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Interesting NYT Article on Obtaining Health Insurance
02-21-2011, 08:09 AM
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#1
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Recycles dryer sheets
Join Date: Sep 2010
Posts: 250
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Interesting NYT Article on Obtaining Health Insurance
http://www.nytimes.com/2011/02/20/op...nsky.html?_r=1
I fear this is what is going to happen to my husband and I when we submit our application. We had a couple of tests done that don't show an ongoing problem but my bet is the insurance company will say it's a potential issue.
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02-21-2011, 09:43 AM
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#2
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Full time employment: Posting here.
Join Date: Nov 2009
Location: VA
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The article could have been entirely summed up by saying "health insurance has underwriting." If you are uninsurable, money won't buy you life insurance, disability insurance, or long term care insurance either. The person in the article admits to having or needing future testing or surgery. That is an automatic decline with all insurance companies until the issue is resolved, under control, or a diagnosis has been made. I'm surprised their agent even had them apply for a policy if that was known up front. The agent also apparently doesn't know what they're doing if they think applying separately would get them approved any differently than applying together.
There is some info missing from this story....something tells me not all of the facts have been disclosed. Would be interesting to see the application and hear the insurance company's side of the story. I often see these type of articles blaming the insurance industry. When all of the facts are made clear, it's usually easy to see why the person was declined. If I had a nickel for every time I heard something to the effect of "well I just have a little bit of diabetes, nothing major" or "I had a heart attack four years ago, but my doctor says I'm in great shape now!" well....I'd have a lot of money.
The article basically says "we have issues, we just want the insurance company to pay for it." Most people have had group plans their entire lives and don't think twice about being uninsurable on the individual market. Of course, that's why group health insurance is so expensive...the article also fails to mention their COBRA or HIPAA options, so yes, money could buy them health insurance, they just didn't like those options.
__________________
Disclaimer - I am an independent insurance agent. If the above message contains insurance-related content, it is NOT intended as advice, and may not be accurate, applicable or sufficient depending on specific circumstances. Don't rely on it for any purpose. I do encourage you to consult an independent agent for insurance-related advice if you have a question that is specific in nature.
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02-21-2011, 10:33 AM
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#3
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: May 2005
Posts: 17,194
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Quote:
Originally Posted by Corporate ORphan
http://www.nytimes.com/2011/02/20/op...nsky.html?_r=1
I fear this is what is going to happen to my husband and I when we submit our application. We had a couple of tests done that don't show an ongoing problem but my bet is the insurance company will say it's a potential issue.
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Link did not work
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02-21-2011, 10:35 AM
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#4
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Full time employment: Posting here.
Join Date: Nov 2009
Location: VA
Posts: 923
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Quote:
Originally Posted by Texas Proud
Link did not work
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I think NYT changed it from a free article to requiring an account. I just saw it yesterday with the same link.
__________________
Disclaimer - I am an independent insurance agent. If the above message contains insurance-related content, it is NOT intended as advice, and may not be accurate, applicable or sufficient depending on specific circumstances. Don't rely on it for any purpose. I do encourage you to consult an independent agent for insurance-related advice if you have a question that is specific in nature.
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02-21-2011, 10:40 AM
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#6
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Recycles dryer sheets
Join Date: Sep 2010
Posts: 250
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Quote:
Originally Posted by dgoldenz
The article could have been entirely summed up by saying "health insurance has underwriting." If you are uninsurable, money won't buy you life insurance, disability insurance, or long term care insurance either. The person in the article admits to having or needing future testing or surgery. That is an automatic decline with all insurance companies until the issue is resolved, under control, or a diagnosis has been made. I'm surprised their agent even had them apply for a policy if that was known up front. The agent also apparently doesn't know what they're doing if they think applying separately would get them approved any differently than applying together.
There is some info missing from this story....something tells me not all of the facts have been disclosed. Would be interesting to see the application and hear the insurance company's side of the story. I often see these type of articles blaming the insurance industry. When all of the facts are made clear, it's usually easy to see why the person was declined. If I had a nickel for every time I heard something to the effect of "well I just have a little bit of diabetes, nothing major" or "I had a heart attack four years ago, but my doctor says I'm in great shape now!" well....I'd have a lot of money.
The article basically says "we have issues, we just want the insurance company to pay for it." Most people have had group plans their entire lives and don't think twice about being uninsurable on the individual market. Of course, that's why group health insurance is so expensive...the article also fails to mention their COBRA or HIPAA options, so yes, money could buy them health insurance, they just didn't like those options.
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Thank you for discussing the other side. I got a nice "chuckle" out of a "little bit of diabetes". Since there wasn't any further treatment suggested maybe we won't have an issue.
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02-21-2011, 01:38 PM
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#7
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Administrator
Join Date: Jan 2008
Location: Chicagoland
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Corporate ORphan, thanks for the new link. The article describes a situation that is quite similar to my own and I can easily identify with the author. No intention here to put one over on the unsuspecting insurance companies, just an effort to get coverage in a country where employer based coverage is regulated but individual is not.
Insurance is a collective initiative to share financial risk. Life, home, umbrella – these are good examples. What we call health care insurance is really health care intermediation – the intermediary is taking from providers and customers and exploiting both. Not insurance because it can’t underwrite effectively for large groups, denies individuals, and keeps the intermediation benefit (profit) entirely for itself.
The conclusion has nothing to do with “we have issues, we just want the insurance company to pay for it”. (are we even reading the same article?) It instead reinforces the need for reform in the individual market with an unlikely but smart proposal.
Quote:
If members of Congress feel so strongly about undoing this important legislation, perhaps we should stop providing them with health insurance. Let’s credit their pay for the amount that has been paid by the taxpayers, and let them try to buy health insurance in the individual market. My bet is that they all would be denied. Health insurance reform might suddenly not seem to them like such a bad idea.
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02-21-2011, 02:40 PM
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#8
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Thinks s/he gets paid by the post
Join Date: Oct 2010
Location: Waimanalo, HI
Posts: 1,881
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I don't see anything wrong with insurance companies delving as deep as they can into people's health histories to identify factors with some statistical tendency to increase the companies' probable payouts. How could they do anything else? They're not state enterprises, but rather private for-profit companies. But I also agree with individuals' intuition that this practice is not fair to them. How do we reconcile the conflict? It's easy. We prohibit by law insurance companies from collecting information or taking into account preexisting conditions. Of course, some insurance rates will have to go up to pay for the higher incidence of health care payouts among those with preexisting conditions, but it won't harm the insurance companies -- just change the playing field a little.
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Greg (retired in 2010 at age 68, state pension)
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02-21-2011, 04:13 PM
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#9
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: May 2005
Posts: 17,194
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Quote:
Originally Posted by Corporate ORphan
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Yep... works... but the first post still does not for me...
I would agree that the people seem to be the average American family... they did not go without coverage and then try to get covered when they found out they had a medical emergency... I would think that as long as you had been covered by SOMEONE, they you should not be denied by another company... we have to remember that all of the companies are regulated, so nobody is going to be way out from the rest of them...
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02-21-2011, 04:18 PM
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#10
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Full time employment: Posting here.
Join Date: Nov 2009
Location: VA
Posts: 923
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Quote:
Originally Posted by Texas Proud
Yep... works... but the first post still does not for me...
I would agree that the people seem to be the average American family... they did not go without coverage and then try to get covered when they found out they had a medical emergency... I would think that as long as you had been covered by SOMEONE, they you should not be denied by another company... we have to remember that all of the companies are regulated, so nobody is going to be way out from the rest of them...
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Again, you could apply that logic to any type of insurance. Had car insurance, got a reckless ticket and DUI, time to get new car insurance, what happens?
Life insurance - buy 20-year term, have heart attack year 19, conversion option expired year 15, should a new company still be required to cover you?
You get the idea. Sure, it can be done, and that is what will happen in 2014 if not repealed. Unfortunately for the healthy, their rates will skyrocket and then they drop the coverage because they don't "need" it and the death spiral of premiums begins.
__________________
Disclaimer - I am an independent insurance agent. If the above message contains insurance-related content, it is NOT intended as advice, and may not be accurate, applicable or sufficient depending on specific circumstances. Don't rely on it for any purpose. I do encourage you to consult an independent agent for insurance-related advice if you have a question that is specific in nature.
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02-21-2011, 04:28 PM
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#11
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Thinks s/he gets paid by the post
Join Date: Jun 2007
Posts: 2,657
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Quote:
I would agree that the people seem to be the average American family..
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I'm not sure I'd call this average: Donna Dubinsky, a co-founder of Palm Computer and Handspring, is the chief executive of a computer software company.
I agree that finding reasonable private coverage can be difficult. I'm especially concerned about the stories of insurance companies denying coverage retroactively on the basis of small discrepancies in applications. I think a lot of the problems arise because health insurance operates much less like insurance and more like a volume buying plan. It would be a lot less distorting to prices if actual costs of medical care were visible to consumers and not wrapped in the insurance price games that make the real cost hidden but charge people without insurance differently than those with.
Also, the article complains about insurance rates that rise every year, doubling in 6 years time. My group insurance through my employer doubled this year alone. Makes the 10-20% per year rise seem not so bad in comparison.
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02-21-2011, 07:27 PM
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#12
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: Apr 2003
Location: Hooverville
Posts: 22,983
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Quote:
Originally Posted by dgoldenz
You get the idea. Sure, it can be done, and that is what will happen in 2014 if not repealed. Unfortunately for the healthy, their rates will skyrocket and then they drop the coverage because they don't "need" it and the death spiral of premiums begins.
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That is in plan. When middle class employed people start to suffer, we will get a single payer option. Once we get a single payer option, it won't take long to get a single payer system.
My only doubt is with what appears to be uniquely dysfunctional low level government workers. If they even wanted to do anything, which they mostly do not, they may well not have the skills needed to do so.
Our best bet would be a heavily regulated but private system, but that may be too complicated for the great American electorate to comprehend.
Ha
__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
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02-21-2011, 10:34 PM
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#13
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Moderator Emeritus
Join Date: Oct 2007
Location: Portland
Posts: 4,946
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Hmm... So, in the ideal unfettered medical insurance marketplace, the only people that can get insurance are those that won't need it, and the people that most need insurance can't get it.
I suspect that sales of such a product would fall off among rational consumers.
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02-22-2011, 06:48 AM
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#14
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Administrator
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,518
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There is no evidence that people will only look for insurance and pay premiums when they get sick. This is a bogeyman, unproven and unsupported by any non-partisan or non-industry, objective study. It assumes people would behave in an irrational manner - different than how they currently approach other types of insurance.
This is a bogus argument that conveniently allows someone to disagree with an aspect of healthcare reform that isn't part of the reform.
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02-22-2011, 08:38 AM
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#15
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Full time employment: Posting here.
Join Date: Nov 2009
Location: VA
Posts: 923
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Quote:
Originally Posted by MichaelB
There is no evidence that people will only look for insurance and pay premiums when they get sick. This is a bogeyman, unproven and unsupported by any non-partisan or non-industry, objective study. It assumes people would behave in an irrational manner - different than how they currently approach other types of insurance.
This is a bogus argument that conveniently allows someone to disagree with an aspect of healthcare reform that isn't part of the reform.
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Best thing I've read all day....you should try selling health insurance. That will be all the evidence you need.
__________________
Disclaimer - I am an independent insurance agent. If the above message contains insurance-related content, it is NOT intended as advice, and may not be accurate, applicable or sufficient depending on specific circumstances. Don't rely on it for any purpose. I do encourage you to consult an independent agent for insurance-related advice if you have a question that is specific in nature.
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02-22-2011, 09:55 AM
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#16
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Administrator
Join Date: Jan 2008
Location: Chicagoland
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Sarcasm? Please. My lack of further response indicates a total lack of interest in this type of discussion. You have a nice day.
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02-22-2011, 09:59 AM
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#17
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Administrator
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,518
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Quote:
Originally Posted by haha
That is in plan. When middle class employed people start to suffer, we will get a single payer option. Once we get a single payer option, it won't take long to get a single payer system.
My only doubt is with what appears to be uniquely dysfunctional low level government workers. If they even wanted to do anything, which they mostly do not, they may well not have the skills needed to do so.
Our best bet would be a heavily regulated but private system, but that may be too complicated for the great American electorate to comprehend.
Ha
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Ha, I agree with all three points, except "this is the plan" - and that because I'm not sure there is "a plan". Maybe that's part of the problem.
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02-22-2011, 11:18 AM
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#18
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: May 2005
Posts: 17,194
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Quote:
Originally Posted by dgoldenz
Again, you could apply that logic to any type of insurance. Had car insurance, got a reckless ticket and DUI, time to get new car insurance, what happens?
Life insurance - buy 20-year term, have heart attack year 19, conversion option expired year 15, should a new company still be required to cover you?
You get the idea. Sure, it can be done, and that is what will happen in 2014 if not repealed. Unfortunately for the healthy, their rates will skyrocket and then they drop the coverage because they don't "need" it and the death spiral of premiums begins.
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Interesting argument...
I disagree with the ticket and DUI... they would raise your insurance for those... so the new company should be able to charge you higher rates...
Life insurance... yep.. got to agree that is an issue... but can it not be addressed with the premium?
Also, we are talking about someone without current health problems that had been insured... not someone with cancer that wants to move to a better paying policy... as an example... our company just changed dental and vision plans... the new plan has a 12 month waiting period for major items, unless you have been covered the past 12 months with another dental plan... I believe the thinking is you would not have put off having something done if you were insured last year to this year and cost them money... sure, someone can... but it is part of the underwriting....
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02-22-2011, 11:24 AM
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#19
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Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Join Date: May 2005
Posts: 17,194
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Quote:
Originally Posted by growing_older
I'm not sure I'd call this average: Donna Dubinsky, a co-founder of Palm Computer and Handspring, is the chief executive of a computer software company.
I agree that finding reasonable private coverage can be difficult. I'm especially concerned about the stories of insurance companies denying coverage retroactively on the basis of small discrepancies in applications. I think a lot of the problems arise because health insurance operates much less like insurance and more like a volume buying plan. It would be a lot less distorting to prices if actual costs of medical care were visible to consumers and not wrapped in the insurance price games that make the real cost hidden but charge people without insurance differently than those with.
Also, the article complains about insurance rates that rise every year, doubling in 6 years time. My group insurance through my employer doubled this year alone. Makes the 10-20% per year rise seem not so bad in comparison.
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I was meaning average in the context of health problems...
Agree with wanting to have price transparancy... and a fair price to the retail customer...
It is amazing to me that in almost every other purchase we know about how much something will cost... not that we all get the same price (as in a car purchase)... but there is a sticker price and we do have sites that tell how much others are paying for something... but when one group is able to get an 80% or so discount from retail... then retail is way out of whack... and the few who have to deal with it can not even do comparison shopping since nobody can tell you the price...
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02-22-2011, 11:26 AM
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#20
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Full time employment: Posting here.
Join Date: Nov 2009
Location: VA
Posts: 923
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Quote:
Originally Posted by Texas Proud
Interesting argument...
I disagree with the ticket and DUI... they would raise your insurance for those... so the new company should be able to charge you higher rates...
Life insurance... yep.. got to agree that is an issue... but can it not be addressed with the premium?
Also, we are talking about someone without current health problems that had been insured... not someone with cancer that wants to move to a better paying policy... as an example... our company just changed dental and vision plans... the new plan has a 12 month waiting period for major items, unless you have been covered the past 12 months with another dental plan... I believe the thinking is you would not have put off having something done if you were insured last year to this year and cost them money... sure, someone can... but it is part of the underwriting....
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A car insurance can drop you in a second if you get a DUI and then when you apply elsewhere you will be auto-declined. I'm not a P&C agent, but I believe you then have to buy SR22 coverage at 3-4 times the price for half the coverage.
Life insurance - sure, you could keep the policy you have, but the premiums will change to annual renewable term insurance and skyrocket as soon as your 20-year guarantee is over. If you look at any term insurance illustration, it will look something like this:
Year 1: $1000
Year 2: $1000
Year 19: $1000
Year 20: $1000
Year 21: $36,957
Year 22: $40,528
Year 23: $46,290
You get the idea. The article is talking about people with health problems moving from one company to another. This person lives in CA, where there are no medical exclusion riders - it's either rate adjustment or decline, so as long as they have prior coverage and get approved, pre-existing conditions would be covered. They obviously had conditions which had pending testing or treatment recommended, which is an auto-decline.
Also, agreed on the price transparency issue. Just ridiculous the way that the healthcare system works in that regard...
__________________
Disclaimer - I am an independent insurance agent. If the above message contains insurance-related content, it is NOT intended as advice, and may not be accurate, applicable or sufficient depending on specific circumstances. Don't rely on it for any purpose. I do encourage you to consult an independent agent for insurance-related advice if you have a question that is specific in nature.
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