Typical lib phony. You choose a moniker that suggests that you’re the town crier, the dispenser of info and knowledge. You’re certainly a cry baby.
Hey, dummy, good to see you’re still trying to learn English usage. Your next lesson should be to learn the proper use of “that” and when the word ‘who’ s/b used instead of the word that.
You’re such a phony clown that I wear with pride any baseless accusation conjured by your clueless & infantile mind.
Get back into your cubicle, punk, and do some work.
Ok Joe, Now you’ve stopped having a debate and started your usual verbal vomit again. How about stop being a f&%king a$$hole and have a discussion. Or, is that too much for your little conservative mind to comprehend?
“A loss in the House would have ended the fight… and left Democrats vulnerable to big losses in next year’s congressional elections.”
Aren’t they already vulnerable to big losses in next year’s elections because the vast majority of the American public is outraged that they aren’t paying attention to us?
I would think that because the bill got passed, that the Democrats that voted for it are now much more vulnerable. They all staked their political careers to that bill.
This bill was supported only by a few Americans… those with no insurance. But Democrats thought they knew better than all of us who didn’t support the bill.
The Kansas Democrat House Rep Dennis Moore received 10 million dollars in Energy Funding THE DAY BEFORE he decided to vote yes. Coincidence?
We will be firing Dennis in 2010! It’s about time!
I don’t think there would be much of a discussion if wasn’t for stories like this one.
Look up Ian’s Law:
The bill is named for Ian Pearl, a 37-year-old man with muscular dystrophy who lost his insurance when Guardian terminated the entire class of policies in the State that covered Ian and others. Mr. Pearl became ventilator-dependent in 1991 and relies on a skilled nursing benefit under his insurance policy to receive care that has kept him alive since he suffered respiratory arrest.
An internal document from the insurer, released as a result of a legal challenge, showed that company officials justified dropping the entire line of policies statewide in order to get rid of “the few dogs”, like Ian Pearl.
So, the health insurance industry brought this on themselves. This isn’t the only story out there like this.
I was back in Washington DC in May speaking to reperesentaives about Health Reform. I am extremely disappointed in our House of Representatives in their vote on Saturday for several reasons. The deficit, loss of jobs that will be created, lack of choice, and lack of freedom are starters. Tort reform does not even appear in the bill. My representative voted yes and I have already been in touch with her office letting her know that I will be contributing the maximum amount of money to her next opponent, and helping her opponent’s campaign. I hope all of you who feel strongly about this issue are contacting your representatives and expressing your feelings.
Congratulations to the House for voting to expand affordable health insurance. Major reform is long overdue and it takes courage to buck the powerful industry lobbyists who have a vested interest in maintaining the status quo. Kudos to Anh Cao – a true leader who put the welfare of her constituents ahead of her adherence to the party line
Ha! I was just wondering the same thing, Eve. What’s a political debate without comments from the sexist, racist, small-minded Joe?
What the conservatives that over-run this site don’t seem to want to accept is that there are PLENTY of people in this country that support the bill (or something very similar). And yes, even those of us that are not uninsured.
You want to talk about un-Constitutional? How about the Patriot Act? I’ve never seen a bigger loss of freedoms…
Joe may be a lot of things, but at least he isn’t clueless like the last few posters. This bill is headed for defeat in the Senate, I hope. Those of you who think the government is here to help you are beyond my capacity to understand. This bill does nothing to actually control costs. I can only hope the Senate spends a little time dealing with the actual issues rather than talking points.
Oh, because the current system is so good now. Read this:
Employer and Employee Health Insurance Costs:
Over the last decade, employer-sponsored health insurance premiums have increased 131 percent. 4
Employees have seen their share of job-based coverage increase at nearly the same rate during this period jumping from $1,543 to $3,515.4
The cumulative increase in employer-sponsored health insurance premiums rose at four times the rate of inflation and wage increases during last decade. This increase has made it much more difficult for businesses to continue to provide coverage to their employees and for those workers to afford coverage themselves.4
The average employer-sponsored premium for a family of four costs close to $13,400 a year, and the employee foots about 27 percent of this cost.4 Health insurance costs are the fastest growing expense for employers. Employer health insurance costs overtook profits in 2008, and the gap grows steadily. 5
Total health insurance costs for employers could reach nearly $850 billion by 2019. Individual and family spending will jump considerably from $326 billion in 2009 to $550 billion in 2019.6
The Congressional Budget Office has estimated that job-based health insurance could increase 100 percent over the next decade.7 Employer-based family insurance costs for a family of four will reach nearly $25,000 per year by 2018 absent health care reform.7
As someone that has done a lot of reading and have not posted, those of you that praise this catastrophie,better hope it does not pass in the Senate. Read the WSJ! Read anything that reports the costs and does not list the false “utopia” that socialism creates.
I grew up with an America capable of thinking and willing to work. Not an America that blindly follows like dogs and needs a hand-out. If you work, you will be giving the hand-out to the millions that do not. Then eventually, you’ll get tired of providing solutions and just start going to work. Then as taxes increase well above 60% you’ll get laid off as America falls into the deepest depression ever.
You are voting your kids into debt, socialism and the ruin of prosperity and opportunity.
Your numbers are terrible. That’s a horrific cost by 2018. With the implementation of socialized insurance, families making $100k will be paying $20,000 immediately and grow from there. These bills state they’ll control costs and eliminate waste once implemented. Why don’t they do that now and not take over insurance. This would prove if they could eliminate waste. It would be nice to see the government implement savings prior instead of just promising. I am tired of that “SMOKE”.
Things that could happen in 9 or 10 years never happen in that manner. Your quotes above or Pelosi’s, Obamas and Reid’s on MSCRAP news.
As a good conservative, I hope you can’t have what you seem to want…
Umm Bob, those are today’s numbers under private insurance plans.
I actually liked some things of what I heard coming from John Boehner’s plan. (What little I heard). Except there was nothing for pre-existing conditions or cancelltion of customers policies due to catostrophic illness.
…Disabled and suffering from muscular dystrophy, Ian Pearl was just weeks away from losing his health insurance.
His New York-based carrier, Guardian Insurance, had canceled Pearl’s family policy as part of a company decision to drop scores of its older small group plans in three states.
But after a public outcry over Guardian’s decision, the company announced Thursday it is reversing its decision and restoring Pearl’s policy.
Part of the outcry stemmed from an internal Guardian company e-mail which was unearthed by Pearl’s attorney.
That e-mail referred to the Pearl family policy as a “dog” that the company could “get rid of.”
In an exclusive on-camera interview with CNN’s American Morning his home in Southwest Ranches, Florida, Pearl said he was deeply offended by the e-mail.
“I want to know myself and others like me who depended on this policy who were paying premiums and did nothing wrong… (are) suddenly targeted as dogs because we are disabled,” Pearl said “Disabled people are not dogs.”
Pearl’s care is estimated to cost $1 million dollars every year. He receives ’round the clock care from an in-home nursing staff.
In a statement, Guardian’s president Dennis Manning admitted the company was wrong.
“Insurance companies are comprised of human beings and sometimes we make mistakes. This was one of them, but we also learn from those mistakes and we seek to correct them,” Manning said.
Guardian also apologized to Ian for the e-mail that called his policy a “dog.”
After battling the insurer in court for over a year, Pearl’s mother, Susan, was stunned by the company’s reversal. “I am very encouraged that Guardian is releasing this statement and is acknowledging its misconduct,” Mrs. Pearl said.
Pearl’s father along with his attorney, John Fried, plan to meet with Guardian officials at the company’s headquarters on Friday to discuss the restoration of the family’s policy.
So the mean insurance company reversed itself in a matter of days?
How long would it have taken a beaurocrat to reverse?
Get real – proponents of this bill are either intensely ignorant or dishonest. There is already coverage available in most states for those with pre-existing issues. This bill was about saving face for Obama and the Dems; not about doing what’s right to “fix” health care. Profits for the health care carriers lag most any other industry. This bill will penalize small business and further deepen the recession with increased costs of doing business and job cuts due to those increased costs. Govt. intervention of this sort won’t resolve health care, nor any other financial issue – just look at Medicare, Social Security or the poor implementation and monitoring of TARP for proof.
Sorry, but the liberal approach to this problem is disgusting. Business is far more likely to actually solve problems than the bureaucrats who will be put into place eternally. No government program ever really gets fixed or just goes away. The solution to fixing anything is seldom destruction of the structure. Why do we need to tear this structure down and start again. Typical liberal, no facts, only feelings. The old phrase, bleeding heart liberals, needs to be brought out of storage.
Vlad, it should have never happend in the first place. It’s not a “mistake” as Guardian’s president put it. They got caught being unethical and now are scrambling to make it right so this story will blow over…quickly.
Under the bill being proposed, there are no cancellations for people like Ian. It’s in the bill.
This is a touching story that is horrible. With socialized medicine/ insurance, they will calculate his value added years and decide if the $1 mil. is worth spending. All socialized care does this and it will occur with ours. Which is lessor of the two evils. With a public outcry he has insurance or with socilized insurance he does not get insurance nor round the clock aid. I pick the former
how about all of the socialists who support this plan including these members of Congress pay for the free loaders who don’t want to work or will not buy health insurance but they $40,000 cars with an additional $10,000 of custom equipment- pay for this plan out of your pockets and the rest of us spend our money as we see fit. What will happen is those of us who are the producers will quit producing and just become consumers waiting on government handouts. All of this coming before Veterans Day too- when we are to honor the men and women who have sacrificed so much in defense of freedom over the 233 years of our country’s history and our society today no longer cherishes or wants freedom. Amazing the residents of the Soviet Union celebrated the downfall of their socialists regime and we exalt ours.
Then lets get rid of all Medicare and Medicade. Lets see how the seniors react to this. I’m sure you now someone on the plan who would be thrilled that government has interfered with their healthcare.
Medicare is bankrupting this country and has to be fixed quickly. But at least it works for the patients.
I’m pretty sure I saw plenty of facts in Allan’s posts, even though yours have been devoid of anything of substance (other than opinions).
There are several ways in which costs will be reduced, which are highlighted in the article. Yet you still claim this bill will not reduce costs. Are you only willing to look at the ‘facts’ that suit your needs/opinions?
I’m sorry. I don’t believe that the health insurance industry brought this on themselves. Look at any industry. Your going to find nightmare stories about how some poor guy got screwed. It happens. You’ll also find many happy customers who are very satisfied with their policies. What has caused this is an entitlement generation that suddenly thinks that their lives will be so much better if the government will just take care of them. Health Insurance costs money and most of us have a sizeable amount withheld from our paychecks every month and get our insurance through our employers. But there are a lot of people out there that have this fantasy that if Uncle Sam would give them free health care then they could spend that money on trips and toys. What they haven’t figured out is that nothing is free and they are just going to get taxed into next week to pay for that “free” health care. Then you have the fairly small group of people that don’t work that are as usual, looking for another handout and somehow have come to believe that they are “entitled” to free health care. The Democrats figured it out first and are controling power by promising these ignorant people free health care for votes. Thats how Obama got elected.
the government is unable to fix things. Look at Fannie Mae, Freddie Mac, Social Security, Medicare, the US Postal Service. All the government does is throw money at a problem and they get the money by overtaxing US- which in turn kills the economy and jobs. If you want solutions- competition is the way to go with all things including health care and tort reform. Its hilarious that this bill is over 2,000 pages and is supposed to reduce medical costs, but it never even mentions tort reform. Lawsuits and threat of lawsuits are a significant reason for outrageous medical costs. But the Dems will never address that-because the trial lawyers are filling their coffers with money hand over fist.
Here in Arizona as I am sure in many of your states we already have a plan for dealing with children who otherwise would not have insurance becaue of affordability. It is call Kid’s Care. Any child can go on Kid’s Care if their parents make less than $50,000. It is on a sliding scale, but most parents that make under $50,000 pay nothing or next to nothing. Many of the parent’s pay $10 per month. The care is exceptional with no copays and no deductibles and a huge choice in doctors. It is far a far better plan than most Major Medical Plans. Noone in the United States is denied care at an emergency room.Everyone has to be treated. This National Health Care is a boondogle that is going to plunge our country into a terrible finacial turmoil. Instead of fixing what is broke the Democrats want to throw out the whole system, take away choice, take away an agent’s opportunity to market health insurance, and drive up our National debt.
Hear, hear – from the CBO: CBO and the staff of Joint Committee of Taxation now estimate that, on balance, the direct spending and revenue effects of enacting H.R. 3962, incorporating the manager’s amendment, would yield a net reduction in federal budget deficits of $109 billion (rather than $129 billion) over the 2010-2019 period.
Wait until Ian is 60 yrs old – he is expendable by government rules. Go ahead
Dems and criticize the insurance companies; wait and see what Obama and his
cronies have in store for you when they think you’re not worth saving either.
you live in fantasy land don’t you. The government is going to take care of 47 million people(it will be more when private health insurers go under) and it will reduce the federal deficit. A knowledgeable person can make numbers say whatever they want them too. Ergo- the CBO under pressure from Obama and Congress comes up with numbers supporting them.
Then why did John Boehner and others look to the CBO when the Republicans bill was announced?
None of this is fantasy land and it’s not a hand out. Where going to pay with this through our taxes. Well, mainly the rich will pay for it. Which I don’t agree with and kinda rubs me the wrong way but, I see insurance carrier after insurance carrier get over on claims because of loop holes or gaps in the policy.
I guess next the government should subsidize homeowners insurance and auto insurance. I mean there are people who can’t afford the rates they are being charged and claims are never settled the way people want. Therefore, I can also not only pay for someone to not work, but they can afford a home and I can pay their monthly income, their health insurance and the auto and home insurance. Why should I keep working? Why not just travel the country and let everybody else pay the freight.
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
HCA INVESTIGATION NETS RECORD TOTAL OF $1.7 BILLION
WASHINGTON, D.C. – HCA Inc. (formerly known as Columbia/HCA and HCA – The Healthcare Company) has agreed to pay the United States $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs, the Justice Department announced today.
So how many Ian’s could have been saved if not for the ineptness of our bureaucrats?
If I’m reading this correctly, the article says that the health insurance carrier submitted fraudulent claims to Medicare and other federal health agencies.
Again, unethical health insurance company.
What does this have to do with government bureaucrats? I see that it all has to do with the insurance company’s bureaucrats.
Just so we’re clear, I was using your posts as a defense to Vlad’s rubbish. You’re the only one that seems to be arguing with logic – not blind fear (Socialism is coming!) or hate for the opposing party (Democrats are destroying the country!).
Allen- you mean you don’t feel sorry for those who can’t afford auto insurance or those who such poor driving histories that they have trouble obtaining coverage? Obviously, you need more indoctrination to become a full-fledged socialists.
As to the sole republican yes vote, Cao represents a welfare city – New Orleans. Evidently he voted in accordance with his constitutents desires, not his own desires! That’s what he should do! Here here to the lone man who got it right – coincidence he’s a Republican? I don’t think so.
That being said, there are going to be alot of Democrats “in disguise” seeking election to Congress next year…nice try………They’ll be running as Republicans because they think they stand a better chance of being elected. But once they open their mouth, we know they’re Dems! It won’t work!
… for proving my point.
Allan: Again, unethical health insurance company.
Fact: Who is HCA? The Hospital Corporation of America (HCA) is the largest private operator of health care facilities in the world.
NOT AN INSURANCE COMPANY, but a healthcare provider.
Which insurance companies did they defraud?
PS, it is in my prior post and they are government owned and controlled.
Ok, whatever. Like I’m supposed to know what HCA stood for. From the sound of the article it sounded like a carrier. In any event, it was someone in the private sector that defrauded the government.
What’s your point to all of this? Fraud happens everday private and public.
1) You type with no facts (only feelings?). Prove any of my postings factually incorrect. Calling my posts rubbish does not suit me nor should it suit you.
2) Do you know the definition of socialism? How about Meriam-Webster – any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods.
So can you explain to me how this is not socialism? Or conversely, can you expalin how this promotes capitalism?
Do you need a definition?
Here you go – an economic system characterized by private or corporate ownership of capital goods, by investments that are determined by private decision, and by prices, production, and the distribution of goods that are determined mainly by competition in a free market.
Read my posts carefully – I’m on your side. Just trying to give you some kudos, but I don’t think it’s coming across right. My posts aren’t sarcasm aimed at you. I agree with what you’re saying and truly appreciate the info you’re providing.
I agree that this bill borrows from Socialist ideology – but its passage wouldn’t make us a Socialist country. Nor would it constitute a ‘slippery slope’ toward Socialism. Last time I checked, Canada and England are not Socialist countries – but both use socialized medicine.
Enough with the fear tactics. There are no death panels in the bill, reformed health care will not immediately turn the country Socialist, and I fail to see how it will be the ‘nail in the coffin’ for the economy. The 10-year war we’re involved in already took care of that. And if you want to point fingers for the recession, I’d look at capitalism first. You know, the Enrons, Lehman Brothers, and AIGs of the world…
Yes this is socialism.
Now we can debate the merits of socialism vs. capitalism.
However, for me its another day for that.
As for you proponents of the bill, please be honest with yourself, this is socialism.
Thanks again for your honesty hear, hear.
PS the proof I am looking for was any of my posting containing factual errors.
I had to cut and paste as this site will not allow the link for some reason. This is from Insurance Journal 10/21/09.
Study: Workers’ Compensation Public Options Outperform Private Industry
By Andrew G. Simpson
October 21, 2009
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An insurance industry think tank has concluded that 25 public and quasi-public workers’ compensation insurance plans perform better financially than the private market in a number of performance categories and at least as well when it comes to the bottom line.
The so-called state funds, typically operating in a single state and driven less by the need to show a profit, also are effective at preventing losses, improving safety at workplaces and contributing to economic development in their states, according to the report by Conning Research and Consulting, based in Hartford, Conn., which counts state funds among its clients.
Without disclosing actual ratios and numbers behind the conclusions, the study’s author says that the research found that while public workers’ compensation providers tend to have higher losses than the workers’ compensation insurance industry as a whole, they more than offset those losses with lower expenses, higher investment returns, bigger dividends to employers and better injury prevention efforts.
The report further concluded that through more stable reserves and superior investment income, state funds have managed to achieve operating income on a par with that of the workers’ compensation industry as a whole.
The study looked at the combined experience of workers’ compensation options in Arizona, California, Colorado, Hawaii, Idaho, Kentucky, Louisiana, Maine, Maryland, Minnesota, Missouri, Montana, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Washington State, West Virginia and Wyoming.
Four states (North Dakota, Ohio, Washington and Wyoming) have monopolistic funds that are employers’ only option for buying coverage. The remaining 21 states have organizations that compete with private insurers. The competitive state funds often act as markets of last resort, providing coverage for high risk or other businesses that can’t obtain it in the private market.
These public and quasi-public workers’ compensation funds specialize in writing insurance in a single state, although some have even branched out into other territories.
The country’s 25 state workers’ compensation state funds have not only performed well but have also achieved a significant share — 25 percent — of the nation’s overall insured workers compensation market, and appear to be growing in many states, according to the Conning study.
“Workers’ compensation state funds now control a quarter of the insured workers compensation market, despite the fact that they only write in 25 states,” said Mark Jablonowski, analyst at Conning and author of the study, Workers’ Compensation State Funds: Evolution of a Competitive Force.
Jablonowski said the findings show that public insurance options, which he prefers to call “private/public interfaces,” do work, depending upon how they are structured, and that the public and private sectors can learn from each other.
“It’s an argument not to fear public options if they’re properly structured,” he said. “I think you have a definite case here where you’ve got …these companies that operate independently within the states and are mandated in most cases to operate on their own, in other words, to not dip into state funds. So, I think there are lessons to be learned on both sides. But obviously it indicates that there is such a thing as an effective public/private interface, absolutely. The devil is in the details; how are you going to structure it?”
State funds are not only operating well financially but also contributing to injury prevention and safer workplaces.
“While state funds have strong financial results, there is more to the story of their successful growth,” said Stephan Christiansen, director of research at Conning. “Our research indicates that a key to the state fund success may well be their dedicated approach to loss prevention and control. Their mission often includes shared responsibility for health and safety with other state agencies, and so they often incorporate state-of-the-art loss prevention initiatives with financial rewards tied to the insured’s loss performance.”
State funds typically have to pay more losses from every premium dollar than private industry. But Jablonowski says this is not necessarily a negative indicator.
“[A] high loss ratio doesn’t mean that somebody is doing something wrong. It really places the emphasis on the combined [losses plus expenses] and, ultimately, the operating ratio,” he told Insurance Journal.
He said that despite their higher loss ratios, state funds are able to still make money.
Spurred by their mission that includes improving safety and their state’s economy, state funds blunt the impact of bigger losses through concerted loss prevention efforts. As Jablonowski put it, “They are able to convert the marginal and poor risk into something better.”
The public providers offer employers significantly higher dividends, which provide an incentive for businesses to adopt safety measures. These dividends can also create a competitive advantage and build customer loyalty, according to the study.
Jablonowski said private carriers are also involved in loss prevention but the “big secret” is that every state fund is doing it.
“When you look at the entire insurance world, there are obviously insurance companies in the private world that do a great job of loss prevention control,” he said. “But the unique thing about funds is that they all do it. Twenty-five of them and they all do it. So it’s not a random sample; it’s a sample that suggests that this group puts an emphasis on loss prevention control.”
This emphasis on loss prevention might be one of the lessons private insurers can learn from the public sector. “That is, maybe going back to basics, trying to link financial performance to health and safety performance. That’s what the old-timers like myself grew up on, and I think that is becoming somewhat of a lost art in the private world, and could cause long term issues,” said Jablonowski.
“When you’ve got a state fund that writes half the business in the state, or 20 or 30 percent, it is a major writer in the state, they’ve got to be doing something right,” he said.
The State Compensation Insurance Fund in California writes about 22 percent of that state’s insured market. The company finished 2008 with $1.66 billion in earned premium, compared to $2.27 billion in 2007. The New York State Insurance Fund, which last month celebrated its 95th anniverary, handles $1.35 billion in premium or 41 percent of the market. In 2008, Texas Mutual wrote $768.3 million in premiums, about a 25 percent market share.
As private insurers that compete with the public options are quick to point out, state funds are able to operate with lower expenses because most do not pay taxes or licensing fees.
But Jablonowski said these exemptions, while contributing to lower expenses, are not a major factor and do not explain why state funds do so well. More significant are the efficiencies state funds realize through their widespread use of technology and their coordination of loss prevention, safety and health efforts with other state agencies.
While many private insurers also effectively employ technology, with state funds, “almost all of them are very savvy to the electronic world,” he said.
State funds’ expense ratios are also helped because they often have government partners to assist them in their loss prevention efforts and thereby absorb some of these costs that private carriers have. “[A] lot of these funds rely on the state to provide ancillary services, like loss prevention, claims management, etc. Most of them, for example, work very closely with state occupational safety and health associations,” Jablonowski said.
Business acquisition costs including agent commissions of state funds were found to be about the same as those of private industry.
Jablonowski said state funds’ reserving practices could be more stable because they might be less influenced by competitive pressures than those of private carriers.
“Private companies are under tremendous pressure to perform. And that means they’re going to be subject to the underwriting cycle. And the underwriting cycle a lot of times causality is disputable, but it’s not disputable the fact that reserves tend to move with the underwriting cycle. So when you see that, when you have those kind of competitive pressures that cause the underwriting cycles, you’re going to see the effect on reserves,” he said. “I think state funds are, to some extent, isolated from that shareholder pressure to earn more and more and more and be aggressive in the market and maintain market share and all this stuff.”
He declined to explain why they have better investment returns, noting that Conning has state fund clients that it advises on their investments.
Jablonowski would not share the actual loss, expense and bottom line numbers for the 25 state funds from his firm’s report— that’s the research information Conning developed and sells. But the report suggests that the state funds beat industry benchmarks reported elsewhere.
According to the National Council on Compensation Insurance (NCCI), which collects financial data and prepares rate filings on behalf of workers’ compensation carriers in 38 states, the private workers compensation calendar year combined ratio was 101 in 2008, which was unchanged from what it was in 2007. A.M. Best’s workers’ compensation composite, which consists of 103 workers’ compensation insurer groups and unaffiliated single companies including state funds, had combined ratios of 110.8 in 2008 and 106.5 in 2007.
Most states require businesses to carry workers’ compensation coverage. Workers’ compensation benefits cover medical care and lost wages for employees who are injured on the job.
Conning provides asset management and insurance industry research and consulting services to insurers and state funds. Until recently, it was indirectly owned by insurer Swiss Re. Earlier this month, its acquisition by private equity firm Aquiline Capital Partners LLC, which is run by Jeffrey Greenberg, was finalized.
I don’t think any politician needs to speak about ethics or not being greedy. That is what being a politician in this country has been about for the last 50 years or so. If it is hysterical. They want to limit a business’s profits while they are making millions in backroom deals.
Not much of a victory for a bill that the vast majority of Americans allegedly support in a House controlled soundly by Democrats.
But hey, one RINO voted for it, so that makes it bipartisan, right? Does that mean that the 39 Democrats who voted against it makes the opposition 39 times more bipartisan?
Of course, they were allowed to vote no to preserve their careers. But wait… why were there careers in jeopardy if Americans overwhelmingly support this takeover?
Oh well, at least it’s not going anywhere in the Senate (at least before the 2010 elections). Too many of them want to keep their jobs.
Understood. The carriers do have the right to offer or withdraw coverage. It may not seem right or impersonal or unjust to cancel say a health policy, but as the contract is written, the insurance company has a right. But the bigger question is where do business ethics come into play?
That’s what I’ve been advocating this whole debate. It was unethical what Guardian did. And now that this story has hit the presses, they are retracting. I’m sure they’re are a number of people like Ian in other states facing similar situations that haven’t gotten any play.
How could the state or anyone not get into this based on emotion? It’s an emotional story.
We’ve all seen companies come and go. When one carrier leaves, another will fill the void. Somtimes it’s noticeable and sometimes it can leave a gap in the market where the others will reap the reward at the policy holders expense.
I myself am all for the free market. I’m for capitalism. I’m for competition. I’m for limited government. I’m also for better business practices and ethics.
Not that ethics play a big part in government but, when I hear my grandparents say that Medicare and the VA is working for them, then that is something to go on.
And Medicare & the VA are such good examples of efficiency and honesty. There are billions of dollars of fraud by recipients and providers in the Medicare program with almost no control. These programs are only a fraction of the size of the business you want the feds to take over. Pure logic.
Have you ever received VA or medicare services? VA care is tolerable and it’s okay for what it’s meant to provide to vets with service-connected medical problems and to indigent vets with non-service-connected medical issues (including basic medical care for such indigents), but in need of medical care; however, it’s not even close to the standards of the private sector. I know first-hand about the VA.
(It’s a bit hypocritcal of you, Allan, to use anecdotal evidence to promote your point of view, but ridicule the same type of evidence when used by Sarah Palin, any conservative, or anyone else who disagrees with your opinion.)
Heh, heh, heh. Really got your goat with that last post, didn’t I, Allan? Nice moniker (“donkey punch”), Allan = so-so socialist = italian male = so many other monikers. Punch (so close to paunch, you cherubic little poked boy); donkey (so, even you know that you’re an a**.) A very revealing Freudian slip, you clown.
Heh, heh, heh, back to your cubicle, you paranoid schizophrenic.
It’s time to vote every single one of the House members out of office in 2010. If the Senate passes this abhorant bill, then vote the 1/3 out in 2010 as well. Obama is seeking to systematically dismantle Capitalism. This country cannot afford this type of government takeover, creating yet another buracracy at taxpayers expense. Overhauling the entire healthcare system for less than 17% of the population? It just doesn’t make sense. But further empowering the federal government, now that makes sense.
Elected officials did not care what the American taxpayers said voiceing their opinions since August. They did what they wanted. Now it’s time for the American voter to implement term limits in 2010 and send them all packing! Starting with Nazi Pelosi…
Amen. The health care vote on Saturday presented to me a real dilemma. I didn’t want it to pass the house, but I know that its passage by the DemonRats (change to R the letter c and that’s what it spells) will be the death knell for it in the 2010 midterms.
Look, I never said there wasn’t anything wrong with the financial side of these programs. I said that the people who recieved care from them liked it. They like the care and the docotors.
My grand parents and father recieve care from the VA and tell me the care they recieve is very good.
My mother in-law is on Medicare and says, so far, the care is good.
Again, try telling a senior citizen that your going to strip them of their Medicare and see what response you’ll get.
Waste and fraud is a problem and should it must be delt with if these programs are going be around. I understand this is difficult with some of the bureaucracy involved. But, it is peoples health we’re talking about.
Isn’t that why programs like these are around? FOR THE PEOPLE???
Allan – comparing government handling of worker’s compensation is moot.
Worker’s Compensation Statutes provide that all injured workers receive the same set of benefits, per law.
That’s that very concern of opponents of the Democrats bill: We don’t all have the exact same coverage, we don’t want it that way. We want to shop for the best coverage for the best price at the limits we want to be insured for. We don’t want the government through any mechanism to tell us what our coverage will be.
Your comparison shows lack of understanding for the complexity of the issues. Not understanding what HCA is but jumping to the conclusion that they were an insurer, also shows you lack details before forming an opinion. Fortunately, you have us conservatives to look out for your interests, that even you don’t know you have.
What do you think the ultimate result will be to the government limiting the amount a health insurer can charge for certain benefits?
If we limit Seven Eleven to charging .14 cents for a can coke that costs them .46 to buy, they’re not going to sell coke any more. Get it?????????
Joe, again, you’re bringing nothing to the table other than far right extremism. And I mean FAR RIGHT!
Definition of the far right: one’s ideoligy to preserve and promote themselves even if means lying, denying, selling out, cheating or defrauding other around them to boost their own ideals and pocket books.
Why are health insurance companies dropping people’s health coverage when they feel the cost is just to high? (Refer to Ian’s Law)
This is blown way out of proportion and being politicized. We represent 7 companies who write individual insurance and never have they dropped an insured in 28 yrs, unless they lied on the app. Insured’s want it all ways – omit info on the application, then get services for conditions they omitted – insurance companies process claim and find out it was a pre-existing condition then have right to deny coverage. Insurance is not a right. Insurance companies have their actuarial tables down to a science. 70% of premium goes to claims, 30% is their aquisition costs (which includes underwriting,commissions and profit). When claims cost exceed 70% that insurance company will have a problem. People think that insurance companies should accept anyone with any condition. In order for companies to remain in business they must underwrite. Unlike the federal government who thinks they have an open checkbook, insurance companies are accountable to stockholders and their respective state insurance commissioners.
Why do many Americans go into bankruptcy due to their health insurance?
Americans demand services, irrespective of what their insurance is designed to pay. Get the services done, then plead ignorant. Or purchase a plan with high deductibles and out-of-pocket expenses cause I will never get sick. When something occurs, I can’t believe the insurance company is not paying or only paying 80%. Well that’s the policy you purchased. Then your agent is bad or a theif mentality. Irrespective of the fact that’s the type of plan you want. Are there some that slip through the cracks, Yes. Will providers work with you when a CAT claim occurs – Yes. But to try and screw the system, it will catch up to you.
Why should I pay into an HSA when I already have health insurance?
You don’t have to. If you want to take advantage of the tax deferrals of an HSA, it’s there for you to do so. If you want to pay as you go and not fund the HSA, that is your perogative. HSA’s are not a cure-all, but it’s a viable option if you feel that you do not or will not use the medical services, reduce your monthly premium outlay and/or if you want to tax defer money, much like an IRA.
Why do health insurance companies deny it’s insured’s procedure’s that are crucial to their health?
Because they have the right. There may be alternative health care options to explore. You think insurance companies are guilty of rationing care, wait till Uncle Sam, Nazi Pelosi and Obamascare start running things. Oh your over 65 and you need a heart bypass, sorry your life expectancy is 3 more years, here’s some pills and talk to our grief counselors and will make funeral arrangements for you.
You’ve made some good points. Although you only represent 7 out of the hundred’s of carriers out there.
Also, what about some of the other horor stories I’ve heard out there regarding some condition like a yeast infection or something insignificant not being included on an application. Then when an insured develops cancer, the carrier probes into that insured’s past only to find out that it was not included in the application and coverage is denied?
I also heard of an insurance carrier that didn’t pay for the ambulence service that was called in after a car accident saying it wasn’t pre-approved. At what point was that supposed to be pre-approved?
You mention that insurance companies have the right to deny procedure’s. True, it is their right. But at what cost to the person’s overall health in need of that procedure?
The bottom line is that health insurance companines will more often than not put profit before a person’s life. Not all the time but, even a few is too many.
Good Questions Allan – 5 yrs ago we represented over 20 companies for individual medical. Many have gone by the waistside, left the state or you simply weed out companies who you know are poor at paying claims.
Our job as agents do not end after you sell a policy. Agents jobs are to help mitigate claims like the ambulance issue. Often times ambulance bills (for instance) are sent directly to the insured and they just toss them. We, agents, do not get copies or notifications of claims filed. We tell our insureds to contact us in the event of a claim issue. Ambulance bills are great example – often times they do not bill the carrier direct. When insured contacts us we help direct those bills to the carriers to process. If the insureds wait over 90 days to file a claim it’s tougher to process, but generally get it done.
7 yrs ago, we could do a spreadsheet for group insurance with over 20 carriers in Florida. Today, that spreadsheet is down to 5. Small group reform in Florida has made it difficult because carriers left the state. Government thinks they are doing a favor by passing so-called “small group reforms”, they just kill the marketplace with unreasonable underwriting restrictions.
As for your “yeast infection” question – For individual health apps, something perceived as insignificant as a Yeast Infection, if the client leaves that off the application that can cause a claim issue. It may have been an acute treatment and if indicated on the initial application, that condition or anything attributed to that condition could have been covered by the company. God forbid cervical cancer or HPV diagnosis occurs in a year or 2 and the yeast infection treatment was listed on the app and app accepted by the company, that condition is covered. But insureds think they know insurance or try to one up the company and low and behold at claim time there is a problem.
Give you an example – a client clean sheeted an application for their son. 4 years ago son had gastric by-pass surgery. He was 400lbs and 17 yrs old, diagnosed with hypertension and Type 2 diabetes. Three years later kid got down to 150lbs and tests results perfect. Father applies for health insurance for the kid. Holds insurance for 1 year and kid (now 22yrs old) goes in for surgery to have skin taken in from all the weight loss. Insurance company requests medical records from doctor, who happened to do gastric bypass and finds out prior treatment including by-pass, diabetes, hypertension issues. Insurance company denies claim and cancels policy. Father thought insurance should pay and elected not to put prior medical on app. Is insurance company wrong to deny? I think not. Now insurance company is bad in father’s eyes.
In Florida group insurance is guaranteed issue, so all pre-existing conditions are covered. There may be a 6 or 12 month waiting period for a specific condition (except maternity)
The bottom line is that health insurance companines will more often than not put profit before a person’s life – I personally do not agree with that statement. The agent plays a key role in servicing the client from the initial app to claims being paid. I think the media and politicians like to demonize insurance companies and are successful. Yet these same politicians don’t have a problem taking their campaign donations.
I sell commercial lines P&C and sometimes have similar issues in the application process where proposed clients do not think to disclose their full operations. A lot of times it’s not intentional, they just do not think it was important or forget about it all together.
I have a roofer that once burned down a few condo units after he applied the torch down material. He was unaware that condo/H.O.A. coverage is excluded from his policy. I asked him during the application process regarding H.O.A. work and at the time, his company was not involved. It was also noted on the proposal that this work was excluded. Had he called me to endorse the coverage on the policy, he would have been covered. He just never gave it any thought because he had a GL policy in effect and assumed it was covered.
I think that a lot of people are unaware of the repercussions that could come back and bite them by not being detailed. It’s also up to the agent/broker to be detailed in blue-printing their prospects.
I have also seen some applications that are very vague when it comes down to particular operation practices and unless you have an agent that knows what to ask for, the insured will be exposed.
Allan we’re in the same boat man. Things that are perceived insignificant by the insured are pertinent to an insurance policy. Insurance industry, at times, can do a poor job in communication and other times they do all they can and still demonized.
Look at the MEWA case in Pensacola after Hurricane (I think) Rita. HO3 policies specifically exclude coverage for Flooding. Insured’s decide not to purchase flood insurance (cost too much), we have them sign off to not purchase flood insurance, then a hurricane comes through causes flood damage and there’s no coverage. Insured sues and courts side with insured’s and re-write HO3 policies to include flood losses after the fact and insurance companies lose again. People then wonder why insurance companies leave the state? Then agents take it on the chin. But hey, we could be unemployed and living off the federal dole. Grin and bear it and move on.
Yeah, I hear ya. At the same time stories like Ian’s Law and other legit stories like his don’t do well for the health carriers….or our industry at all.
Allan, this is where mixed emotions comes into play. States now are going to mandate insurance companies not be able to cancel policies. I personally see insurance companies are “Private Enterprises” who offer a service to an individual or group of people. They, insurance companies in this case, have the right to offer or withdraw coverage. It may not seem right or impersonal or unjust to cancel say a health policy, but as the contract is written, the insurance company has a right. From a PR standpoint The Guardian has retracted canceling the policy and done what appears to be the right thing. Guardian spokesperson statement below:
“We believe that the people we insure should be treated equitably and [we] are confident that we acted legally, in full compliance with state insurance regulation, and underscore that at no time did we cancel coverage for an entire block of policies in order to discontinue coverage for any particular individual,” Guardian spokesman Richard Jones wrote in a statement.
The private sector at work!
Now the state government is getting into the picture on pure emotion. Was there a maximum limit under the policy and Ian has approached it? Is reinsurance dictating to get off the risk since they will never recoupe the losses incurred? But it’s a private company. Private companies do not have the leisure government has to pay for things carte blanc. However, the politicians know nothing of insurance and they appeal to this issue on purely an emotional basis. They will pass legislation to impose their own moral code, but in the process insurance companies will stop writing in the State of New York and now what happens. It will insure that New Yorkers will demand the government do something, hence here comes Government run health insurance.
Not to be cold hearted, the efforts by Ian Pearl to change the hearts of The Guardian officials was great and they did concede they were wrong. The private company made that decision and they will have to live by it. Ah, Free Enterprise at work. But why change the entire system? People are understanding less and less of the Free Enterprise system. They are of the mindset that government is the answer to all our ills. As long as we continue to have so-called leaders as Obama, Nazi Pelosi and Scary Reid the government mentality to take care of us will only grow. But who’s the government? The taxpayers and I don’t know how much more taxpayers can pay out to fund all these government schemes?
I think your mixed up on the conversation I was having with Tar. I never said anything regarding a contract. I was referring to an application. I never said anything about a health application. I was referring to a few commercial lines P&C apps I’ve filled out. Some of them are vague in terms of the info they are requesting. Especially the RRG apps. I try to stay away from them as much as I can but, sometimes I’m forced to go that route because of the clients needs.
Now, the ones that deliberately lie on the application about their medical history, that purposely lie and commit fraud, I don’t feel for either.
From now on, please read my posts thoroughly. Thank you.
Allen, the people that deliberately cheat the system chose to spend their money on something else, until they get sick,and need benefits. So, they deliberately lie on the application about their medical history because otherwise they would be denied. That’s called FRAUD. I don’t feel sorry one bit for them. If the insurance company would not have written them, or their premium would have been higher, the insurer is the one getting screwed by the unhealthy liar.
There’s also nothing vague about an insurance contract. Have you read one? It’s real clear what is covered, and what’s not, so nice try.
I have thoroughly read your posts, assure me. My discussion about the health apps comes from your numerous comments about the health insurer wronging the insured in circumstances such as pre existing conditions. My point was that you did not have all of the information. The application specifically discusses pre existing conditions, so if there turned out to be one that wasn’t disclred, it was likely the insured’s failure to close, not the insurer’s failure to ask.
I also don’t find any other applications to be vague, but if you don’t understand the question well enough to get the proper answer from the insured, I’m sure the writing carrier’s underwriter would be able to clarify.
Of course I still want to see where in the US Constitution the Congress was given the right to require health insurance for all people.
Typical lib phony. You choose a moniker that suggests that you’re the town crier, the dispenser of info and knowledge. You’re certainly a cry baby.
Hey, dummy, good to see you’re still trying to learn English usage. Your next lesson should be to learn the proper use of “that” and when the word ‘who’ s/b used instead of the word that.
You’re such a phony clown that I wear with pride any baseless accusation conjured by your clueless & infantile mind.
Get back into your cubicle, punk, and do some work.
Where in the Constitution?
Why ask such a silly question? NOBODY questions that Congress can do this. Didn’t you hear?
It’ll never make it out of the Senate.
Ok Joe, Now you’ve stopped having a debate and started your usual verbal vomit again. How about stop being a f&%king a$$hole and have a discussion. Or, is that too much for your little conservative mind to comprehend?
How’s that for some english f*ck face.
“A loss in the House would have ended the fight… and left Democrats vulnerable to big losses in next year’s congressional elections.”
Aren’t they already vulnerable to big losses in next year’s elections because the vast majority of the American public is outraged that they aren’t paying attention to us?
I would think that because the bill got passed, that the Democrats that voted for it are now much more vulnerable. They all staked their political careers to that bill.
This bill was supported only by a few Americans… those with no insurance. But Democrats thought they knew better than all of us who didn’t support the bill.
The Kansas Democrat House Rep Dennis Moore received 10 million dollars in Energy Funding THE DAY BEFORE he decided to vote yes. Coincidence?
We will be firing Dennis in 2010! It’s about time!
Excommunicate the *******!
Has our President ever even read
The Constitution of The United States?????
I don’t think there would be much of a discussion if wasn’t for stories like this one.
Look up Ian’s Law:
The bill is named for Ian Pearl, a 37-year-old man with muscular dystrophy who lost his insurance when Guardian terminated the entire class of policies in the State that covered Ian and others. Mr. Pearl became ventilator-dependent in 1991 and relies on a skilled nursing benefit under his insurance policy to receive care that has kept him alive since he suffered respiratory arrest.
An internal document from the insurer, released as a result of a legal challenge, showed that company officials justified dropping the entire line of policies statewide in order to get rid of “the few dogs”, like Ian Pearl.
So, the health insurance industry brought this on themselves. This isn’t the only story out there like this.
Many of you supported Bush blindly and the GOP House — with diastrous results. Doing so opened the door to a Democratic sweep.
If you had paid attention to your P’s and Q’s withot slavish devotion to party line, this may not have happened.
Having said that, something had to happen with the broken medical insurance system.
If you don’t like it, look to yourselves for how we got to where we are.
Thanks for posting Ian’s story, Allan.
Guardian is diabolical!
I was back in Washington DC in May speaking to reperesentaives about Health Reform. I am extremely disappointed in our House of Representatives in their vote on Saturday for several reasons. The deficit, loss of jobs that will be created, lack of choice, and lack of freedom are starters. Tort reform does not even appear in the bill. My representative voted yes and I have already been in touch with her office letting her know that I will be contributing the maximum amount of money to her next opponent, and helping her opponent’s campaign. I hope all of you who feel strongly about this issue are contacting your representatives and expressing your feelings.
Congratulations to the House for voting to expand affordable health insurance. Major reform is long overdue and it takes courage to buck the powerful industry lobbyists who have a vested interest in maintaining the status quo. Kudos to Anh Cao – a true leader who put the welfare of her constituents ahead of her adherence to the party line
I agree, totally.. Although one wonders where Joe is, crawl out of whatever rock you’re hiding under Joe! Must be a good day for ya!..
Ha! I was just wondering the same thing, Eve. What’s a political debate without comments from the sexist, racist, small-minded Joe?
What the conservatives that over-run this site don’t seem to want to accept is that there are PLENTY of people in this country that support the bill (or something very similar). And yes, even those of us that are not uninsured.
You want to talk about un-Constitutional? How about the Patriot Act? I’ve never seen a bigger loss of freedoms…
Joe may be a lot of things, but at least he isn’t clueless like the last few posters. This bill is headed for defeat in the Senate, I hope. Those of you who think the government is here to help you are beyond my capacity to understand. This bill does nothing to actually control costs. I can only hope the Senate spends a little time dealing with the actual issues rather than talking points.
Oh, because the current system is so good now. Read this:
Employer and Employee Health Insurance Costs:
Over the last decade, employer-sponsored health insurance premiums have increased 131 percent. 4
Employees have seen their share of job-based coverage increase at nearly the same rate during this period jumping from $1,543 to $3,515.4
The cumulative increase in employer-sponsored health insurance premiums rose at four times the rate of inflation and wage increases during last decade. This increase has made it much more difficult for businesses to continue to provide coverage to their employees and for those workers to afford coverage themselves.4
The average employer-sponsored premium for a family of four costs close to $13,400 a year, and the employee foots about 27 percent of this cost.4 Health insurance costs are the fastest growing expense for employers. Employer health insurance costs overtook profits in 2008, and the gap grows steadily. 5
Total health insurance costs for employers could reach nearly $850 billion by 2019. Individual and family spending will jump considerably from $326 billion in 2009 to $550 billion in 2019.6
The Congressional Budget Office has estimated that job-based health insurance could increase 100 percent over the next decade.7 Employer-based family insurance costs for a family of four will reach nearly $25,000 per year by 2018 absent health care reform.7
Read the rest of the article at:
http://www.nchc.org/facts/cost.shtml
As someone that has done a lot of reading and have not posted, those of you that praise this catastrophie,better hope it does not pass in the Senate. Read the WSJ! Read anything that reports the costs and does not list the false “utopia” that socialism creates.
I grew up with an America capable of thinking and willing to work. Not an America that blindly follows like dogs and needs a hand-out. If you work, you will be giving the hand-out to the millions that do not. Then eventually, you’ll get tired of providing solutions and just start going to work. Then as taxes increase well above 60% you’ll get laid off as America falls into the deepest depression ever.
You are voting your kids into debt, socialism and the ruin of prosperity and opportunity.
Allan,
Your numbers are terrible. That’s a horrific cost by 2018. With the implementation of socialized insurance, families making $100k will be paying $20,000 immediately and grow from there. These bills state they’ll control costs and eliminate waste once implemented. Why don’t they do that now and not take over insurance. This would prove if they could eliminate waste. It would be nice to see the government implement savings prior instead of just promising. I am tired of that “SMOKE”.
Things that could happen in 9 or 10 years never happen in that manner. Your quotes above or Pelosi’s, Obamas and Reid’s on MSCRAP news.
As a good conservative, I hope you can’t have what you seem to want…
That is what this debate is about … Morality. Not the Wall Street Journal.
You conservatives are disgusting.
politics & crime are the same thing
Umm Bob, those are today’s numbers under private insurance plans.
I actually liked some things of what I heard coming from John Boehner’s plan. (What little I heard). Except there was nothing for pre-existing conditions or cancelltion of customers policies due to catostrophic illness.
…Disabled and suffering from muscular dystrophy, Ian Pearl was just weeks away from losing his health insurance.
His New York-based carrier, Guardian Insurance, had canceled Pearl’s family policy as part of a company decision to drop scores of its older small group plans in three states.
But after a public outcry over Guardian’s decision, the company announced Thursday it is reversing its decision and restoring Pearl’s policy.
Part of the outcry stemmed from an internal Guardian company e-mail which was unearthed by Pearl’s attorney.
That e-mail referred to the Pearl family policy as a “dog” that the company could “get rid of.”
In an exclusive on-camera interview with CNN’s American Morning his home in Southwest Ranches, Florida, Pearl said he was deeply offended by the e-mail.
“I want to know myself and others like me who depended on this policy who were paying premiums and did nothing wrong… (are) suddenly targeted as dogs because we are disabled,” Pearl said “Disabled people are not dogs.”
Pearl’s care is estimated to cost $1 million dollars every year. He receives ’round the clock care from an in-home nursing staff.
In a statement, Guardian’s president Dennis Manning admitted the company was wrong.
“Insurance companies are comprised of human beings and sometimes we make mistakes. This was one of them, but we also learn from those mistakes and we seek to correct them,” Manning said.
Guardian also apologized to Ian for the e-mail that called his policy a “dog.”
After battling the insurer in court for over a year, Pearl’s mother, Susan, was stunned by the company’s reversal. “I am very encouraged that Guardian is releasing this statement and is acknowledging its misconduct,” Mrs. Pearl said.
Pearl’s father along with his attorney, John Fried, plan to meet with Guardian officials at the company’s headquarters on Friday to discuss the restoration of the family’s policy.
So the mean insurance company reversed itself in a matter of days?
How long would it have taken a beaurocrat to reverse?
Get real – proponents of this bill are either intensely ignorant or dishonest. There is already coverage available in most states for those with pre-existing issues. This bill was about saving face for Obama and the Dems; not about doing what’s right to “fix” health care. Profits for the health care carriers lag most any other industry. This bill will penalize small business and further deepen the recession with increased costs of doing business and job cuts due to those increased costs. Govt. intervention of this sort won’t resolve health care, nor any other financial issue – just look at Medicare, Social Security or the poor implementation and monitoring of TARP for proof.
Sorry, but the liberal approach to this problem is disgusting. Business is far more likely to actually solve problems than the bureaucrats who will be put into place eternally. No government program ever really gets fixed or just goes away. The solution to fixing anything is seldom destruction of the structure. Why do we need to tear this structure down and start again. Typical liberal, no facts, only feelings. The old phrase, bleeding heart liberals, needs to be brought out of storage.
Vlad, it should have never happend in the first place. It’s not a “mistake” as Guardian’s president put it. They got caught being unethical and now are scrambling to make it right so this story will blow over…quickly.
Under the bill being proposed, there are no cancellations for people like Ian. It’s in the bill.
This is a touching story that is horrible. With socialized medicine/ insurance, they will calculate his value added years and decide if the $1 mil. is worth spending. All socialized care does this and it will occur with ours. Which is lessor of the two evils. With a public outcry he has insurance or with socilized insurance he does not get insurance nor round the clock aid. I pick the former
Don’t be stupid.
how about all of the socialists who support this plan including these members of Congress pay for the free loaders who don’t want to work or will not buy health insurance but they $40,000 cars with an additional $10,000 of custom equipment- pay for this plan out of your pockets and the rest of us spend our money as we see fit. What will happen is those of us who are the producers will quit producing and just become consumers waiting on government handouts. All of this coming before Veterans Day too- when we are to honor the men and women who have sacrificed so much in defense of freedom over the 233 years of our country’s history and our society today no longer cherishes or wants freedom. Amazing the residents of the Soviet Union celebrated the downfall of their socialists regime and we exalt ours.
Then lets get rid of all Medicare and Medicade. Lets see how the seniors react to this. I’m sure you now someone on the plan who would be thrilled that government has interfered with their healthcare.
Medicare is bankrupting this country and has to be fixed quickly. But at least it works for the patients.
I’m pretty sure I saw plenty of facts in Allan’s posts, even though yours have been devoid of anything of substance (other than opinions).
There are several ways in which costs will be reduced, which are highlighted in the article. Yet you still claim this bill will not reduce costs. Are you only willing to look at the ‘facts’ that suit your needs/opinions?
I’m sorry. I don’t believe that the health insurance industry brought this on themselves. Look at any industry. Your going to find nightmare stories about how some poor guy got screwed. It happens. You’ll also find many happy customers who are very satisfied with their policies. What has caused this is an entitlement generation that suddenly thinks that their lives will be so much better if the government will just take care of them. Health Insurance costs money and most of us have a sizeable amount withheld from our paychecks every month and get our insurance through our employers. But there are a lot of people out there that have this fantasy that if Uncle Sam would give them free health care then they could spend that money on trips and toys. What they haven’t figured out is that nothing is free and they are just going to get taxed into next week to pay for that “free” health care. Then you have the fairly small group of people that don’t work that are as usual, looking for another handout and somehow have come to believe that they are “entitled” to free health care. The Democrats figured it out first and are controling power by promising these ignorant people free health care for votes. Thats how Obama got elected.
the government is unable to fix things. Look at Fannie Mae, Freddie Mac, Social Security, Medicare, the US Postal Service. All the government does is throw money at a problem and they get the money by overtaxing US- which in turn kills the economy and jobs. If you want solutions- competition is the way to go with all things including health care and tort reform. Its hilarious that this bill is over 2,000 pages and is supposed to reduce medical costs, but it never even mentions tort reform. Lawsuits and threat of lawsuits are a significant reason for outrageous medical costs. But the Dems will never address that-because the trial lawyers are filling their coffers with money hand over fist.
http://www.huffingtonpost.com/2009/08/12/stephen-hawking-enters-us_n_257343.html
Socialized medicine’s dastardly villians did not pull the plug on Dr. Hawkings now, did they?
Here in Arizona as I am sure in many of your states we already have a plan for dealing with children who otherwise would not have insurance becaue of affordability. It is call Kid’s Care. Any child can go on Kid’s Care if their parents make less than $50,000. It is on a sliding scale, but most parents that make under $50,000 pay nothing or next to nothing. Many of the parent’s pay $10 per month. The care is exceptional with no copays and no deductibles and a huge choice in doctors. It is far a far better plan than most Major Medical Plans. Noone in the United States is denied care at an emergency room.Everyone has to be treated. This National Health Care is a boondogle that is going to plunge our country into a terrible finacial turmoil. Instead of fixing what is broke the Democrats want to throw out the whole system, take away choice, take away an agent’s opportunity to market health insurance, and drive up our National debt.
Hear, hear – from the CBO: CBO and the staff of Joint Committee of Taxation now estimate that, on balance, the direct spending and revenue effects of enacting H.R. 3962, incorporating the manager’s amendment, would yield a net reduction in federal budget deficits of $109 billion (rather than $129 billion) over the 2010-2019 period.
There ya go.
Wait until Ian is 60 yrs old – he is expendable by government rules. Go ahead
Dems and criticize the insurance companies; wait and see what Obama and his
cronies have in store for you when they think you’re not worth saving either.
you live in fantasy land don’t you. The government is going to take care of 47 million people(it will be more when private health insurers go under) and it will reduce the federal deficit. A knowledgeable person can make numbers say whatever they want them too. Ergo- the CBO under pressure from Obama and Congress comes up with numbers supporting them.
Then why did John Boehner and others look to the CBO when the Republicans bill was announced?
None of this is fantasy land and it’s not a hand out. Where going to pay with this through our taxes. Well, mainly the rich will pay for it. Which I don’t agree with and kinda rubs me the wrong way but, I see insurance carrier after insurance carrier get over on claims because of loop holes or gaps in the policy.
I guess next the government should subsidize homeowners insurance and auto insurance. I mean there are people who can’t afford the rates they are being charged and claims are never settled the way people want. Therefore, I can also not only pay for someone to not work, but they can afford a home and I can pay their monthly income, their health insurance and the auto and home insurance. Why should I keep working? Why not just travel the country and let everybody else pay the freight.
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
HCA INVESTIGATION NETS RECORD TOTAL OF $1.7 BILLION
WASHINGTON, D.C. – HCA Inc. (formerly known as Columbia/HCA and HCA – The Healthcare Company) has agreed to pay the United States $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs, the Justice Department announced today.
So how many Ian’s could have been saved if not for the ineptness of our bureaucrats?
If I’m reading this correctly, the article says that the health insurance carrier submitted fraudulent claims to Medicare and other federal health agencies.
Again, unethical health insurance company.
What does this have to do with government bureaucrats? I see that it all has to do with the insurance company’s bureaucrats.
Oh boy. Those lines of insurance or anything else you mentioned doesn’t have an effect on ones health.
You’re missing the point.
Awesome, Allan! Keep it coming!
Just so we’re clear, I was using your posts as a defense to Vlad’s rubbish. You’re the only one that seems to be arguing with logic – not blind fear (Socialism is coming!) or hate for the opposing party (Democrats are destroying the country!).
Get a room and stop posting please.
Allen- you mean you don’t feel sorry for those who can’t afford auto insurance or those who such poor driving histories that they have trouble obtaining coverage? Obviously, you need more indoctrination to become a full-fledged socialists.
Why? We have just as much right to post hear as you do.
Would this be a conservative trying to censor us? Wouldn’t be the first time.
the Marxists that now run the White House and the Congress. If you don’t agree with their utopian ideas they will jail or murder you. Its coming.
Again, it doesn’t affect thier/our health.
As to the sole republican yes vote, Cao represents a welfare city – New Orleans. Evidently he voted in accordance with his constitutents desires, not his own desires! That’s what he should do! Here here to the lone man who got it right – coincidence he’s a Republican? I don’t think so.
That being said, there are going to be alot of Democrats “in disguise” seeking election to Congress next year…nice try………They’ll be running as Republicans because they think they stand a better chance of being elected. But once they open their mouth, we know they’re Dems! It won’t work!
Ok there conspiracy theorist. And 9/11 was an inside job.
Obama is out in 4 years, maybe 8 if he is lucky. I doubt whatever he does now will benefit him after term expires.
Sheesh.
I know you wish myself and the likes with rational thinking would log off. That’s how people like you take control.
That’s why we debate and vote. You know, the way our founding fathers wanted it.
… for proving my point.
Allan: Again, unethical health insurance company.
Fact: Who is HCA? The Hospital Corporation of America (HCA) is the largest private operator of health care facilities in the world.
NOT AN INSURANCE COMPANY, but a healthcare provider.
Which insurance companies did they defraud?
PS, it is in my prior post and they are government owned and controlled.
Ok, whatever. Like I’m supposed to know what HCA stood for. From the sound of the article it sounded like a carrier. In any event, it was someone in the private sector that defrauded the government.
What’s your point to all of this? Fraud happens everday private and public.
1) You type with no facts (only feelings?). Prove any of my postings factually incorrect. Calling my posts rubbish does not suit me nor should it suit you.
2) Do you know the definition of socialism? How about Meriam-Webster – any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods.
So can you explain to me how this is not socialism? Or conversely, can you expalin how this promotes capitalism?
Do you need a definition?
Here you go – an economic system characterized by private or corporate ownership of capital goods, by investments that are determined by private decision, and by prices, production, and the distribution of goods that are determined mainly by competition in a free market.
Look forward to your rational responses.
Read my posts carefully – I’m on your side. Just trying to give you some kudos, but I don’t think it’s coming across right. My posts aren’t sarcasm aimed at you. I agree with what you’re saying and truly appreciate the info you’re providing.
Whoa! Struck a nerve there Vlad?
… in arguing any more. It is clear you look to the government, I look to free markets.
That is our difference.
I will agree to disagree.
Vlad – There is nothing wrong with Capitalism. There is nothing wrong with cashing in on huge profits. But, it should be done ETHICALLY!
I’ve been advocating ethics on these boards ever since this debate started and hardly anyone is getting the message.
Health insurance companies should be very profitable. They also should be ethical towards their policy holders.
I’m waiting.
Vlad – who are you addressing? It’s a bit confusing sometimes on these things. What are you talking about?
I agree that this bill borrows from Socialist ideology – but its passage wouldn’t make us a Socialist country. Nor would it constitute a ‘slippery slope’ toward Socialism. Last time I checked, Canada and England are not Socialist countries – but both use socialized medicine.
Enough with the fear tactics. There are no death panels in the bill, reformed health care will not immediately turn the country Socialist, and I fail to see how it will be the ‘nail in the coffin’ for the economy. The 10-year war we’re involved in already took care of that. And if you want to point fingers for the recession, I’d look at capitalism first. You know, the Enrons, Lehman Brothers, and AIGs of the world…
Yes this is socialism.
Now we can debate the merits of socialism vs. capitalism.
However, for me its another day for that.
As for you proponents of the bill, please be honest with yourself, this is socialism.
Thanks again for your honesty hear, hear.
PS the proof I am looking for was any of my posting containing factual errors.
Yeah, there are a lot of public and social programs out there and for the most part, it hasn’t changed our freedoms one bit.
I had to cut and paste as this site will not allow the link for some reason. This is from Insurance Journal 10/21/09.
Study: Workers’ Compensation Public Options Outperform Private Industry
By Andrew G. Simpson
October 21, 2009
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An insurance industry think tank has concluded that 25 public and quasi-public workers’ compensation insurance plans perform better financially than the private market in a number of performance categories and at least as well when it comes to the bottom line.
The so-called state funds, typically operating in a single state and driven less by the need to show a profit, also are effective at preventing losses, improving safety at workplaces and contributing to economic development in their states, according to the report by Conning Research and Consulting, based in Hartford, Conn., which counts state funds among its clients.
Without disclosing actual ratios and numbers behind the conclusions, the study’s author says that the research found that while public workers’ compensation providers tend to have higher losses than the workers’ compensation insurance industry as a whole, they more than offset those losses with lower expenses, higher investment returns, bigger dividends to employers and better injury prevention efforts.
The report further concluded that through more stable reserves and superior investment income, state funds have managed to achieve operating income on a par with that of the workers’ compensation industry as a whole.
The study looked at the combined experience of workers’ compensation options in Arizona, California, Colorado, Hawaii, Idaho, Kentucky, Louisiana, Maine, Maryland, Minnesota, Missouri, Montana, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Washington State, West Virginia and Wyoming.
Four states (North Dakota, Ohio, Washington and Wyoming) have monopolistic funds that are employers’ only option for buying coverage. The remaining 21 states have organizations that compete with private insurers. The competitive state funds often act as markets of last resort, providing coverage for high risk or other businesses that can’t obtain it in the private market.
These public and quasi-public workers’ compensation funds specialize in writing insurance in a single state, although some have even branched out into other territories.
The country’s 25 state workers’ compensation state funds have not only performed well but have also achieved a significant share — 25 percent — of the nation’s overall insured workers compensation market, and appear to be growing in many states, according to the Conning study.
“Workers’ compensation state funds now control a quarter of the insured workers compensation market, despite the fact that they only write in 25 states,” said Mark Jablonowski, analyst at Conning and author of the study, Workers’ Compensation State Funds: Evolution of a Competitive Force.
Jablonowski said the findings show that public insurance options, which he prefers to call “private/public interfaces,” do work, depending upon how they are structured, and that the public and private sectors can learn from each other.
“It’s an argument not to fear public options if they’re properly structured,” he said. “I think you have a definite case here where you’ve got …these companies that operate independently within the states and are mandated in most cases to operate on their own, in other words, to not dip into state funds. So, I think there are lessons to be learned on both sides. But obviously it indicates that there is such a thing as an effective public/private interface, absolutely. The devil is in the details; how are you going to structure it?”
State funds are not only operating well financially but also contributing to injury prevention and safer workplaces.
“While state funds have strong financial results, there is more to the story of their successful growth,” said Stephan Christiansen, director of research at Conning. “Our research indicates that a key to the state fund success may well be their dedicated approach to loss prevention and control. Their mission often includes shared responsibility for health and safety with other state agencies, and so they often incorporate state-of-the-art loss prevention initiatives with financial rewards tied to the insured’s loss performance.”
State funds typically have to pay more losses from every premium dollar than private industry. But Jablonowski says this is not necessarily a negative indicator.
“[A] high loss ratio doesn’t mean that somebody is doing something wrong. It really places the emphasis on the combined [losses plus expenses] and, ultimately, the operating ratio,” he told Insurance Journal.
He said that despite their higher loss ratios, state funds are able to still make money.
Spurred by their mission that includes improving safety and their state’s economy, state funds blunt the impact of bigger losses through concerted loss prevention efforts. As Jablonowski put it, “They are able to convert the marginal and poor risk into something better.”
The public providers offer employers significantly higher dividends, which provide an incentive for businesses to adopt safety measures. These dividends can also create a competitive advantage and build customer loyalty, according to the study.
Jablonowski said private carriers are also involved in loss prevention but the “big secret” is that every state fund is doing it.
“When you look at the entire insurance world, there are obviously insurance companies in the private world that do a great job of loss prevention control,” he said. “But the unique thing about funds is that they all do it. Twenty-five of them and they all do it. So it’s not a random sample; it’s a sample that suggests that this group puts an emphasis on loss prevention control.”
This emphasis on loss prevention might be one of the lessons private insurers can learn from the public sector. “That is, maybe going back to basics, trying to link financial performance to health and safety performance. That’s what the old-timers like myself grew up on, and I think that is becoming somewhat of a lost art in the private world, and could cause long term issues,” said Jablonowski.
“When you’ve got a state fund that writes half the business in the state, or 20 or 30 percent, it is a major writer in the state, they’ve got to be doing something right,” he said.
The State Compensation Insurance Fund in California writes about 22 percent of that state’s insured market. The company finished 2008 with $1.66 billion in earned premium, compared to $2.27 billion in 2007. The New York State Insurance Fund, which last month celebrated its 95th anniverary, handles $1.35 billion in premium or 41 percent of the market. In 2008, Texas Mutual wrote $768.3 million in premiums, about a 25 percent market share.
As private insurers that compete with the public options are quick to point out, state funds are able to operate with lower expenses because most do not pay taxes or licensing fees.
But Jablonowski said these exemptions, while contributing to lower expenses, are not a major factor and do not explain why state funds do so well. More significant are the efficiencies state funds realize through their widespread use of technology and their coordination of loss prevention, safety and health efforts with other state agencies.
While many private insurers also effectively employ technology, with state funds, “almost all of them are very savvy to the electronic world,” he said.
State funds’ expense ratios are also helped because they often have government partners to assist them in their loss prevention efforts and thereby absorb some of these costs that private carriers have. “[A] lot of these funds rely on the state to provide ancillary services, like loss prevention, claims management, etc. Most of them, for example, work very closely with state occupational safety and health associations,” Jablonowski said.
Business acquisition costs including agent commissions of state funds were found to be about the same as those of private industry.
Jablonowski said state funds’ reserving practices could be more stable because they might be less influenced by competitive pressures than those of private carriers.
“Private companies are under tremendous pressure to perform. And that means they’re going to be subject to the underwriting cycle. And the underwriting cycle a lot of times causality is disputable, but it’s not disputable the fact that reserves tend to move with the underwriting cycle. So when you see that, when you have those kind of competitive pressures that cause the underwriting cycles, you’re going to see the effect on reserves,” he said. “I think state funds are, to some extent, isolated from that shareholder pressure to earn more and more and more and be aggressive in the market and maintain market share and all this stuff.”
He declined to explain why they have better investment returns, noting that Conning has state fund clients that it advises on their investments.
Jablonowski would not share the actual loss, expense and bottom line numbers for the 25 state funds from his firm’s report— that’s the research information Conning developed and sells. But the report suggests that the state funds beat industry benchmarks reported elsewhere.
According to the National Council on Compensation Insurance (NCCI), which collects financial data and prepares rate filings on behalf of workers’ compensation carriers in 38 states, the private workers compensation calendar year combined ratio was 101 in 2008, which was unchanged from what it was in 2007. A.M. Best’s workers’ compensation composite, which consists of 103 workers’ compensation insurer groups and unaffiliated single companies including state funds, had combined ratios of 110.8 in 2008 and 106.5 in 2007.
Most states require businesses to carry workers’ compensation coverage. Workers’ compensation benefits cover medical care and lost wages for employees who are injured on the job.
Conning provides asset management and insurance industry research and consulting services to insurers and state funds. Until recently, it was indirectly owned by insurer Swiss Re. Earlier this month, its acquisition by private equity firm Aquiline Capital Partners LLC, which is run by Jeffrey Greenberg, was finalized.
I don’t think any politician needs to speak about ethics or not being greedy. That is what being a politician in this country has been about for the last 50 years or so. If it is hysterical. They want to limit a business’s profits while they are making millions in backroom deals.
True. No argument there. But it is all we got. So, if Medicare, Medical and the V.A. exist with no profit motivation involved, I think this will work.
Now the cost is a whole other issue that MUST be delt with.
Unless the healt carriers decide to join the BBB and be ethical. Not likely.
Not much of a victory for a bill that the vast majority of Americans allegedly support in a House controlled soundly by Democrats.
But hey, one RINO voted for it, so that makes it bipartisan, right? Does that mean that the 39 Democrats who voted against it makes the opposition 39 times more bipartisan?
Of course, they were allowed to vote no to preserve their careers. But wait… why were there careers in jeopardy if Americans overwhelmingly support this takeover?
Oh well, at least it’s not going anywhere in the Senate (at least before the 2010 elections). Too many of them want to keep their jobs.
Understood. The carriers do have the right to offer or withdraw coverage. It may not seem right or impersonal or unjust to cancel say a health policy, but as the contract is written, the insurance company has a right. But the bigger question is where do business ethics come into play?
That’s what I’ve been advocating this whole debate. It was unethical what Guardian did. And now that this story has hit the presses, they are retracting. I’m sure they’re are a number of people like Ian in other states facing similar situations that haven’t gotten any play.
How could the state or anyone not get into this based on emotion? It’s an emotional story.
We’ve all seen companies come and go. When one carrier leaves, another will fill the void. Somtimes it’s noticeable and sometimes it can leave a gap in the market where the others will reap the reward at the policy holders expense.
I myself am all for the free market. I’m for capitalism. I’m for competition. I’m for limited government. I’m also for better business practices and ethics.
Not that ethics play a big part in government but, when I hear my grandparents say that Medicare and the VA is working for them, then that is something to go on.
And Medicare & the VA are such good examples of efficiency and honesty. There are billions of dollars of fraud by recipients and providers in the Medicare program with almost no control. These programs are only a fraction of the size of the business you want the feds to take over. Pure logic.
Allan,
Have you ever received VA or medicare services? VA care is tolerable and it’s okay for what it’s meant to provide to vets with service-connected medical problems and to indigent vets with non-service-connected medical issues (including basic medical care for such indigents), but in need of medical care; however, it’s not even close to the standards of the private sector. I know first-hand about the VA.
(It’s a bit hypocritcal of you, Allan, to use anecdotal evidence to promote your point of view, but ridicule the same type of evidence when used by Sarah Palin, any conservative, or anyone else who disagrees with your opinion.)
The point was, Allan, that if you don’t know something as fundamental as the corporate status of HCA, then you probably don’t know shitake mushroom.
And, please google ending sentences with a preposition.
Heh, heh, heh. Really got your goat with that last post, didn’t I, Allan? Nice moniker (“donkey punch”), Allan = so-so socialist = italian male = so many other monikers. Punch (so close to paunch, you cherubic little poked boy); donkey (so, even you know that you’re an a**.) A very revealing Freudian slip, you clown.
Heh, heh, heh, back to your cubicle, you paranoid schizophrenic.
It’s time to vote every single one of the House members out of office in 2010. If the Senate passes this abhorant bill, then vote the 1/3 out in 2010 as well. Obama is seeking to systematically dismantle Capitalism. This country cannot afford this type of government takeover, creating yet another buracracy at taxpayers expense. Overhauling the entire healthcare system for less than 17% of the population? It just doesn’t make sense. But further empowering the federal government, now that makes sense.
Elected officials did not care what the American taxpayers said voiceing their opinions since August. They did what they wanted. Now it’s time for the American voter to implement term limits in 2010 and send them all packing! Starting with Nazi Pelosi…
Amen. The health care vote on Saturday presented to me a real dilemma. I didn’t want it to pass the house, but I know that its passage by the DemonRats (change to R the letter c and that’s what it spells) will be the death knell for it in the 2010 midterms.
Look, I never said there wasn’t anything wrong with the financial side of these programs. I said that the people who recieved care from them liked it. They like the care and the docotors.
My grand parents and father recieve care from the VA and tell me the care they recieve is very good.
My mother in-law is on Medicare and says, so far, the care is good.
Again, try telling a senior citizen that your going to strip them of their Medicare and see what response you’ll get.
Waste and fraud is a problem and should it must be delt with if these programs are going be around. I understand this is difficult with some of the bureaucracy involved. But, it is peoples health we’re talking about.
Isn’t that why programs like these are around? FOR THE PEOPLE???
Pure logic.
Umm….that wasn’t me man. But, I will ask this….why are you so angry?
Allan – comparing government handling of worker’s compensation is moot.
Worker’s Compensation Statutes provide that all injured workers receive the same set of benefits, per law.
That’s that very concern of opponents of the Democrats bill: We don’t all have the exact same coverage, we don’t want it that way. We want to shop for the best coverage for the best price at the limits we want to be insured for. We don’t want the government through any mechanism to tell us what our coverage will be.
Your comparison shows lack of understanding for the complexity of the issues. Not understanding what HCA is but jumping to the conclusion that they were an insurer, also shows you lack details before forming an opinion. Fortunately, you have us conservatives to look out for your interests, that even you don’t know you have.
Allen
What do you think the ultimate result will be to the government limiting the amount a health insurer can charge for certain benefits?
If we limit Seven Eleven to charging .14 cents for a can coke that costs them .46 to buy, they’re not going to sell coke any more. Get it?????????
Allan, Allan, Allan, don’t flatter yourself by mischaracterizing as anger my loathing, contempt, and disdain for libs and their phoniness.
Def. of a Liberal: Someone who’s willing to give away everything that he/she doesn’t own.
Why are health insurance companies dropping people’s health coverage when they feel the cost is just to high? (Refer to Ian’s Law).
Why do many Americans go into bankruptcy due to their health insurance?
Why do health insurance companies deny it’s insured’s procedure’s that are crucial to their health?
Why should I pay into an HSA when I already have health insurance?
Joe, again, you’re bringing nothing to the table other than far right extremism. And I mean FAR RIGHT!
Definition of the far right: one’s ideoligy to preserve and promote themselves even if means lying, denying, selling out, cheating or defrauding other around them to boost their own ideals and pocket books.
Closed minded.
Why are health insurance companies dropping people’s health coverage when they feel the cost is just to high? (Refer to Ian’s Law)
This is blown way out of proportion and being politicized. We represent 7 companies who write individual insurance and never have they dropped an insured in 28 yrs, unless they lied on the app. Insured’s want it all ways – omit info on the application, then get services for conditions they omitted – insurance companies process claim and find out it was a pre-existing condition then have right to deny coverage. Insurance is not a right. Insurance companies have their actuarial tables down to a science. 70% of premium goes to claims, 30% is their aquisition costs (which includes underwriting,commissions and profit). When claims cost exceed 70% that insurance company will have a problem. People think that insurance companies should accept anyone with any condition. In order for companies to remain in business they must underwrite. Unlike the federal government who thinks they have an open checkbook, insurance companies are accountable to stockholders and their respective state insurance commissioners.
Why do many Americans go into bankruptcy due to their health insurance?
Americans demand services, irrespective of what their insurance is designed to pay. Get the services done, then plead ignorant. Or purchase a plan with high deductibles and out-of-pocket expenses cause I will never get sick. When something occurs, I can’t believe the insurance company is not paying or only paying 80%. Well that’s the policy you purchased. Then your agent is bad or a theif mentality. Irrespective of the fact that’s the type of plan you want. Are there some that slip through the cracks, Yes. Will providers work with you when a CAT claim occurs – Yes. But to try and screw the system, it will catch up to you.
Why should I pay into an HSA when I already have health insurance?
You don’t have to. If you want to take advantage of the tax deferrals of an HSA, it’s there for you to do so. If you want to pay as you go and not fund the HSA, that is your perogative. HSA’s are not a cure-all, but it’s a viable option if you feel that you do not or will not use the medical services, reduce your monthly premium outlay and/or if you want to tax defer money, much like an IRA.
Why do health insurance companies deny it’s insured’s procedure’s that are crucial to their health?
Because they have the right. There may be alternative health care options to explore. You think insurance companies are guilty of rationing care, wait till Uncle Sam, Nazi Pelosi and Obamascare start running things. Oh your over 65 and you need a heart bypass, sorry your life expectancy is 3 more years, here’s some pills and talk to our grief counselors and will make funeral arrangements for you.
Tar, well written. I agree with you 100%.
You’ve made some good points. Although you only represent 7 out of the hundred’s of carriers out there.
Also, what about some of the other horor stories I’ve heard out there regarding some condition like a yeast infection or something insignificant not being included on an application. Then when an insured develops cancer, the carrier probes into that insured’s past only to find out that it was not included in the application and coverage is denied?
I also heard of an insurance carrier that didn’t pay for the ambulence service that was called in after a car accident saying it wasn’t pre-approved. At what point was that supposed to be pre-approved?
You mention that insurance companies have the right to deny procedure’s. True, it is their right. But at what cost to the person’s overall health in need of that procedure?
The bottom line is that health insurance companines will more often than not put profit before a person’s life. Not all the time but, even a few is too many.
Good Questions Allan – 5 yrs ago we represented over 20 companies for individual medical. Many have gone by the waistside, left the state or you simply weed out companies who you know are poor at paying claims.
Our job as agents do not end after you sell a policy. Agents jobs are to help mitigate claims like the ambulance issue. Often times ambulance bills (for instance) are sent directly to the insured and they just toss them. We, agents, do not get copies or notifications of claims filed. We tell our insureds to contact us in the event of a claim issue. Ambulance bills are great example – often times they do not bill the carrier direct. When insured contacts us we help direct those bills to the carriers to process. If the insureds wait over 90 days to file a claim it’s tougher to process, but generally get it done.
7 yrs ago, we could do a spreadsheet for group insurance with over 20 carriers in Florida. Today, that spreadsheet is down to 5. Small group reform in Florida has made it difficult because carriers left the state. Government thinks they are doing a favor by passing so-called “small group reforms”, they just kill the marketplace with unreasonable underwriting restrictions.
As for your “yeast infection” question – For individual health apps, something perceived as insignificant as a Yeast Infection, if the client leaves that off the application that can cause a claim issue. It may have been an acute treatment and if indicated on the initial application, that condition or anything attributed to that condition could have been covered by the company. God forbid cervical cancer or HPV diagnosis occurs in a year or 2 and the yeast infection treatment was listed on the app and app accepted by the company, that condition is covered. But insureds think they know insurance or try to one up the company and low and behold at claim time there is a problem.
Give you an example – a client clean sheeted an application for their son. 4 years ago son had gastric by-pass surgery. He was 400lbs and 17 yrs old, diagnosed with hypertension and Type 2 diabetes. Three years later kid got down to 150lbs and tests results perfect. Father applies for health insurance for the kid. Holds insurance for 1 year and kid (now 22yrs old) goes in for surgery to have skin taken in from all the weight loss. Insurance company requests medical records from doctor, who happened to do gastric bypass and finds out prior treatment including by-pass, diabetes, hypertension issues. Insurance company denies claim and cancels policy. Father thought insurance should pay and elected not to put prior medical on app. Is insurance company wrong to deny? I think not. Now insurance company is bad in father’s eyes.
In Florida group insurance is guaranteed issue, so all pre-existing conditions are covered. There may be a 6 or 12 month waiting period for a specific condition (except maternity)
The bottom line is that health insurance companines will more often than not put profit before a person’s life – I personally do not agree with that statement. The agent plays a key role in servicing the client from the initial app to claims being paid. I think the media and politicians like to demonize insurance companies and are successful. Yet these same politicians don’t have a problem taking their campaign donations.
Very well explained.
I sell commercial lines P&C and sometimes have similar issues in the application process where proposed clients do not think to disclose their full operations. A lot of times it’s not intentional, they just do not think it was important or forget about it all together.
I have a roofer that once burned down a few condo units after he applied the torch down material. He was unaware that condo/H.O.A. coverage is excluded from his policy. I asked him during the application process regarding H.O.A. work and at the time, his company was not involved. It was also noted on the proposal that this work was excluded. Had he called me to endorse the coverage on the policy, he would have been covered. He just never gave it any thought because he had a GL policy in effect and assumed it was covered.
I think that a lot of people are unaware of the repercussions that could come back and bite them by not being detailed. It’s also up to the agent/broker to be detailed in blue-printing their prospects.
I have also seen some applications that are very vague when it comes down to particular operation practices and unless you have an agent that knows what to ask for, the insured will be exposed.
Allan we’re in the same boat man. Things that are perceived insignificant by the insured are pertinent to an insurance policy. Insurance industry, at times, can do a poor job in communication and other times they do all they can and still demonized.
Look at the MEWA case in Pensacola after Hurricane (I think) Rita. HO3 policies specifically exclude coverage for Flooding. Insured’s decide not to purchase flood insurance (cost too much), we have them sign off to not purchase flood insurance, then a hurricane comes through causes flood damage and there’s no coverage. Insured sues and courts side with insured’s and re-write HO3 policies to include flood losses after the fact and insurance companies lose again. People then wonder why insurance companies leave the state? Then agents take it on the chin. But hey, we could be unemployed and living off the federal dole. Grin and bear it and move on.
Yeah, I hear ya. At the same time stories like Ian’s Law and other legit stories like his don’t do well for the health carriers….or our industry at all.
Allan, this is where mixed emotions comes into play. States now are going to mandate insurance companies not be able to cancel policies. I personally see insurance companies are “Private Enterprises” who offer a service to an individual or group of people. They, insurance companies in this case, have the right to offer or withdraw coverage. It may not seem right or impersonal or unjust to cancel say a health policy, but as the contract is written, the insurance company has a right. From a PR standpoint The Guardian has retracted canceling the policy and done what appears to be the right thing. Guardian spokesperson statement below:
“We believe that the people we insure should be treated equitably and [we] are confident that we acted legally, in full compliance with state insurance regulation, and underscore that at no time did we cancel coverage for an entire block of policies in order to discontinue coverage for any particular individual,” Guardian spokesman Richard Jones wrote in a statement.
The private sector at work!
Now the state government is getting into the picture on pure emotion. Was there a maximum limit under the policy and Ian has approached it? Is reinsurance dictating to get off the risk since they will never recoupe the losses incurred? But it’s a private company. Private companies do not have the leisure government has to pay for things carte blanc. However, the politicians know nothing of insurance and they appeal to this issue on purely an emotional basis. They will pass legislation to impose their own moral code, but in the process insurance companies will stop writing in the State of New York and now what happens. It will insure that New Yorkers will demand the government do something, hence here comes Government run health insurance.
Not to be cold hearted, the efforts by Ian Pearl to change the hearts of The Guardian officials was great and they did concede they were wrong. The private company made that decision and they will have to live by it. Ah, Free Enterprise at work. But why change the entire system? People are understanding less and less of the Free Enterprise system. They are of the mindset that government is the answer to all our ills. As long as we continue to have so-called leaders as Obama, Nazi Pelosi and Scary Reid the government mentality to take care of us will only grow. But who’s the government? The taxpayers and I don’t know how much more taxpayers can pay out to fund all these government schemes?
I think your mixed up on the conversation I was having with Tar. I never said anything regarding a contract. I was referring to an application. I never said anything about a health application. I was referring to a few commercial lines P&C apps I’ve filled out. Some of them are vague in terms of the info they are requesting. Especially the RRG apps. I try to stay away from them as much as I can but, sometimes I’m forced to go that route because of the clients needs.
Now, the ones that deliberately lie on the application about their medical history, that purposely lie and commit fraud, I don’t feel for either.
From now on, please read my posts thoroughly. Thank you.
Riiiiiiiight. (wink)
You have some real issues.
Allen, the people that deliberately cheat the system chose to spend their money on something else, until they get sick,and need benefits. So, they deliberately lie on the application about their medical history because otherwise they would be denied. That’s called FRAUD. I don’t feel sorry one bit for them. If the insurance company would not have written them, or their premium would have been higher, the insurer is the one getting screwed by the unhealthy liar.
There’s also nothing vague about an insurance contract. Have you read one? It’s real clear what is covered, and what’s not, so nice try.
Allen,
I have thoroughly read your posts, assure me. My discussion about the health apps comes from your numerous comments about the health insurer wronging the insured in circumstances such as pre existing conditions. My point was that you did not have all of the information. The application specifically discusses pre existing conditions, so if there turned out to be one that wasn’t disclred, it was likely the insured’s failure to close, not the insurer’s failure to ask.
I also don’t find any other applications to be vague, but if you don’t understand the question well enough to get the proper answer from the insured, I’m sure the writing carrier’s underwriter would be able to clarify.