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View Full Version : Why I HATE the Health Insurance Industry


highnote
10-14-2009, 04:31 AM
OK. Here's my story.

Way back in the early 1990's -- way before my kids were born -- my wife was laid off from her job which provided health insurance. I've always been self-employed. So when she was laid off, we paid for our own health insurance.

We bought a plan from a company called M.D. Healthplan. They were Connecticut based -- that's where we live. They had reasonable and affordable premiums and low co-pays and deductibles and covered almost everything except dental. I know! Sounds almost too good to be true, doesn't it?

Along comes a company called ConnectiCare. One of the big investors in ConnectiCare was George Bush, Sr. Well, ConnectiCare bought M.D. Healthplan. You can guess what happened to our premiums. Due the cost of the acquisition and the need to compensate shareholders, our premiums literally doubled -- and they dropped our plan from their product offerings. They were nice enough to offer us a new plan -- but at twice the price.

My wife found another job and for a few years she got health insurance as a benefit. We had our kids and all the hospital bills were covered.

Then along comes the dot com bust and she gets laid off again.

So I sign up with Golden Rule insurance from Indiana. Turns out their CEO and founder is a big Republican supporter.

Now in the past 3 to 4 years my premiums have gone up 50% and we've never once filed a claim. It's major medical coverage only. Full coverage would be close to $1500 per month. Plus there are still deductibles and co-pays. So we have a $5,000 deductible and we pay for doctor visits when necessary -- usually only about $100 per visit. The co-pays with a full-coverage plan would be $50 so it's not much difference -- but the monthly premiums are lower with a major medical plan.

When I signed up for Golden Rule I chose the $5000 deductible because the premiums were lower than the $2 or $3 thousand deductible plans. I figured I'd insure myself for the extra risk. But it turns out it's not a $5,000 deductible for our family -- it's a $5,000 deductible per person. So if all four people in my family by some chance got in a car crash and had to go to the hospital it would cost us $20,000 out of pocket -- not $5,000 like I thought the plan said and like my insurance agent didn't make clear to me. Hell, it's called the Share Plan 5000. I pay one premium for my family -- not 4 premiums. So you'd think there would only be 1 deductible. Whatever.

OK. So I studied up on insurance and found that George W. Bush signed a bill for the Health Savings Accounts. This allows people to deposit money into an account and the money can be used to pay medical expenses. The deposits are tax deductible -- just like an IRA. Sounds great, right?

So I call up my bank and say I want to open an HSA. They say, what is that? I explain it. They have never heard of it. Connecticut is the insurance capital of the world and my bank has never heard of an HSA.

So I call Golden Rule -- my health insurer and ask about HSA accounts. They offer them, but I have to switch to a different kind of health insurance plan. So great. I give even more money to Golden Rule which they pay low interest on and can loan it out at a higher interest rate. Sounds like a bank, not an insurance company. Whatever.

OK. So it's not a big deal if I have to give them my money so I can get a tax deduction on the deposits. The cost of the plan is about the same or a little more per month than I'm currently paying and it has an actual $5000 per family deductible. But there's a catch -- our whole family has to undergo a medical exam to see if we are fit enough for this new plan.

But wait... I say to them, you, Golden Rule, are already my health insurance provider. Why do I have to undergo an exam just to switch plans that is basically the same as my current plan? The representative says to me, "That's just our policy."

So I say, "So if we get an exam and you find something you don't like, you can turn us down?" She says, "That's right."

"So all this money I've paid you over the past several years means nothing?"

"That's right. You are asking for a new plan."

So now, we'll just stick with the plan we have and wait and see what our government can work out.

By the way, Golden Rule is owned by UnitedHealthcare. One lobbyist working for UnitedHealthcare recently worked for Baucus. Baucus' current assistant recently worked for UnitedHealthcare. That's the revolving door Bill Moyers wrote about in his essay that I posted on PA yesterday.

Now you know why Max Baucus does not want a public health option -- because the private insurance companies are making so much money and are funding his campaign.

Baucus' message to me -- "Too bad for you. I need to get reelected. And in order to get reelected I need money from the health insurance industry. I don't care if you can afford health insurance or not. And if you can't afford it, we're going to make you buy it. And if you can't afford to buy it, we're going to fine you. And I'm going to get reelected."

So that's why I hate the Health Insurance Industry.

highnote
10-14-2009, 04:54 AM
Correction -- The lobbyists who worked (and work) for Baucus worked (and work) for Wellpoint, not UnitedHealthCare.

Valuist
10-14-2009, 08:29 AM
Do we really need two threads on the same thing started by the same poster?

senortout
10-14-2009, 08:38 AM
of course, he is correcting something, which is an implied obligation, sir...do you really feel obliged to add your two cents is such a rude manner?

senortout

highnote
10-14-2009, 12:08 PM
Do we really need two threads on the same thing started by the same poster?


Somebody woke up on the wrong side of the bed. :D

This thread started with an essay on why I don't like the health insurance industry's practices. The other thread is my opinion on why their won't be a public option in the health care bill.

I could have put them back to back in one thread. I felt they were different enough. It was a judgement call. Maybe it was the right call or maybe it wasn't. I've made plenty of bad judgement calls -- and I've got a stack of pari-mutuel tickets to prove it.

Now please go back to :sleeping:

46zilzal
10-14-2009, 12:11 PM
As if his story, the one HE LIVED, was fantasy and the line of malarkey these thieves give out is somehow the truth.

Just read about Dr. Linda Peeno and how she exposed about Humna Health Care in Kentucky

Tom
10-14-2009, 12:38 PM
I think there were two copies of this thread....at least I think I saw it twice?
One is gone now....maybe deleted as a duplicate by mistake?

But, one ins company in not the whole industry. There are like 1750 nationwide. But congress doesn't want you to be able to look at them all and find the best plan for you. Because there is no kickback for them that way.
If you hate the industry, the hate congress more - they provide NOTHING but the industry provide good care for most people.

dartman51
10-14-2009, 12:40 PM
Swetyejohn, as President Clinton once said, "I feel your pain". But don't hate the insurance companies. They are like children. They will do whatever the laws let them. Until Congress cracks down on them(like that will ever happen), they will continue on the same path. They are , in fact, much like Congress. Politicians will continue to do what THEY want, until they are slapped down(voted out of office). And this is NOT party specific. They ALL do it. We the people, need to keep voting them out, until we get some in office, that actually represent, we the people, instead of their OWN SELF INTEREST.

highnote
10-14-2009, 12:51 PM
Swetyejohn, as President Clinton once said, "I feel your pain". But don't hate the insurance companies. They are like children. They will do whatever the laws let them. Until Congress cracks down on them(like that will ever happen), they will continue on the same path. They are , in fact, much like Congress. Politicians will continue to do what THEY want, until they are slapped down(voted out of office). And this is NOT party specific. They ALL do it. We the people, need to keep voting them out, until we get some in office, that actually represent, we the people, instead of their OWN SELF INTEREST.


You're right to a large degree. There are a lot of good people in the health insurance industry. I used the title to creat a little shock value.

Also, I had a line at the end of my essay, but it didn't appear for some reason.

It said, "I'm not fond of politicians, either."


And TOM, you're right, too. I tried searching for insurance plans, but because of state regulations, not all plans are available in my state. Connecticut is an insurance company Mecca. They protect their interests.

I like the concept of health insurance and I even like the concept of politics. But in practice, there is a lot to hate about both of them.

Tom
10-14-2009, 01:50 PM
The bottom line is the whole HC debate has nothing to do with health care.

highnote
10-14-2009, 01:54 PM
The bottom line is the whole HC debate has nothing to do with health care.


You're probably right.

GameTheory
10-14-2009, 02:19 PM
You're probably right.I don't know ANYONE who isn't for health care reform. But that doesn't mean any reform is good reform.

And I'm in a similar boat as you -- since I had health problems in the last year now I've got a pre-existing condition. And since I'm self-employed any change of plan whatsoever is "a new plan" and I can be turned down. So I can never ever change my plan (because I'll be rejected) and I can never leave the state of CO (because that would be a new plan). The only thing I can do is become rich enough not to worry about it. I'm taking that option.

highnote
10-14-2009, 02:34 PM
I don't know ANYONE who isn't for health care reform. But that doesn't mean any reform is good reform.

And I'm in a similar boat as you -- since I had health problems in the last year now I've got a pre-existing condition. And since I'm self-employed any change of plan whatsoever is "a new plan" and I can be turned down. So I can never ever change my plan (because I'll be rejected) and I can never leave the state of CO (because that would be a new plan). The only thing I can do is become rich enough not to worry about it. I'm taking that option.


Spot on.

Most Americans probably favor capitalism. Most Americans just want affordable health insurance coverage. Most Americans don't have any problem with health insurance companies making reasonable profits. Most Americans don't mind investors in health insurance companies getting a decent return on their investments.

Most Americans, who have a clue, don't like the way our government is influenced by lobbyists.

So the question is how to come up with health care reform that benefits everyone because if everyone isn't covered then insurance is going to keep rising for everyone who can afford it, until fewer and fewer companies and indivduals can afford it. If coverage is mandated and there is no public option I don't see how health insurance costs will not rise.

But if nothing is done, costs are still going to rise and our society will still be in the same situation.

I can not see any good outcome if nothing changes.

If nothing changes then the best option for the uninsured and those barely able afford insurance is just to drop insurance altogether. Pay for doctors when needed. And if they need emergency services then don't pay the bill when it arrives in the mail. The hospital will eat the cost and pass it onto those with insurance. This is the way it's done now, but will only get worse.

GameTheory
10-14-2009, 02:42 PM
In some countries they have non-profit insurance that is still private. Why no non-profit insurance companies here? They don't need a government mandate to create one, right? It isn't like they are illegal. It seems like there would be groups creating their own co-ops, etc. (Or are there?)

I think the fact the most get insurance through their job in this country (which makes no sense to me) is actually a big impediment to sensible reform because that system needs to go and it is quite entrenched. The only proposals I've heard involve creating a big burden for the employer, not getting rid of the system altogether so the market is more of a true market.

highnote
10-14-2009, 02:52 PM
In some countries they have non-profit insurance that is still private. Why no non-profit insurance companies here? They don't need a government mandate to create one, right? It isn't like they are illegal. It seems like there would be groups creating their own co-ops, etc. (Or are there?)

We were able to create the non-profit Horseplayers Association of North America here on PA -- so why not create a non-profit health insurance company here on PA? :D You laugh. Don't tempt me. I can't turn down a
challenge. :bang:

As an executive of a non-profit insurance company you could name your own salary. I would think it would be pretty generous. $500,000 per year minimum seems reasonable for a large non-profit -- given that there would be no stock options available. You'd have to spend at least $500,000 to attract a strong candidate.

I think the fact the most get insurance through their job in this country (which makes no sense to me) is actually a big impediment to sensible reform because that system needs to go and it is quite entrenched. The only proposals I've heard involve creating a big burden for the employer, not getting rid of the system altogether so the market is more of a true market.

People who get insurance from their employers don't pay taxes on that benefit, but it is quite a substantial benefit -- especially if they had to buy it out of their own pocket. If they had to buy it on their own they would not get the tax benefit.

I only get a about a 20% tax deduction for my health insurance through my business. If I dropped my insurance not only would my company be more profitable, but I could also shift my health care cost to the rest of society. It's tempting.

GameTheory
10-14-2009, 02:59 PM
We were able to create the non-profit Horseplayers Association of North America here on PA -- so why not create a non-profit health insurance company here on PA? :D You laugh. Don't tempt me. I can't turn down a
challenge. :bang: What I want HANA to do next is to buy a racetrack and show 'em how it's done right. I guess you could do both.

Pell Mell
10-14-2009, 03:00 PM
In some countries they have non-profit insurance that is still private. Why no non-profit insurance companies here? They don't need a government mandate to create one, right? It isn't like they are illegal. It seems like there would be groups creating their own co-ops, etc. (Or are there?)

I think the fact the most get insurance through their job in this country (which makes no sense to me) is actually a big impediment to sensible reform because that system needs to go and it is quite entrenched. The only proposals I've heard involve creating a big burden for the employer, not getting rid of the system altogether so the market is more of a true market.

As I recall, shortly after WW2 ended, and the top tax rate was over 90%, is when employer health care came on. I believe the big reason was that in many cases when a worker got a raise in pay it actually cost him money by putting him in a higher tax bracket. I remember my father refusing a raise because he would have ended up with less money after taxes.

In order to combat the taxes, companies started to give employees non taxable fringe benefits and the benefits are still tax free but I think there are those in congress that want to put a stop to that.

highnote
10-14-2009, 03:05 PM
What I want HANA to do next is to buy a racetrack and show 'em how it's done right. I guess you could do both.


I have brought up the subject. I mentioned that I thought buying Thistledown could be doable. I even called TD to see if what I could find out. Never got anywhere with it.

I think TD was just sold and the price seemed awfully high, but I don't know much about Cleveland real estate. Maybe it was a bargain. The buyer probably is hoping to get slots -- like Stronach was hoping. Hope springs eternal.

ddog
10-14-2009, 10:58 PM
the barriers to entry and success for non-profit are immense.

the medical providers are locked in to the main ins. co.

the mass of policies one needs for a startup to be viable are not easy to obtain.
the current gvt protected and supported ins co. , granted monopoly power by the gvt would kill anything of scope.

there are some non-profits, but you need to have a captive group - like a union that can bring a bunch of people in at once to get it going and to have any scale to bargain for good prices.

the system is setup to protect the insurance company s , by the gvt.

SO much for the mantra of "leave the free market HC as is".

In fact one of the insurance company main points against any change has always been that no competition will keep prices down! :lol:

The whole thing is so distorted as to be a joke if it wasn't so deadly to the economy now days.

:D

highnote
10-14-2009, 11:07 PM
If there was ever a time for the government to fund non-profit health insurance start ups this would be it.

I would think there are a lot of mid level health insurance executives who would love to run a non-profit insurance company. Only one executive can become the CEO of a health insurance company. What a great way to become CEO -- be the founder of the company.