffering through endless, expensive operations, I keep a shotgun under my bed... my form of euthanasia. If my time has come, why fight it? Everyone has got to die sometime, just a question of when. I don't mind dying if my quality of life is gone. I just don't want to suffer.
Remember in most states your retirement savings like 401k are protected,
IRAs as well in some states, so if you had no taxable money, the I'm poor
strategy might work, without the extra work.

You could try something like : How the Plan Works

Shotguns are a messy way to go, try a plastic bag tied around your
head, way cleaner, also gives you a few minutes to reflect on what
you are doing. And doesn't give gun haters more ammo
TJ
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Old 10-08-2009, 10:25 AM   #34
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You are advocating that two wrongs make a right? That we should stoop to their level and wallow in the mud with the slimy b@stards rather than go after them and make them pay for and change their unethical practices?

Sounds too much like a 'third world' approach to doing business...
I would love to change the system if I had the power to do it. An overwhelming number of Americans would like to change the system, but true, cost cutting changes do not look like they are anywhere on the horizon. I do not consider it unethical to use every legal means possible to fight corruption and unethical business practice. You have to fight fire with fire.
Quote:
I sure am glad I don't think like you, I would have died over 40 years ago.
Yes, it has been expensive and yes, my quality of life would be better without diabetes. But having 40-90 years of life I truly enjoy cut short at my own hand? That just seems stupid.

Oh, and thank you for making health care more expensive for the rest of us:P
You misunderstood what I said, or perhaps I was unclear. About 10 years ago I needed a thyroidectomy because of pre-cancerous nodules. But that is not "something really serious", it is an operation and I live a perfectly healthy life today. I used my frequent flier miles to fly to Singapore and had the operation for under US$5000, complete.

Something really serious is an illness where I can never recover to a normal life - like cardio-vascular disease which can be delayed with operations, but can never healed. Brain tumors also fall into that category.

Oh yea, :P, a heck of a lot of slime ball lawyers and inefficient hospitals that make health care far more expensive for the rest of you. Don't shoot the messenger.
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Old 10-08-2009, 10:30 AM   #35
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I'd only go uninsured if I had no assets to protect.
Ditto: "thank you for making health care more expensive for the rest of us"
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Old 10-11-2009, 08:26 AM   #36
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Hobo--I agree that using every legal means to get the best for you is a good idea, however when you say "use every available technique to cheat the system", you are advocating illegal actions.
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Old 10-11-2009, 08:51 AM   #37
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Hobo--I agree that using every legal means to get the best for you is a good idea, however when you say "use every available technique to cheat the system", you are advocating illegal actions.
Ok, so the hospitals and the insurance companies can cheat me, but I can't fight back by using "extra-legal" techniques to fight their "extra legal" scams? You thing that is fair. A scam is a scam, no matter how big the corporation. We are getting scammed big time, and Congress is cutting deals with hospitals. lawyers and insurance companies in exchange for campaign contributions. You think that is not cheating. We are the victim, and if I can think up a way to avoid being scammed and still not break the law, I will do it.

It is the health care system that is cheating us. They are driving up your bills. Don't blame me and my civil disobedience for fighting back.
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Old 10-11-2009, 09:09 AM   #38
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...if I can think up a way to avoid being scammed and still not break the law, I will do it.
I believe this is where I and other posters have an issue. Although you are now saying "still not break the law", that wasn't how you began your position nor is it how I am interpreting your real message. "Cheating" isn't legal to my way of thinking.
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Old 10-11-2009, 10:40 AM   #39
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Hobo, I do understand where you are coming from.
I still disagree though.
When you 'cheat' the insurance/healthcare corporations, do you thing THEY pay for it? No, they don't, they pass the costs along to the rest of us.
So essentially you are cheating us.
And yes, if they do anything illegal, you should cry out loud and make a stink and take them to task if they do cross the line.
I applaud you for getting your healthcare much less expensively elsewhere. This has been a growing trend and hopefully it will force some semblance of competition.
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Old 10-11-2009, 11:14 AM   #40
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I believe this is where I and other posters have an issue. Although you are now saying "still not break the law", that wasn't how you began your position nor is it how I am interpreting your real message. "Cheating" isn't legal to my way of thinking.
I guess we can parse words. But I am presumed innocent until proven guilty - only a court can say I am guilty. Unethical, devious, deceptive, cheating may or may not be illegal. I am not such a fool as to do something blatantly illegal, I just use the manipulate the system to avoid being a victim of a legal scam that the health care system uses to cheat me.

If I tried to get health insurance as an individual 61 year-old-man with a history of high blood pressure and other health problems, my rates would be astronomical - if I could even find it. On the other hand, if I worked for a company who negotiated health insurance for its employees, my employer could get inexpensive coverage by signing up during the yearly "enrollment period". Don't you think that is cheating? I do; but it is is not illegal.

I can hide my assets by giving them to my children, or putting them in a foreign bank account - that's legal. I can take money earned under a corporate umbrella and buy a private jet, but only pay myself a token salary - that's legal. And I can forget to pay a debt the only way someone can force me to pay is to take me to court - that's cheating, but legal.

By the way, I am a very generous and ethical person. I have formed a scholarship trust that is now sending 3 student to college. I give money generously to charities that I know to be trustworthy. But if you try to scam me, like the health care system tries to do, I will pull out every dirty trick I can possibly think of to fight an injustice. And I know a whole lot of unethical, mean, and extra-legal tricks that I know most corporations are unable to combat. That is the all-American way of keeping my freedom and not be a slave to any system.
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