Domestic Abuse? Denied Health Insurance!

[Excaliber]

I was surprised to see this. Eight states allow a Health Insurance program to deny coverage to someone who has been a victim of domestic violence. Even years after the incident, following divorce, etc. It make's sense from a purely mathmetical stand point. Such a person is more likely to end up in the emergency room, etc. This cannot be justified from a ethical stand point. Another example of how the insurance companies can "cherry pick" their clients to limit their exposure.

Here's the article:
http://www.msnbc.msn.com/id/33198459...h-health_care/

[Bobcat]

Ernie .... just saw in the Augusta , GA paper that Medicare rejection rate for procedures is far greater than any of the private insurance companies . Are they perfect ??? No , but , according to the article , they are a whole lot better than the government single payer system known as Medicare . They seem to be able to cover more procedures at a lower cost per patient than Medicare . I just had a claim denied by Medicare because the procedure wasn`t "medically necessary " .... but they never talked to my doctor or me .... just a bureaucrat somewhere . My doctor ( I`ve known him for 30 years ) wouldn`t have been ordered it if it wasn`t necessary .
I agree that insurance are , in some cases , "cherry picking " their clients ... however , looks like the government is much worse .
The way I see it , is if you have a problem with a private company , you`re free to look elsewhere ... with the government , you`re stuck with what you have .
However , I do agree that it sucks if you are a victim of domestic abuse and then denied insurance for that reason .

[Excaliber]

I was surprised at this issue because it's a double whammy for the victim. Get's beat up and then can't get coverage. Man, that's cold. I suppose no worse than someone who's coverage was dropped when the big C diagnosis came in...

For that reason, and the reasons you cited in your post, we need some kind of health care reform.

[Dan40]

Let's say you are playing hold 'em. Board has 3 Q's an Ace and a 3. You have 2 Aces in the hole and you SAW one of your opponents hole cards, ANOTHER QUEEN.
He goes ALL IN with his 4 ladies. KNOWING THAT, do you call him with 3 aces? You can't bluff, the hand is dealt and he IS all in.
So you fold.

That is insurance. If there is not a bet, it is not insurance. People have somehow come to BELIEVE that an insurance company is an alternative PAYER. They are not. They are betting that you WILL NOT get sick. YOU, strangely enough, are betting them you WILL get sick. Your past medical history IS showing your hole card. And if it shows the insurance company they cannot win the bet, same as you above, they fold.
And they CANNOT cancel a policy because you get sick. Once a policy is in force past the incontestability period. If you get sick with anything, they are stuck with you up to the limits of the policy. The horror stories that people like to cite, especially obummer, are about NEW policies being canceled because the person got sick while still in the period where the insurance company can still research an insureds past. And it is ALWAYS because there is something IN the records that WAS NOT put on the insurance application.
REMEMBER THAT ELECTED POLITICIANS REGULATE INSURANCE COMPANIES THROUGHLY. Your elected politicians tell the insurance companies what they can and cannot do and say. Amazing that these same politicians then turn around and blame the insurance companies for doing what the politicians said they can, OR MUST do.

[BeanCounter]

How is this any different than smoking, which I believe you've been all for penalizing in the past. All kinds of penalties are placed on smokers from higher rates to refusal of services. But you say that they could stop smoking. I say she could walk away from the abuser. Maybe denial of medical services for that reason might wake her up and be better for her in the long run.

[Bobcat]

Dan .... you put it a whole lot better than I did/could . You are exactly right about one is "betting" you don`t get sick and the other is "betting" they do .
In some of my past posts , I`ve said that the government causes a lot of the insurance problems we have now .... and we want to turn over our health care to the people who gave us Amtrak , the Post Office , an almost bankrupt Social Insecurity , Mediscare and Medicaid ... both soon to be insolvent ?? I know you aren`t for that , but it seems a lot of people who don`t see the whole picture are .
Ernie , reform health care ? I agree .... but do it carefully ! How about getting rid of the thousands of government regs the companies have to meet ... i.e. hair transplants , single men having to pay for pregnancy benefits , not being able to have a plan specifically for me or not allowing me to shop across state lines for the best policy etc .
This thing is too important and has far too many implications to rush something in place just so some people can strut around and say they "solved" the health care "crisis" .
I can hear it now .... if I don`t like Social Security , Medicare .... why don`t I drop out ? I will as soon as the government gives me back all the money they confiscated from me and my employers , plus interest , over the years . That is MY money ... not theirs !
Going back to Ayn Rand and Atlas Shrugged ... we now have in this country today the Looters ( Government ) , the Moochers ( self explanatory) and the Producers . Looks like the Producers are in trouble .

[Excaliber]

I'm encouraged that a health care bill is being reviewed, tinkered with and polished to address some of these issues. It seems to be moving forward and gaining more support for the Repubs. Of course insurance is fundamentally about risk control, betting you won't get sick and all that. Unlike a poker game, it's a matter of life and death. Spreading the risk out to a larger group of people is one way to control it. Cutting people off when they need it most is another way. I vote for the former method over the later one.

[mdmull]

But - the government wants to turn coverage, even private coverage, into a utility - not insurance. There is in most of the current bills being debated, some sort of minimum loss ratio that insurance companies will be required to meet. Now it is a utility - losses go up, rates go up - losses go down, rates come down. This stifles invention, makes the business less profitable, economy of scale enhances business model, presto - less competition & even if "private" is monopolistic & not very different from single payer. - ComEd & ConEd aren't really much different to their customers.

[BeanCounter]

SOME people have no idea how health insurance works. Having dealt with Kathleen Sebelius for years when she was insurance commissioner for the state of Kansas I can tell you she was a tough as they come on mandates and rating. She literally drove health insurance companies out of the state by making it literally unprofitable to operate there. Why else do you think Obama chose her. They will do the same thing on a federal level until only one plan remains.......that is a public "non-optional" plan that will escalate costs and the related taxes to fund those costs all the while lowering standards of care. Check out the recent revelations on what Medicare pays versus what private insurors pay all as a result of bumbling bureaucrats running the show rather than health care professionals.

[VRM]

Ernie,
You have to allow insurance companies to make a profit. Bernies comment about abuse and smoking is a good one, and is very valid. I would rather that higher risk people retain coverage, but they should certainly be charged more as long as they remain in the higher risk category.

I agree that having a bigger insured group is better, but government is the least efficient entity that could administer some sort of plan. There needs to be an incentive to reduce costs by increasing efficiency - government will never have that incentive.

Government should encourage healthy living learning in school, but states and local communities should be the ones implementing that policy. Having a skinnier population that does not smoke is also going to significantly reduce medical costs for any insured pool of people.

Steve

[Excaliber]

But you say that they could stop smoking. I say she could walk away from the abuser.

No, those are not valid options and clearly show a complete lack of understanding on the two issues.

Some studies suggest smokers cost LESS for health care because they die at a younger age! Along with that to say they can quit or she can walk away are not valid options for many folks. Far easier said than done. In the domestic abuse case cited in this thread the lady DID walk away! It was YEARS later she still found herself penalized by higher insurance costs based on her history.

There has been a push for Federal Law to address the abuse problems, prohibiting insurance companies from denying coverage in such a case. If private insurance companies can't cut it and make a profit under proposed Federal Guidelines, tough. EVERY business in America has to deal with it. They WILL figure it out, those they do will have business, those that don't, won't. Simple.

[Bobcat]

Ernie .... " If private companies can`t cut it and make a profit undermproposed federal guidelines , tough ....... etc " ignores the fact that the playing field will be tilted in favor of the government . The government will NOT have to operate under the same restraints as the insurance companies and can run at massive losses as long as our tax money and the printing presses hold out . All you have to do is look at Amtrak and the Post Office as examples of "companies" that would never be able to survive without massive influxes of subsidies ( our taxes ) .
Private companies don`t have the ability to put a confiscate our money by force as the government has .... and does .... they have to make a profit !
I hope you really don`t believe the government rules will be intended to be fair .... because if you do , I have some swamp land in South GA I would like to sell you .
I understand , I think , where you are coming from ... but to allow the government with its horrible track record to run this will be a disaster .

[Excaliber]

This ASS-UMES they will even be a Government option...

[Dan40]

Originally Posted by Excaliber

This ASS-UMES they will even be a Government option...

Ernie,
A Government option would/will be a disaster as all Guv. programs always are. In short order it will be filled with fraud and waste and funding shortfalls combined with skyrocketing higher costs. Typical of past history. The Government has an unblemished record of FAILURE in administrative ventures.

The only worse choice is for the Government to tell private insurers how to run their business.

[Excaliber]

I'm not so sure a Government option would be a bad idea. Current forecasts for the health plan(s) offered to date show a DECLINE in the deficit under these plans and, as Obama has said, NOT an increase in Government spending.

The Senate Finance Committee’s healthcare plan got a clean bill of fiscal health from key congressional scorekeepers – that is, it insures most Americans without adding a dime to the federal deficit, according to nonpartisan Congressional Budget Office (CBO).

Source: http://features.csmonitor.com/politi...t-your-wallet/

[Bobcat]

Ernie .... according to what I`ve been able to find out , those figures are estimates only from the CBO based on reviewing a summary .... not the actual plan(s) . I thought it interesting that a while back the head of the CBO was summoned to the White House when the CBO published some figures that Obama didn`t like .... and all at once , we have these favorable figures ?? As everyone knows , the devil is in the details ... and there is a real devil here . There will be massive tax increases on the insurance companies .... which will raise everyone`s premiums and force people to look to the government as their savior . Also , those tax increases , and many others , apply immediately , while the actual plan doesn`t come into play until 2013 .... isn`t that playing fast and loose with the "facts " ?
All government programs ever put in place have had massive cost overruns and been nowhere near projections on cost . I`m afraid I have to disagree with you on this ... I see a massive train wreck in the offing .

Bob

[Excaliber]

The costs are estimates, as are the health plans themselves, it's all being considered. Including who/how the plan will ultimately be paid for.

[Dan40]

Originally Posted by Excaliber

I'm not so sure a Government option would be a bad idea. Current forecasts for the health plan(s) offered to date show a DECLINE in the deficit under these plans and, as Obama has said, NOT an increase in Government spending.



Source: http://features.csmonitor.com/politi...t-your-wallet/

The decline [89 billion] in the deficit is predicated on approximately $300. billion in tax increases +++ SAVING $400 billion [ ALMOST HALF THE TOTAL COST] from waste in Medicare and Medicaid. In 44 years of complaints, reforms, adjustments, and investigations, in M&M the total savings so far EQUALS $00.00! The $300 billion in tax increases on businesses, called fees and fines etc., WILL be passed on to the consumer as EVERY tax on business ALWAYS has been and will be.
So IF $889 billion would be the number [not damn likely] And you take away $300 billion in extra costs to the average citizen and find NONE of the "savings: in M&M [and NONE will be found] Instead of an $89 billi8on reduction in the deficit, it will be an additional $611 billion ADDED to the deficit and that is wishful thinking.
And if that was NOT bad enough, as I said above, NONE of the plans under consideration do beans to help the poorest, and still leave 20 million of the imaginary 47 million uncovered.
Even if we could forget about the money that WILL not be available to pay for it. None of the plans are worth consideration for more than a few seconds before tearing them up and starting over.
The reason they do not want them posted online in advance is not because of all the 'dangerous' clauses therein, but because ALL could plainly see the plans to be stupid and worthless to accomplish the stated goals! That becomes more and more obvious every day!