July 22, 2009

Do you know what's annoying about the health care issue?

The subject is insurance. People hate to talk about insurance.

34 comments:

Fred4Pres said...

People hate to pay for insurance and people hate to deal with insurance companies when they make claims.

The best insurance spoof was in The Incredibles, when Mr. Incredible, working as an adjuster in the Super Hero protection program, asks his boss about whether he is supposed to help customers with claims.

The Insurance supervisor in digust says, "You know the law requires I say yes to that question."

chickenlittle said...

Health insurance should be for catastrophic, unforeseen health emergencies.

Healthy people, including the poor, should get used to paying their way for the routine stuff. Tax incentives can help encourage this.

The best health insurance I ever bought was co-signing the notes on my wife's school loans to become a nurse.

Hoosier Daddy said...

People hate to pay for insurance and people hate to deal with insurance companies when they make claims.

Well for someone who has worked in insurance for the better part of 15years I can regale you with the inner workings of what claims people see. Take for instance homeowners insurance. When you take out a policy you list 'roughly' the value of the personal possessions in the house. For this one case I speak of, the individual stated that the value of his possessions were $25,000 which he listed on his application. One day files a claim because his basement flooded (sump pump failed). Total claim came out to $55K. This was his 55 inch tv, stereo system, a couple of electric guitars and amps as well as some other 'valuable' electronic equipment. Naturally none of this was visible to the adjustor because he already disposed of it but he had a list prepared.

When asked why this wasn't disclosed on the application he claimed he didn't own it then. Well gee, when you acquired it you should have updated your insurance so it would be covered.

As Suzie Orman says, DENIED!

Hoosier Daddy said...

Another personal favorite was the guy who needed a new roof due to a major storm that hit and ripped half his tiles off.

Problem was there was no storm the day he claimed. Adjustor estimated his roof was 30 years old and was in need of repair five years ago.

MadisonMan said...

The problem with paying for routine stuff is that if you're truly poor, I think you'll be paying for food and shelter before you pay for, say, vaccinations or drugs to combat your tuberculosis.

traditionalguy said...

Insurance is the first successful "pay me up front for services in the future" industry. In other words insurance can easily be used as a ponzi scheme, like FICA insurance, unless regulated by honest people who cannot be bought off. Since 98% of Congress members are bought off in all small things, they certainly cannot be trusted with regulating our big things. Their power to vote taxes from people and give them to insider friends is normal everyday Government corruption. But the Obama/Dems use of that normal robbery by government with absolutely no care for our survival is the brand new development. This President whom we expected to be our pragmatic defender has become our worst attacker out to destroy the American golden goose for revenge.

MadisonMan said...

Hoosier Daddy, you make me think I should list out all the items in my house and send it to my insurer.

Balfegor said...

There's sort of a whiff of newspeak in referring to it as "insurance" at this point, no? Am I reading existing law incorrectly (I'm just browsing, after all), or are "insurers" basically prevented from rejecting customers when the customers try to purchase "insurance" only after they get sick? That's like trying to purchase fire insurance after your house burns down. It's not "insurance," it's just health care.

Anyhow, even if existing law doesn't do that, the House bill will -- everyone must enroll in a "qualified health benefits plan", or they get hit with a penalty tax (Sec. 401), and a qualified health benefits plan may not impose a "pre-existing condition exclusion," (Sec. 111 -- cite is to the provision I linked above.) You also cannot price "insurance" in pools based on anything other than age and region (Sec. 113). It's not "insurance" as I understand it anymore.

The problem with paying for routine stuff is that if you're truly poor, I think you'll be paying for food and shelter before you pay for, say, vaccinations or drugs to combat your tuberculosis.

Medicaid is there to cover the truly poor, and we blow like 300 billion dollars on it every year. That would be $1,000 a year for every American -- that would add up to $10,000 a year for, say the bottom 10% -- $20,000 a year for the bottom 5% (I don't actually know how low the cut goes -- I think medicaid eligibility starts below the poverty line, though). Either way, that ought to be more than enough to pay for an annual check-up for some, and more serious care for a few.

I am given to understand, however, that many of the most destitute simply cannot be bothered to apply for Medicaid coverage, even when there are pro bono organizations eager to help, so it doesn't really help them all that much. And neither will this bill.

Hoosier Daddy said...

Hoosier Daddy, you make me think I should list out all the items in my house and send it to my insurer.

MM
You don’t necessarily have to do that but it doesn’t hurt to take an inventory of items and put a reasonable estimate on the value those items and ensure that your current coverage is consistent with the value of that inventory.
Here is the problem and this is seen with major home destructions like fires and tornadoes is that people will claim all kinds of losses. The case I mentioned is a good example. If you claim that you have $25K in personal property and your house burns down and one of the ‘losses’ is a $10K diamond necklace you bought Mrs. Madison, you might be asked to provide some documentation or proof of purchase. With big ticket items it certainly behooves you to have some documented proof of ownership.

Hell I would encourage people to video tape their stuff or at the very least keep their receipts. The one company I worked for in cases of total losses would just cut a check for the amount of personal property value you listed on your application and that’s all you get (aside from the replacement of the home of course).

People would be amazed and probably shocked to see how many people use their homeowner’s insurance as a maintenance policy and then wonder why they get cancelled.

Fred4Pres said...

Hoosier Daddy, no doubt insureds get greedy, so do insurers. I could give you dozens of examples of insurance companies putting the screws to claimants.

Hoosier Daddy said...

The problem with paying for routine stuff is that if you're truly poor, I think you'll be paying for food and shelter before you pay for, say, vaccinations or drugs to combat your tuberculosis.


That is true but when you boil down the 'truly poor' who can't afford routine care, you've cut down the 'uninsured' to a much lower number than the 50 million constantly touted.

Keep in mind that the truly poor already have access to coverage through medicaid and schip.

I'll beat the horse again, there is health insurance and health care coverage. If you want a policy that allows you to only pay a $1000 deductible and a $20 co-pay, that's health care coverage, not insurance. If we used our auto or homeowners insurance like we use our 'health insurance', we'd have a crisis in those areas of insurance as well.

Hoosier Daddy said...

Hoosier Daddy, no doubt insureds get greedy, so do insurers. I could give you dozens of examples of insurance companies putting the screws to claimants.

I have no doubt. I'm simply showing the perspective from the other side.

Dust Bunny Queen said...

Hoosier Daddy, you make me think I should list out all the items in my house and send it to my insurer.

Also.... Take photos and put them on a CD to be stored in your safe deposit box.

CFP tips: check your policy for limits or coverage at all on things like silver, jewelry and other collectible, art and antique items and if you are over the limit buy the additional riders.

Make sure that your house insurance is keeping pace with the value of your home. If it is under a certain percentage to value (under insured) and you have a claim, the amount the insurer will pay will be reduced.

Re: health insurance. I agree with chickenlittle. Most people can afford to pay for the minor things and really only need coverage for catastrophic events.

@ Madison Man: If you truly poor; are unable to pay for routine care there already exist programs to help out. It isn't the job of the government or the duty of the taxpayers to pay for every little sniffle and scrape. Take some responsiblity for yourselves.

Hoosier Daddy said...

One other thing Fred, I would encourage people who purchase insurance to actually sit down and read their homeowners and auto policy because I will bet you $5 that the 'screwing' a lot of claimants get is expecting coverage for something that isn't in the policy.

Case in point. Several years back when I was working for a health insurer, we sold the Medicare Advantage plans. One insured raised three kinds of hell because her claim was denied. Claim was for the removal of varicose veins which was not covered by 1) our policy or 2) Medicare.

Nevertheless she ranted and snorted and complained to the DOI as well as her state rep and Congressional rep, both of whom we had to educate on what procedures Medicare covers and varicose vein removal wasn't one of them.

Hoosier Daddy said...

Make sure that your house insurance is keeping pace with the value of your home. If it is under a certain percentage to value (under insured) and you have a claim, the amount the insurer will pay will be reduced.

Excellent point!

Pogo said...

The key for a universal gummint program is to rake in the fees by the healthy, and to make old age and chronic illness painless but brief.

It all works out if granny don't get no hip, and gramps don't get no chemo. Instead, give 'em the Obama Cocktail, mighty tasty, but the last thing you'll ever drink.

Add in advanced abortion rules, like mandatory termination of abnormal fetuses and more abortions among the poor, and fewer of Ginsburg's undesireables need to be covered.

Problem solved.

Pogo said...

Let's call it Obama's Modest Proposal.

chickenlittle said...

LOL Pogo

Too true!

Donna B. said...

Medicaid is for very specific groups of poor people:

pregnant women
children
families with children
elderly, blind or disabled
terminally ill (for hospice services)

Simply being poor doesn't qualify by itself (unless you're 18 or under).

Most of the adults without qualifying dependents who are eligible for Medicaid but don't enroll fall under the disabled category. Many in that group are mentally ill and have a hard time helping themselves and cooperating with those who want to help them.

Balfegor said...

Medicaid is for very specific groups of poor people:

pregnant women
children
families with children
elderly, blind or disabled
terminally ill (for hospice services)
.

If you look at those, that probably covers the majority of the truly poor -- old people and disabled people are substantially over-represented among the destitute, to my understanding. And those limitations there seem pretty reasonable -- able-bodied poor people without child dependents ought to have jobs which keep them out of the ranks of the absolutely destitute, even if they're still below the poverty line. Right now, of course, that's probably not the case, given our ever-increasing unemployment, but under ordinary circumstances that's what one would expect. Illegal immigration puts a lot more pressure on this particular class of Americans, particularly to the extent illegal immigrants are willing and able to undercut the minimum wage laws, but that's a separate issue.

Florida said...

Insurance is the single most profitable business that has ever been invented - and they want more.

It's about time we stopped talking about "health care reform" when all we're really talking about is forcing people to buy insurance products they don't need or want.

I do not need health insurance; and I do not want to purchase it. This is a free country. I should not be FORCED to buy it.

That the insurance industry is working so diligently to FORCE me to buy their crap product is really quite revealing about what is really going on.

If I require health care, I can get it on my own far cheaper than I can purchase insurance. Thanks.

Those with insurance want to lower their premiums by forcing people who don't need insurance to buy it.

That's the only reform going on here.

srfwotb said...

@MadisonMan One day when the house is clean, get your video camera out and go from room to room for documentation.

MadisonMan said...

Two things: We don't own a video camera. And the house is never clean! (laugh). But yes, I understand the idea.

AllenS said...

Save your receipts!

Balfegor said...

Those with insurance want to lower their premiums by forcing people who don't need insurance to buy it.

That's the only reform going on here
.

Not exactly. From casual inspection, there are a number of things going on in the proposed health care bill. Unlike, say, the stimulus or the cap & trade bill, it's actually a serious attempt at addressing the situation it is trying to regulate, even if I think it's misguided (and ludicrously overspecified).

One of the things it is trying to do is mandate a standardised market in health care insurance by establishing a baseline insurance package and exchanges for health care insurance programs. See here for an exploration of why this might be a good idea. It's not, per se, a bad idea, but the framework established in the bill seems kind of inflexible -- it might depend on what the independent panel of experts, consumer representatives, industry representatives, and so on comes up with in their recommendations (essentially, this is an attempt at an American implementation of a Japanese shingikai system, as far as I can tell).

Another thing it's trying to do, as you note, is get people who otherwise would prefer not to buy health care -- or at least, not to buy healthcare matching up to the government's idea of an appropriate health insurance package, opting instead for, say, catastrophic insurance only -- to purchase a government approved health insurance package, and penalise them with taxes if they don't. On the employer side, the employers will be penalised in the same way, with a tax of 8% of total payroll, if they don't provide government approved health insurance to their employees.

As I understand it, the taxes it's levying are supposed to go into a health care "trust fund," which will be used, in future years, to subsidise health insurance for particular income brackets -- I think this is the main driver of that 2012 explosion in government costs (and attendant deficits) you see in all those graphs after the CBO report. I got the impression the tax on rich people is also going to be used for this purpose.

In addition to all that, there's some tweaks to Medicare and Medicaid that take up a huge proportion of the 1000 pages or so the House spewed out.

I don't know what all the differences between the House version and the Senate version we saw in June are, but in at least one respect, the House version is superior -- the Senate version I read had a provision basically limiting the profit health insurers could make (and the incentive to reduce costs) by requiring insurers to rebate excess amounts back to their customers. That, at least, has dropped out, although about 400 pages of other junk has been stuffed in.

All told, I don't think it's a good bill, but neither is it just an irresponsible bit of vote-buying pork like the stimulus bill, or an ineffectual bit of grandstanding like Waxman-Markey. I don't support it, but of the three, this is, I think, clearly the best.

Balfegor said...

Oh, and I forgot one of the major points of contention -- the bill is also trying to set up a government-run health insurance plan.

Joe said...

Again, this isn't about insurance, but prepaid health care. It's also about the payment system, not the actual health care system since that's pretty damn good and most people, even the uninsured, are happy with the health care they receive.

Propose to make many prescription medications OTC, like Birth Control, Acid-reflux and statin medications. The protests you hear will tell you what this is all about and it isn't medicine.

avwh said...

Why would it be a priority to screw with 85% of the population that HAS coverage to get coverage to the 15% who don't, at the cost of trillions we don't have? Especially since many who don't have coverage are young, and don't want to pay for something they won't use (even if they have the wherewithal to pay)?

And it's not "insurance" if the law says providers HAVE to take all applicants, even if they have a pre-existing condition - that's nothing more than "welfare" by another name.

Balfegor said...

Why would it be a priority to screw with 85% of the population that HAS coverage to get coverage to the 15% who don't, at the cost of trillions we don't have? Especially since many who don't have coverage are young, and don't want to pay for something they won't use (even if they have the wherewithal to pay)?

The bill isn't likely to achieve full health care coverage for the population. CBO projects it will leave about 37 million without insurance -- fewer than projected under current law, but far from 100% coverage.

Florida said...

@Balfegor

I don't disagree with much of anything you've written.

The salient part of what is being proposed is the requirement to purchase health insurance (which is against the religion of one of the largest religions on Earth).

Massachusetts passed a mini version of what is being proposed nationally and it has failed miserably.

* It has not controlled costs.
* It has not guaranteed that everyone must buy insurance.
* It does not cover all uninsured.
* We still have people without insurance showing up at emergency rooms - especially illegal aliens that the hospitals MUST by law treat.

The Massachusetts tax does however penalize Jews and Christians with a punitive insurance tax not imposed on Muslims.

So if your goal is to create a Sharia-like Jew tax, this is an excellent way to do it.

Muslims are not required to pay the tax in Massachusetts. Jews are required to pay the tax.

So, in this way, it's a tax on being a Jew.

chickenlittle said...

@Florida:

Thanks for sharing that-I wasn't aware of those religious inequities.

rosinonthebeau said...

Florida,

You don't need health insurance? Because you're healthy?

Fine.

What's your net worth, liquid?

Because if it's less than 2 million dollars or so, you already have health insurance... if you have a major medical event, youre irresponsible, immature ass is foisting it off on me.

If I have to cover you out of my tax dollars, or if my neighborhood hospital has to eat the loss because of your selfishness and shortsightedness, I'm going to be pissed as hell.

Kirby Olson said...

Will the 29 million illegal aliens also be getting health insurance? Will legal citizens have to pay their freight, too?

I haven't understood the details.

I realize that that is the main thing behind all the different people who want marriage rights. Can't blame them. Insurance costs a fortune. They say if your job covers it, it's usually equal to about a third of your salary in terms of a compensation.

The history of insurance probably starts with the mafia and more or less ends there via a slightly more legal route.

cubanbob said...

" rosinonthebeau said...
Florida,

You don't need health insurance? Because you're healthy?

Fine.

What's your net worth, liquid?

Because if it's less than 2 million dollars or so, you already have health insurance... if you have a major medical event, youre irresponsible, immature ass is foisting it off on me.

If I have to cover you out of my tax dollars, or if my neighborhood hospital has to eat the loss because of your selfishness and shortsightedness, I'm going to be pissed as hell.

7/22/09 8:13 PM"

First you don't know what his net worth is. Second morons that make your argument are hardly ever real net tax payers. Third he may become in the future a possible charge off on the tax payers or may never become one but you seem to have no problem with the parasites that currently drain the blood from the taxpayers.
Fourth its a federal law that was passed by statist that force hospitals to write off those expenses instead of collecting them; those charge offs are passed on to the insurance patients such as the several dollars per pill aspirin to offset the free riders forced on them by the government and of course the increases insurance patients pay in premiums to offset medicare and medicaid underpayments to hospitals and doctors. That law can be repealed saving insured patients billions. If Congress wants to be a sport let the government reimburse the providers directly for the deadbeat's medical costs. But then again that would require a vote and an unpopular one at that so they force these unfunded mandates on a small section of the public just as the unfunded mandates the states are compelled to absorb.

If Obumba care is such a great idea, why isn't manadated on all federal, state, local employees as well as every member of congress, the courts, the president and every governor, state legislator, mayor and councilman and on all union members. If its not good enough for them it is not good enough for the taxpayers and no, no one who lives of other people's taxes is a tax payer. As a net tax payer just because you have a problem I don't see why that becomes my obligation. Anyone born and raised in this country, is 25 years of age or older and who poseses an average intelligence and is not otherwise handicapped has no right to be poor. And no right to other people's money.