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Unprotected, And Driven Bankrupt By Health Crises

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http://www.nytimes.com/2009/07/01/business...ml?ref=business

Health insurance is supposed to offer protection — both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.

And so, even as Washington tries to cover the tens of millions of Americans without medical insurance, many health policy experts say simply giving everyone an insurance card will not be enough to fix what is wrong with the system.

Too many other people already have coverage so meager that a medical crisis means financial calamity.

One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.

He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.

In the House and Senate, lawmakers are grappling with the details of legislation that would set minimum standards for insurance coverage and place caps on out-of-pocket expenses. And fear of the high price tag could prompt lawmakers to settle for less than comprehensive coverage for some Americans.

But patient advocates argue it is crucial for the final legislation to guarantee a base level of coverage, if people like Mr. Yurdin are to be protected from financial ruin. They also call for a new layer of federal rules to correct the current state-by-state regulatory patchwork that allows some insurance companies to sell relatively worthless policies.

“Underinsurance is the great hidden risk of the American health care system,†said Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.â€

Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to “confuse their customers and dump the sick.â€

“The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance,†Wendell Potter, the former Cigna executive, testified.

More at the link.

The US is screwed.

More money is needed and they don't have it and neither does anyone else.

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http://www.nytimes.com/2009/07/01/business...ml?ref=business

More at the link.

The US is screwed.

More money is needed and they don't have it and neither does anyone else.

I think what is being talked about here isn't the lack of money, it's outright fraud by medical insurance companies.

Imagine issuing insurance policies which say in the small print you cannot claim if you have DNA.

I think the wording of insurance policies... ALL insurance policies, should be standardised. That goes to mortgage and loan agreements too, along with bank accounts, rental agreements, lease contracts, with a cover-page with the amounts on it. The amounts on the cover-page can change, the rest of the terms set by law.

There is no legitimate reason why any of the wording on the contracts/policies should be different, apart from to enable fraud. Insurance should be insurance, a loan a loan and a lease agreement a lease agreement. Subtle changes in wording are anticompetetive and unfair on consumers.

Edited by TaxAbuserOfTheWeek

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There is no legitimate reason why any of the wording on the contracts/policies should be different, apart from to enable fraud. Insurance should be insurance, a loan a loan and a lease agreement a lease agreement. Subtle changes in wording are anticompetetive and unfair on consumers.

Actually, there is a good reason - US medical policies come in a couple of general flavours, one covers any treatment deemed medically necessary (i.e. up to the doctor's discretion), the other offer set treatments provided by an approved list of doctors/hospitals (called an HMO). The second type is a lot cheaper than the first. Agreed that within certain boundaries there's no excuse for weasel words in policies, but, aside from that, the US system is a free market and you get what you pay for. Having experienced both the US and UK medical systems, I definitely think that, for 95% of people, the NHS is much better.

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Actually, there is a good reason - US medical policies come in a couple of general flavours, one covers any treatment deemed medically necessary (i.e. up to the doctor's discretion), the other offer set treatments provided by an approved list of doctors/hospitals (called an HMO). The second type is a lot cheaper than the first. Agreed that within certain boundaries there's no excuse for weasel words in policies, but, aside from that, the US system is a free market and you get what you pay for. Having experienced both the US and UK medical systems, I definitely think that, for 95% of people, the NHS is much better.

The situation in the US is quite scary.

In terms of % of GDP, the US spends more - a lot more - on healthcare than the european countries; given the generally higher GDP per capita that translates into a *lot* more cash; and their demographics are better than most Europeans as well. So the fact they they end up with a huge chunk of the population either not covered for or bankrupted by health care costs suggests that the market doesn't work very well for health..

(Shock! Horror! Heresey!)

Problem is, the insurance companies make quite vast amounts of money from taking premiums and then not paying out - it's in their interests to deny and delay payment as much as possible; hence there are huge campaign contributions and a massive lobbying effort to make sure the system does not change, despite a massive majority of Americans being in favour of a national system.

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Actually, there is a good reason - US medical policies come in a couple of general flavours, one covers any treatment deemed medically necessary (i.e. up to the doctor's discretion), the other offer set treatments provided by an approved list of doctors/hospitals (called an HMO). The second type is a lot cheaper than the first. Agreed that within certain boundaries there's no excuse for weasel words in policies, but, aside from that, the US system is a free market and you get what you pay for. Having experienced both the US and UK medical systems, I definitely think that, for 95% of people, the NHS is much better.

The entry- and liability-barriers to practitioners in that "free market" are high, and erected/maintained by the state.

In a true free market there would be an economic niche for cheap-and-cheerful clinics, maybe staffed by Cuban doctors ;)

It's pretty clear that the demand is there.

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Imagine. You have a job with free healthcare insurance for you and your family. You feel safe, protected.

Then you get made redundant. Not too much of a problem because you can always find another one. You do, within three months but during that three months you're diagnosed with something like mild angina. It's controllable with drugs and not a day-to-day problem but when you get your health insurance policy from your new employers, you find that you're not covered for any heart problems, because it's a 'pre-exisiting condition'.

Five years later and you have a heart attack. You need a triple heart bypass... Dying must seem preferable to the medical bills.

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I broke my elbow a couple of months ago. Went to casualty, was given a sling and a follow-up appointment at the fracture clinic and dismissed. It's back to normal now except for the occasional twinge.

During that time I read about a couple who lived in Spain, visiting America with a serious view to living there. That was until the bloke had a bike accident and broke his elbow...

They had health insurance but subsequently discovered that it only covered $20,000. Still not a problem you may think but the elbow 'needed' pinning and an operation and the bill at the end was for $50,000!

At the time of reading, I assumed that he'd sustained a worse injury than I did but on thinking about it, what would have happened if I'd broken my elbow in the US? Would I have been encouraged to have a pin put in - ostensibly to ensure joint stability but really to ensure surgeon income stability?

It's why private insurance can never work. Costs spiral and profit is put ahead of peoples' well-being and lives.

For all that is bad about the UK, praise God for the NHS.

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