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Forum Post: Health Care Insurance Industry should be exposed

Posted 5 months ago on Nov. 6, 2013, 8:20 p.m. EST by windyacres (1002)
This content is user submitted and not an official statement

The health care insurers are dropping millions of policies. The reason given is that the policies don't actually adequately cover health care! I'm shocked !

Why aren't reporters pointing out specific insurance policies that wouldn't have covered health problems? Many people complaining that they liked their policies don't even know that the policy they've paid thousands of dollars for wouldn't have covered them if they had gotten sick! It shouldn't be too difficult to read the fine print in individual policies and expose the insurance companies for the frauds they have been committing.

The insurance companies should be compelled to reveal how misleading their policies have been in the past, and apologize for cashing all of the premiums they have received!

60 Comments

60 Comments


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[-] 4 points by beautifulworld (20419) 5 months ago

Health insurance in this country is way too complicated, with purpose, I am sure, and way too much money is spent on administration and profit and not on healthcare itself.

We need a single payer universal not-for-profit healthcare system.

[-] 7 points by windyacres (1002) 5 months ago

We do need a single payer universal healthcare system where anyone that gets sick, gets help. Yes, and it is complicated with purpose, so that the insurance companies can make more profits, while unsuspecting policy holders believe they have good insurance.

Why isn't anyone pointing out the specific fine print that would have devastated policy holders of these bogus policies. Why aren't people realizing that the reason millions of policies are being dropped is because the policies themselves are no good!

[-] 3 points by beautifulworld (20419) 5 months ago

Basically, there is too much profit to be made, that is why. Healthcare should be not-for-profit.

[-] 7 points by windyacres (1002) 5 months ago

Some would argue that profit improves the quality of health care but i don't agree. We should as a society provide healthcare for all.

[-] 0 points by HCHC4 (-28) 5 months ago

Its always baffled me how the laws of elasticity can be applied to healthcare.

Apples get more expensive, buy oranges.

You break your arm, you're going to the doctor regardless. And less and less small clinics are available these days due to the corporatist model this country is running on. So no matter what, you are stuck with some huge corporation charging you- no pun intended- an arm and a leg.

[-] 6 points by windyacres (1002) 5 months ago

Good example. Buy oranges until apples come down in price.

Going to the doctor should be like electricity or water, a crucial service but completely inefficient to consider competition.

[-] 2 points by prospector22 (185) from Brooklyn, NY 5 months ago

And the better the insurance plan you have, the more often harmful, uneeded tests that will be done. A lot of it is a well worked-out scam in which insurance companies, the mediical profession, the pharmaceitical companies and the manufactures of medical devices work out...not for your benefit though, but for their'$. And the body's amazing ability to heal itself through good nutrition and exercise is almost completely discounted. Slowly that is changing though.

[-] 1 points by GirlFriday (21785) 5 months ago

Not with the ACA. There is language included that does what is possible to stop that crap. Start here http://www.sciencebasedmedicine.org/a-skeptical-look-at-screening-tests/

Then go here: https://www.healthcare.gov/what-are-my-preventive-care-benefits/#part=1

[-] 0 points by prospector22 (185) from Brooklyn, NY 5 months ago

Thanks, that was very informative. I realize that we will never have a perfect health-care system, but single-payer has to remain our goal.

And it is my feeling we should be able to choose between traditional treatments, and alternative ones, or a combination thereof. The Europeans seem to be a bit ahead of us in this regard.

http://www.efcam.eu/

There are always tough decisions to make when you are faced with a life-threatening disease, or preventing one that runs in the family. I know. And no one should make these choices for you exept for yourself, so it becomes paramount that you learn as much as you can; get in tune with your body; weigh the risks and advantages... and then go for it.

[-] 2 points by GirlFriday (21785) 5 months ago

That's a great goal but this won't be scrapped for some cockamamie bs or due to a bunch of repeated idiocy.

[-] -1 points by prospector22 (185) from Brooklyn, NY 5 months ago

I think that most reasonable people are taking a wait and see attitude on the ACA.

But given Obama's shitty track record on a whole bunch of different fronts; the fact that he never fought hard for single-pay; the ACA has a Heritage Foundation smell to it, and the insurance companies stand to benefit hand$omely.....well many people including me are very skeptical of Obamacare.

Just on the latter of reasons, it is another example of the transferrence of wealth from the bottom up.

[-] 2 points by GirlFriday (21785) 5 months ago

You can't have it both ways. You cannot have a shut down on those policies that were ripping people off AND have the continued melt down on the rest. Last year the big issue was those non profits that were actually profiting. Now, it is the pretense of confusion. You can't stand around and bemoan that there is a Heritage Foundation smell while they are spending mass amounts of cash spinning lies in an attempt to defund it.

The single payer was taken off the table via congress. That is what the rest of us wanted and we were furious when we didn't get it.

[-] -1 points by monkman (-1) 5 months ago

Let us not forget it was a DEMOCRATIC controlled Congress. Why didn't they just ram single payer through instead of ACA??

[-] 1 points by GirlFriday (21785) 5 months ago

What else you got?

[-] -2 points by monkman (-1) 5 months ago

What else do I need?

[-] 2 points by GirlFriday (21785) 5 months ago

You're going to need to bring more to the table then what you are holding.

[-] -1 points by HCHC4 (-28) 5 months ago

That smell is...ummm...

A corporate MANDATE!!

[-] 1 points by GirlFriday (21785) 5 months ago

That smell is you getting paid to spin shit.

[-] -1 points by HCHC4 (-28) 5 months ago

Is there or is there not a corporate mandate?

So much for Occupy Wall St.

[-] 1 points by GirlFriday (21785) 5 months ago

An insurance mandate like........Switzerland (sort of) http://prescriptions.blogs.nytimes.com/2009/09/18/health-care-abroad-switzerland/?_r=0

subsidized as well.

You have zero interest in health care or education or unions or people in general. Keep talking. It keeps shining through. You had ample time to read the material. It was given to you in pieces broken down for you to read. So, what is happening is that you have noooooo clue what the hell is going on. Keep talking.

[-] -2 points by HCHC4 (-28) 5 months ago

Try reading your article before posting it.

You are backing forced corporatism. Whether it leads to universal eventually is anyones guess.

But you are backing wall st for right now.

You need to accept that.

"Is there an employer mandate, too?

A. No, it’s an individual mandate. Group health insurance does not exist in Switzerland.

Q. That’s a major difference between the Swiss system and most of the proposals in Congress. Are there others?

A. The most important difference is that health insurance in Switzerland is provided by nonprofit insurers — though some are affiliated with for-profit companies that offer supplemental policies along the lines of Medigap in the United States. The basic benefit package is defined by law and is quite generous. Maximum drug prices are regulated"

[-] 2 points by GirlFriday (21785) 5 months ago

States are reporting far higher enrollment in Medicaid than in private insurance since the Affordable Care Act exchanges opened Oct. 1. In Maryland, for example, the number of newly eligible Medicaid enrollees is more than 25 times the number of people signed up for private coverage.

Even some Medicaid experts say they are surprised at the early numbers.

A Stateline survey of the 25 expansion states and the District of Columbia provides clear explanations for the strong Medicaid rollout so far.

The biggest reason for the initial jump in Medicaid enrollment is that hundreds of thousands of people in the expansion states have been pre-qualified for expanded Medicaid because they are already enrolled in low-income state health care. Illinois, for example, will roll over 100,000 Cook County residents who have received expanded Medicaid benefits since 2011.

Another reason for the big numbers is aggressive outreach campaigns in many states, including mailings to residents enrolled in other safety net programs. Oregon, for example, signed up 70,000 enrollees in October by contacting residents who receive food stamps.

A much smaller number of people in expansion states are also signing up on state exchanges and Medicaid websites. The federal government has not yet released the number of Medicaid applications filed on federally-operated exchange sites in the 34 states that are not running their own exchanges.

To be sure, the rush to enroll in Medicaid indicates a strong demand for health care coverage. But the early spike is more a function of states' proven ability to find, educate and enroll low-income residents than an indication of an imbalance with healthier people who can afford insurance, as has been suggested.

It is important to note that early enrollment numbers reflect so-called "low hanging fruit," said Matt Salo, director of the National Association of Medicaid Directors. Future increases are expected to be smaller.

The states that chose to expand Medicaid, Salo said, are predisposed to aggressively reach out to potential beneficiaries. "Most have been more committed to Medicaid than the other states," he said.

After the U.S. Supreme Court ruled last year that Medicaid expansion was up to states, the Congressional Budget Office downgraded its original projection that 13 million people would qualify for expanded Medicaid in 2014 and 17 million by 2020. Now, the federal estimate is 7 million by the end of 2014 and 11 million by 2020.

Stateline's survey indicates at least 1.5 million people have already signed up or have been pre-qualified for expanded Medicaid in the 19 states that provided counts. Expected total enrollment in those states is 3.7 million.

Following are the details available as of Nov. 5: http://www.usatoday.com/story/news/nation/2013/11/06/new-medicaid-enrollment-healthcare/3453929/

No, jack off ^^^^^^^^^^^^^^^^^^^^^^^^ that is where I am at.

[-] -3 points by HCHC4 (-28) 5 months ago

"Theres a small subset that can afford this. The rest is still fucked. And now the insurance companies are more impowered than ever. Yes, they sure are more "impowered" and now have to have Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care."

Right, and are they providing it at the same price, or charging for it?

They're charging for it, duh. Wall St. Hello. wake the hell up. Anyone home?

[-] -3 points by HCHC4 (-28) 5 months ago

You can look for all the little silver linings you want.

Preexisting conditions now have access to insurance they can afford.

They bumped up medicaid threshold a few thousands dollars by cutting medicare services.

Those are trade offs that corporations are more than willing to make in order to force the entire population into buying their shit products.

And you are falling for it, hook, line and sinker.

Way to really push the envelope.

[-] 1 points by GirlFriday (21785) 5 months ago

You mean like people having access to health care? Where was that going to come from? You? Get back to me when you have a legitimate argument.

[-] -2 points by HCHC4 (-28) 5 months ago

If the trade off for one aspect of a basic human right- that no one can afford anyways- is now forcing the entire population to purchase corporate shit, then we have miserably failed as a society.

You need to accept that. And you're one of the cheerleaders leading the charge towards more corporatism down the road.

Cant wait to see what you think we should all purchase next!

[-] 1 points by GirlFriday (21785) 5 months ago

If the trade off for one aspect of a basic human right-


Say again?

[-] -3 points by HCHC4 (-28) 5 months ago

Of course its boring to you, you are already insured. Wont affect you at all, so it doesnt really interest you.

Have a nice day in your internet bubble.

Later.

[-] 1 points by GirlFriday (21785) 5 months ago

Boring? Absolutely not and it damn sure does effect me. But, hey thanks for exposing your right wing ideology...........again. Run away lil' teathuglican.

[-] -3 points by HCHC4 (-28) 5 months ago

Access is still determined by $$$$. And by what corporations say.

Its the same theory as the voting ID laws. Making lots of restrictions doesnt mean its still a level field.

Sure, no one is denying you access. But they make it financially impossible, whats the difference? 7k pay in requirements...whats the difference?

Theres a small subset that can afford this. The rest is still fucked. And now the insurance companies are more impowered than ever.

So in the end, money won again. Humans lost again. And you cheered whatever solution the donkey was proposing.

"When I was your age they would say we can become cops, or criminals. Today, what I'm saying to you is this: when you're facing a loaded gun, what's the difference?"

[-] 1 points by GirlFriday (21785) 5 months ago

Sure, no one is denying you access. But they make it financially impossible, whats the difference? 7k pay in requirements...whats the difference?

For whom?

Theres a small subset that can afford this. The rest is still fucked. And now the insurance companies are more impowered than ever.

Yes, they sure are more "impowered" and now have to have Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

So, in the end, you really don't have an argument. You just can't stand the fact that someone is going to receive health care.

[-] 1 points by GirlFriday (21785) 5 months ago

zzzzzzzzzzzzzzzzzzzzzzzz

Try again.

[-] 2 points by GirlFriday (21785) 5 months ago

It’s a new campaign organized by the Senate Republican conference to turn your frustration, anger and/or confusion over the Affordable Care Act into an anecdote for a floor speech or a sound bite for a reporter whose job it is to find some Obamacare “losers.” http://www.salon.com/2013/11/06/gops_desperate_obamacare_strategy_try_to_confuse_americans/

[-] 3 points by shooz (26679) 5 months ago

http://wendellpotter.com/

This guy did one too.

[-] 2 points by shooz (26679) 5 months ago

http://www.michaelmoore.com/books-films/sicko

Mike should do an update, perhaps?

[-] 2 points by GirlFriday (21785) 5 months ago

Special Investigation: How Insurers Are Hiding Obamacare Benefits From Customers

HUMANA IS FINED (COMPELLED) http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare

[-] 2 points by GirlFriday (21785) 5 months ago

A set of health care service categories that must be covered by certain plans, starting in 2014.

The Affordable Care Act ensures health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

Insurance policies must cover these benefits in order to be certified and offered in the Health Insurance Marketplace. States expanding their Medicaid programs must provide these benefits to people newly eligible for Medicaid. https://www.healthcare.gov/glossary/essential-health-benefits/

[-] 2 points by GirlFriday (21785) 5 months ago

Florida Go Blue Plan exposed here and here

[-] 2 points by windyacres (1002) 5 months ago

Thanks for those links. I have Florida Blue for my insurance so it is especially interesting to me. I also have end stage kidney disease and hopefully will be able to have a kidney transplant. A kidney transplant is $250,000 and would be impossible for me to afford, having good insurance is something I'm especially thankful for.

[-] 1 points by GirlFriday (21785) 5 months ago

Well, living in Florida anything you guys have to have will be unnecessarily expensive but that is a state problem as Florida refused to participate.

But, I'm sure a healthy diet will solve everything and, of course, the natural healing powers of the body will kick in.

[-] 0 points by GirlFriday (21785) 5 months ago

Well, there is Iran http://www.rawstory.com/rs/2013/11/07/fox-business-john-stossel-upset-poor-people-arent-selling-kidneys-for-1200/

OR perhaps you could ask good old HC to donate one because he is all about community. Perhaps, because you do live in Florida you might want to look at a medical travel destination to have the procedure done.

[-] 2 points by windyacres (1002) 5 months ago

Interesting link. Reminds me of my college roommate selling his plasma back in the 70's on a regular basis for money.

I'm fortunate that 4 people volunteered to donate a kidney, and it's looking good that my son will be a match. It's a wonderful thing that donating a kidney is relatively simple and there are no long term harmful effects from donating. I've learned that there are some people offering to donate a kidney to people they don't even know, these people are the kind of people we need in the world. Having insurance for this gift of life makes me a fortunate person. The misery I'm currently living with will hopefully be cured in a few months.

As for John Stossel's idea of allowing poor people to sell a kidney, the case for allowing this has been agonizing. There are people in this country that would happily give someone $10,000 or more for a kidney, but the ramifications would become complicated.

[-] 1 points by GirlFriday (21785) 5 months ago

Stossel is an idiot. I doubt very seriously that you are living with any misery.

[-] 2 points by MattLHolck (16833) from San Diego, CA 5 months ago

fine print should not justify wealth

I understand the ADA us written intentionally long to be inaccessible to must that might read it

[-] 4 points by windyacres (1002) 5 months ago

Fine print should not justify wealth, and it's a travesty that it does. Complexity breeds fraud!

[-] 1 points by GirlFriday (21785) 5 months ago

The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act

Just for you!

[-] 1 points by shooz (26679) 5 months ago

Their desire to shirk their responsibility to mental health care is about to be.

http://www.truthdig.com/eartotheground/item/new_rule_makes_mental_health_care_available_to_million_of_americans_2013110

Now if only they would work on the cure for pleonexia.

[-] -2 points by HCHC4 (-28) 5 months ago

The thing is, insurance is supposed to be just that- insurance. As in, if something dramatic happens, you arent totally screwed.

Its not meant to cover you if your nose is running and you go to the emergency room.

The expectations we have on health insurance would be like filing a home owners insurance claim to get your gutters cleaned.

Or expecting your car insurance to cover new headlights.

Many people are fine with just having catastrophic insurance.

That being said, this is just one more way the insurance companies made out like bandits on this law. Kick em out of their old policy, tell em its the govs fault, and then the gov forces them right back in, with a more expensive policy.

Expect record profits in the insurance industries to continue. Mandates are like a gift from god for them.

[-] 2 points by windyacres (1002) 5 months ago

I agree that insurance is to prevent something dramatic happening from causing a person to be totally screwed, but your examples of the gutters cleaned or new headlights is wrong.

I don't know for sure but insurance profits have probably been good in the past, just as they surely will be in the future. The key now will be what they can include in their 80% for expenses and administration. I'm not optimistic that the consumer will benefit, but healthcare for every person is a worthy goal.

[-] 2 points by beautifulworld (20419) 5 months ago

We need a universal healthcare system that we can afford. So, cover people, all people, for catastrophic to start and then for whatever else is affordable, not necessarily coverage for the sniffles, I agree. Then sit back and watch, as healthcare becomes cheaper and cheaper once everyone is in the plan and broader coverage becomes more and more affordable.

[-] -2 points by HCHC4 (-28) 5 months ago

Its truly amazing how something as simple as going to the doctor has turned into such an expensive and insane mess.

I mean, people have been breaking their arms since forever. How have we ended up in a situation where people are getting charged 10's of thousands of dollars?

I dislocated my elbow when I was 23 - little brothers 21st birthday, go figure :) Ambulance took me to the emergency room. Two nurses and doc pulled my arm, popped it back in, done deal.

$7k. That what the average person makes in 3 months TOTAL in this country! For a few people to pull my arm. Absolute insanity. What a racket.

[-] 3 points by beautifulworld (20419) 5 months ago

Exactly. And, this has zero to do with Obamacare. It has to do with the American system as a whole. Obamacare is no more confusing than the system that has existed for decades. Obamacare is an improvement, in my opinion, in that it expands coverage, but it is merely a meager compromise.

We need universal, single-payer, not-for-profit health coverage where all the money goes to healthcare and not the crazy complex administration expenses of thousands of plans and the extraction of profits for the 1%.

[-] 1 points by GirlFriday (21785) 5 months ago

But if your representatives are Republicans, the very idea of providing you assistance runs at cross-purposes with their desire to turn you into a talking point.

Introducing… #YOURSTORY!

It’s a new campaign organized by the Senate Republican conference to turn your frustration, anger and/or confusion over the Affordable Care Act into an anecdote for a floor speech or a sound bite for a reporter whose job it is to find some Obamacare “losers.”

Now obviously most of the submissions Senate Republicans will field will come from constituents who are already unfavorably disposed toward the law. And their stories will be relayed to other constituents who are unfavorably disposed to the law. So the public relations value of #YOURSTORY is probably pretty marginal.

But consider for a moment what it implies about the GOP’s commitment to providing responsible constituent services.

The ugly subtext to stories like these — which proliferate so rapidly, but then turn out upon closer inspection to be less black-and-white than originally depicted — is that Republicans are fostering and nurturing constituent confusion.

YOURSTORY is a manifestation of that strategy. A site like #YOURSTORY could be just as easily used to field inquiries and respond to troubled constituents with useful information. Instead it’ll be used as a crowdsourcing tool for anti-Obamacare opportunists.

The existence of a campaign like this suggests that the universe of individual Republicans who are refusing to help constituents navigate the Affordable Care Act is larger than we know. And we know it exists.

http://www.salon.com/2013/11/06/gops_desperate_obamacare_strategy_try_to_confuse_americans/

[-] -3 points by HCHC4 (-28) 5 months ago

I figured the 80% care aspect of things was for the individual, as in if I paid $1500 this past year and at least 80% wasnt for care, I would get the refund.

Nope, its for the entire insurance company. So basically its another feel good piece of bullshit that their accountants will just run circles around anyways.

[-] 3 points by windyacres (1002) 5 months ago

Exactly. Expensive trips and perks for agents will be part of the 80%.

[-] -2 points by HCHC4 (-28) 5 months ago

The ACA alone was over 1000 pages, who knows how much of that is financial nonsense. Imagine the field day a good accountant could have with the entire healthcare system?!

[-] 3 points by windyacres (1002) 5 months ago

A good accountant would make the company look like it was barely making any profits at all.

[-] -2 points by HCHC4 (-28) 5 months ago

Ah good point.

This here looks like its 2400+ pages: http://www.hhs.gov/healthcare/rights/law/patient-protection.pdf

[-] 2 points by GirlFriday (21785) 5 months ago

Read the Law

The Affordable Care Act was passed by Congress and then signed into law by the President on March 23, 2010. On June 28, 2012 the Supreme Court rendered a final decision to uphold the health care law.

Read the Supreme Court’s Decision on the Affordable Care Act (PDF – 779 KB)

The Affordable Care Act, Section by Section

Below you will find all 10 Titles of the Affordable Care Act, with amendments to the law called for by the reconciliation process. Click on each Title to see a brief outline and then read the law section by section. Title I. Quality, Affordable Health Care for All Americans Title II. The Role of Public Programs Title III. Improving the Quality and Efficiency of Health Care Title IV. Prevention of Chronic Disease and Improving Public Health Title V. Health Care Workforce Title VI. Transparency and Program Integrity Title VII. Improving Access to Innovative Medical Therapies Title VIII. Community Living Assistance Services and Supports Act (CLASS Act) Title IX. Revenue Provisions Title X. Reauthorization of the Indian Health Care Improvement Act Read the Full Text of the Affordable Care Act

Full Text of the Affordable Care Act and Reconciliation Act (PDF – 2.6 MB)
Certified Full-Text Version: Affordable Care Act (PDF – 4.27 MB)
Certified Full-Text Version: Reconciliation Act (PDF – 282 KB)

The first link listed above contains the full text of the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 in one document. It is not official and is provided for your convenience. The second and third links contain the official certified full text of the law.

Note: The text is searchable within each PDF file. Use 'CTR + F' on your keyboard. If you are looking for a specific page, try to enter just the page number into the search box within the PDF. To save a copy of a PDF to your computer, right click your mouse and select 'save link as' then click the 'save' button http://www.hhs.gov/healthcare/rights/law/