Posted by admin on April 13th, 2011
Insurance companies are never slow in protecting their own interests. Give them half a chance and they have taken action before you knew there was half a chance. The way it most often works is that insurers write a term into policies giving them the right to cancel the cover if they find any error or mistake in the paperwork. This may look perfectly reasonable. Insurers cannot know everything about you and so must rely on what you tell them. If there’s a breakdown in communication, they should have the right to refuse a claim. Except, in most countries where insurance is written, this is limited to situations where the failure to submit the right paperwork is evidence of fraud or a deception. Most other countries prevent insurers from canceling for trivial reasons. Well, that’s there and we are here.
In the US, insurers routinely cancel policies on any technicality they can find. This is used to save them from having to pay out on claims. Thus, they collect the premiums while the going is good, and then refuse to pay out. Not very fair, is it? Well, the area in which it’s been most unfair is the pre-existing condition. You would be amazed if you knew the range of medical problems some insurers have decided are pre-existing and the failure to disclose means they will cancel. Of course, it then gets worse because once you are pitched out into the market, you are labeled as having a pre-existing condition and no new insurer will pick you up. As an example, suppose you have transplant surgery and all goes well. Then you fail to respond to a routine request for information. Now your paperwork is incomplete and the insurer cancels – it’s bad news to have the continuing bills for the drugs to suppress rejection. Then you find no other insurer will cover you.
Well, now look out for the pre-existing condition insurance plans to help those who are considered uninsurable. This is not yet a comprehensive solution. That must wait for 2014 when the Affordable Care Act comes fully into force. But, as from July 2010, every state must offer this safety net. Twenty-seven states have developed their own plans and run the program with federal money. The Department of Heath and Human Services run the plans in the other states. To find your local plan search for PCIP.gov which has details of all the states. Unfortunately, you must be uninsured for six months. That means a gap between reliance on COBRA or other benefits. Then you need evidence insurers have refused you cover for a pre-existing condition. If necessary, ask insurers for a letter refusing you cover. Read the rest of this entry »
Posted by admin on April 13th, 2010
Looking at the title of this article again, it seems a little strange. Surely it goes without saying that having a company insure your health is a good thing? How can it not be good? Surely people who are insured have better health and live longer? One of the more interesting things about the so-called scientific method is that everyone knows how it is supposed to work. You have to start with a hypothesis. In this case, it would be: people with health plans enjoy better health. You then devise an experiment involving a statistically significant number of people. One group, drawn randomly from the population have health plans. The other group (the control group) do not have health plans. Researchers then monitor their health for, say, ten years. Data is collected and analyzed. Results are published in a peer reviewed journal. Human knowledge is increased. Except, the US has been running this experiment for decades. Millions of people across the age range and with differing levels of health are uninsured. Millions more pay for private coverage. The remainder have plans provided by their employers. The data over the years shows that uninsured people have a lower life expectancy. In fact, the poor on average die seven years earlier than the rich. By a coincidence, many of those without insurance are poor. Now that is bad news for this research. There are many factors contributing to death. They are directly related to the social class and lifestyles of the individuals involved. In this, lack of access to medical care is not a major contributing factor. Put another way: there has never been any research to answer the question posed in the title to this article.
We need to consider two contradictory statements: when they fall sick, the poor go to an emergency room and, if they are lucky, receive treatment that keeps them alive; when they are insured, the rich receive care that gives them better health. Except the international statistics show the US has higher mortality rates than most of the other developed countries. To help you understand, we need a comparison with Europe where there is a completely socialized healthcare service and better life expectancy. Both at a European and individual state level, there are panels of experts who decide what treatments and which drugs represent good value for money. States will only pay for treatment proven effective and safe, and will not pay drug companies the retail price they claim. Instead, the states will only pay for approved drugs at prices agreed in negotiations. In the US, insurance companies happily pay for a battery of medical tests and procedures even though there is no evidence any of this work is effective. This adds to the irony. Sometimes the rich die young even though they have received multiple treatments. This is because their expensive treatments are ineffective. Read the rest of this entry »
