Obama’s real ObamaCare agenda
[Posted by Karl]
Lefty blogger Mike Lux is a trifle miffed:
My question now is why are certain anonymous White House officials trying to undermine the President? I ask this question in all seriousness, because this is exactly what happened in the Clinton fight for health care reform. We would do these terrific, thoughtful, complex policy meetings where we go over various options on the health care bill but make no firm decisions. The next day in the New York Times or The Washington Post, some particularly controversial aspect of the bill would be headlined as in “High-ranking administration officials say Clinton is considering X.” It was without question one of the things that eventually killed health care reform.
The cause of his angst is the Washington Post’s coverage of debate over a government-run health insurance plan:
Administration officials insisted that they have not shied away from their support for a public option to compete with private insurance companies, an idea they said Obama still prefers to see in a final bill.
But at a time when the president had hoped to be selling middle-class voters on how insurance reforms would benefit them, the White House instead finds itself mired in a Democratic Party feud over an issue it never intended to spotlight.
“I don’t understand why the left of the left has decided that this is their Waterloo,” said a senior White House adviser, who spoke on the condition of anonymity. “We’ve gotten to this point where health care on the left is determined by the breadth of the public option. I don’t understand how that has become the measure of whether what we achieve is health-care reform.”
“It’s a mystifying thing,” he added. “We’re forgetting why we are in this.”
Another top aide expressed chagrin that a single element in the president’s sprawling health-care initiative has become a litmus test for whether the administration is serious about the issue.
“It took on a life of its own,” he said.
Lux suggests that the problem is people working in the Obama White House whose primary loyalty is not to the President but to themselves. But is that really why White House flack Robert Gibbs was back singing a bipartisan tune yesterday? A quick read from Marc Ambinder suggests the answer is “No”:
The White House and Senate Democrats won’t buckle to demands from liberals that they revise their health care strategy, officials said today.
***
A White House official conceded today that Obama would have to weather anger from liberals for a while.
More worrisome, officials said, was the growing belief that Obama’s brand is being tarnished. A new Pew poll shows that voters don’t think Obama is working with Republican leaders, and that a plurality blame Republican leaders. They believe that Obama’s favorability rating declines, largely from independents (and within that group, women), can be reversed if he reminds these voters of the bipartisan instincts in his bones.
***
…Privately, White House aides have communicated to the House leadership that the onus on changing minds about the public plan is on Congress, not on the president. (Emphasis added.)
Clearly, Lux failed to consider that the first interest of people working in the Obama White House is boosting the popularity of Pres. Obama. However, that is not Obama’s only interest, as Ambinder reveals the president’s real priorities and tactics:
The president continues to operate under the belief that liberals will warm to the bill when presented with a goodybag that includes includes an individual mandate, community rating, guaranteed issue, and a minimum required package. There’s no chance, really, that a bill WON’T feature these reforms. Quietly, to secure and keep Democrats on board, the White House is going to bargain, providing inducements, like more money for favored projects, etc., in order to secure individual votes.
Somehow, it keeps coming back to that individual mandate, doesn’t it? A law requiring people to buy health insurance requires Congress to define what health insurance is, which creates that minimum required backage (not a minimal required package). Without the individual mandate, guaranteed issue does not work. Pres. Obama used to be against an individual mandate. Now it is his bottom line. The good news is that if Senate Democrats try to split the bill, trying to pass the most controversial parts through reconciliation, they might lose all GOP support for the individual mandate they absolutely must have to take over the US healthcare system, and quite possibly lose on a filibuster.
–Karl
Nat Hentoff joins us right-wing extremists in opposing ObamaCare.
Condemning the furor at town-hall meetings around the country as “un-American,” Harry Reid and Nancy Pelosi are blind to truly participatory democracy — as many individual Americans believe they are fighting, quite literally, for their lives.
Bradley J. Fikes, C. O.R. (a18ddc) — 8/20/2009 @ 9:22 amIf private health insurance is so bad, why did the VA propose that veterans use their private insurance to pay for service connected medical issues?
ROA (e2e9ec) — 8/20/2009 @ 9:27 amEpisode #20 from the Gang That Couldn’t Shoot Straight: Marshall Obama’s Deputy Rahm threatens anyone who doesn’t support their Dear Leader by sending them dead fish wrapped up in their incoming mail. I’m channeling Maureen “I slept to get where I am” Dowd on that one.
Dmac (e6d1c2) — 8/20/2009 @ 9:47 amI think EVERYONE needs to keep foremost in their minds that this is not really about reform as much as it is about the accretion of power to the federal government with an “urgent”, but decidedly stealth move towards a single payor system.
It really is about power, and the solidification of power in the hands of an elite few.
GM Roper (85dcd7) — 8/20/2009 @ 9:48 amThis idea of Barcky’s bipartisan instincts is laughable.
JD (e3dc4f) — 8/20/2009 @ 9:53 amAre we free men or are we but serf? The federal goverment has no authority to mandate the puchase of healthcare.
DavidL (02e14f) — 8/20/2009 @ 9:59 amHave any of you heard of rescissions?
This practice should be made a capital crime, and strict price controls should be placed on health insurance premiums, punishable by death.
No need for a public option; price controls would solve everything.
Michael Ejercito (833607) — 8/20/2009 @ 10:05 amThey believe that Obama’s favorability rating declines, largely from independents (and within that group, women), can be reversed if he reminds these voters of the bipartisan instincts in his bones.
JD already pointed it out, but exactly where has Obama shown any inclination to work in a bipartisan fashion? Was it all that legislation he co-sponsored with GOP Senators during his brief stint on the other end of the Capitol Mall? Was it all of his cooperation with Republicans while in the Illinois legislature? Was it is tireless work to register Republican voters when he worked for project ACORN? By this time in their respective Presidencies, Bill Clinton and George Bush had worked with the opposite party to pass free trade and education reform. When has Obama reached across the aisle?
JVW (812c1f) — 8/20/2009 @ 10:10 amThis is dragging on. These stupid socialists gave people too much time to see how they’re being manipulated.
happyfeet (71f55e) — 8/20/2009 @ 10:12 amMichael, you usually post smarter stuff than this, so it really surprises me.
Price controls only have bad effects on the market. Set it too low, and there’s not enough profit, so providers will leave the market. Set it too high, and people will leave other markets to enter the high-profit one.
If, for example, you set CT Scan prices too low, no one will be willing to provide the service. Set it too high, and people will stop doing X-Rays and start doing CTs…
Just remember back to Carter, and his price controls on domestic oil and fuel?
Same thing.
Scott Jacobs (d027b8) — 8/20/2009 @ 10:25 amThe Democrat Party is a criminal enterprise.
kazooskibum (a4dd38) — 8/20/2009 @ 10:26 amThe claim is that the need for reform is to:
– a) cover more people (everyone); and
– b) lower health care costs (by which they seem to mean premiums).
As to “b”, the democrats have not provided any solid information as to how the pending bills will reduce costs – only vague promises of “bending the curve” and “competition”. I don’t think anyone, even people far to the left, believe that the pending bills will reduce cost – as no real arguments have been made that such will happen – only vague conclusory assertions.
So that leaves us with “a” being the only real goal (if we assume, for purposes of this comment, that the urge to “reform health care” is not about expanding gov’t and redistributing wealth).
So, if getting the uninsured health insurance is the only real goal, why not just expand Medicare to cover these people? Or, come up w/ a new program to cover just these people but leave the private health insurance market untouched? If all of the vague claims of savings through curve-bending are true, wouldn’t the gov’t be able to do this w/o altering the private insurance market and without raising taxes?
And, if that was accomplished, we could try to lower health-care costs (note, address health care costs, not health insurance, if the health care costs come down, the insurance costs will follow). We could try some of the things htat have been proposed to do this – such as tort reform and allowing insurers to cross state lines.
Now, as to point “A”, I know some people will say we can’t simply create a new program to insure the uninsured b/c “the gov’t can’t take on all of the uninsured b/c they are high risk and will need more medical care which will be expensive.”
To which I say, exactly. If you argue that, you are conceding that passing a law requiring insurance companies to take on all comers, regardless of pre-existing condition, and to give them the same benefits at the same cost as everyone else, the gov’t is purposefully driving the insurnace companies into bankruptcy.
monkeytoe (e66874) — 8/20/2009 @ 10:51 amAre you, yes you, aware that Obama is trying to rejoin church and state?
Fred Beloit (15d9a8) — 8/20/2009 @ 11:01 amFrom the NYT (via Greta van Susteren)
BARACK OBAMA, PRESIDENT OF THE UNITED STATES tells a collection of religious leaders he wants their help in selling his political ideas:
“These are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation. That is that we look out for one other, that I am my brother’s keeper, I am my sister’s keeper. And in the wealthiest nation on earth right now, we are neglecting to live up to that call.”
Via Ann Althouse:
“Now, we know that Barack Obama doesn’t “keep” his actual brother — we remember George Hussein Onyango Obama, the brother who lives a hut — and it’s clear that what he means is that government has the moral obligation to regard all citizens as brothers and sisters — I’m coining the word sibizens — and to care for them.”
One reason for price controls is to punish insurance companies that engage in wrongful rescissions.
When times are good, the insurance company is happy to sign you up and take your money in the form of premiums,” Stupak said. “But when times are bad, and you are afflicted with cancer or some other life-threatening disease, it is supposed to honor its commitments and stand by you in your time of need.
“Instead, some insurance companies use a technicality to justify breaking its promise, at a time when most patients are too weak to fight back,” he said.
Michael Ejercito (833607) — 8/20/2009 @ 11:07 amWe can solve this by excluding certain people from coverage- like illegal aliens, child molesters, people convicted of domestic violence, people who would rather do drugs than work, , etc.
Michael Ejercito (833607) — 8/20/2009 @ 11:12 amThen make rescissions illegal. Don’t punish the entire system to get the insurance companies.
Scott Jacobs (d027b8) — 8/20/2009 @ 11:13 amMichael,
I note in that article about recisions you keep linking to, that it does not discuss what “irregularities” were found that allowed the company to rescind.
Typically, rescission occurs where there was some fraud in the application, such as not disclosing a pre-existing condition.
The article simply states, in a conclusory fashion, that the insurer rescinded X number of policies and allegedly saved millions of dollars. It gives no basis for that allegation, nor does it describe what basis the insurance company claimed to rescind policies.
I’m sure there are insurers who abuse this, just as I’m sure there are bad doctors who commit insurance fraud, and bad patients who commit medicare, medicaid or insurance fraud.
I’m not sure that one article establishes the need for destroying our private enteriprise system viz a viz health insurance.
monkeytoe (e66874) — 8/20/2009 @ 11:32 amThe purpose of punishing an entire system is to set an example.
I do know that rescissions are only available during the contestability period.
Of course, you should look at the examples in this thread.
“My niece has a PRE APPROVED shoulder surgery. After all was said and done, she was denied payment on the claim. $60,000 out of pocket now she owes. Shes was off work for a couple months and no disability pay availble to her. Her and her hubby barely earn over minimum wage. They will either be forced into bankruptsy or be debted their entire lives. Why on earth did the insurance company pre approve this only to deny it after the fact. She never was treated prior for this issue but because she was on her job less than one year, the insurance labeled it pre existing. This has been submitted to the state Attorney Generals office in MN with the help of the hostpital and hopefully they will able to help her. The hospital is presntly taking $200,00 per month out of her wages and again they make just over min, wage, Its sensless!”
The above example is the best argument to impose punitive price controls on hospitals and health insurance companies.
Michael Ejercito (833607) — 8/20/2009 @ 12:10 pmWhy would the author of the article omit such details if they were important?
Michael Ejercito (833607) — 8/20/2009 @ 12:19 pmForgive me if I am not going to take the claims made on the huffington post as evidence of anything.
there is already an avenue for people to contest rescission – court and/or arbitration. The insurance company has to demonstrate proof of the fraud.
You are allowing your emotional response to cloud your judgment. You seem to believe that the insurance company must always pay and completely discount the possibility that the insured defrauded the insurance company by not disclosing a known ailment that required expensive care in order to get the insurance company to pay for it.
And punishing a whole industry with price controls? That’s foolish. It is simply a lazy way to nationalize the industry. Either call for socialism or don’t. don’t hide behind “price controls” to “punish” the industry for some perceived malfeasance.
My guess is that insurance companies do look very closely at insurance applications when they get hit w/ extremely expensive claims – particularly w/in 1 year of issuing the policy. As evil as you may think that is, it is good business practice to defend against fraud.
The only way to make rescission illegal would be to take away the possibility of fraud, which this bill plans to do by requiring insurers to insure anyone, regardless of pre-exesting injury. this will eventually bankrupt all insurers and leave us w/ a single-payer gov’t system.
The idea of health insurance is that you pool the risk. If you take away the insurer’s ability to limit their exposure, they can’t succeed financially.
Again, if the issue here is simply to cover the currently uninsured, then the Dems should be pushing a program to do that – not trying to dismantle the existing insurance system that a vast majority of americans are perfectly content with.
The reasons that the Dems don’t push that are (a) that is not the real agenda here – expanded gov’t is; and (b) the dems know that such a new program would be just as inefficient and costly as medicare or medicaid. If they can create a system that strangles private insurers until there is only the gov’t plan left, then they will get the expanded gov’t and it won’t matter what the cost is – at that point they can ration care and raise taxes b/c the voters will have no other option. Once the insurance companies are gone, they won’t be able to just pop back up, we’ll be stuck w/ the gov’t only care.
monkeytoe (e66874) — 8/20/2009 @ 12:29 pmBecaue it does not support the author’s agenda?
Or, the author is not smart enough to realize such facts are important.
Or, b/c of the author’s political bias, he simply took the one side’s word for it that what the insurance company did was “wrong” rather than try to discover any facts for himself.
monkeytoe (e66874) — 8/20/2009 @ 12:32 pmI have to agree with Michael on this one – less than two days after my cancer diagnosis, my insurance company (I bought it privately, on the open market) contacted every doctor I had seen over the past two years, despite the fact that I’d signed up with them five months previously. Then while I was undergoing chemo and was basically disabled for many weeks at a time, their threatening letters about denying coverage for pre – existing conditions intimated that bankruptcy was soon in the offing. I don’t know what the perfect solution is regarding this situation, but the courts are not the panacea for regular folk who don’t have the monetary resources to fight a giant insuracne company that can just play out the string until you’ve either run out of money or perished. It’s a Hobson’s choice for the consumer at present.
Just remember back to Carter, and his price controls on domestic oil and fuel?
Carter was plenty awful, but Nixon and his entire price control freeze was even worse. Connolly had no idea what he was doing, and the price freeze on consumer products as well as wages was a complete disaster.
Dmac (e6d1c2) — 8/20/2009 @ 12:48 pmBy this time in Bush’s first term, he had a huge signing ceremony at the White House with Ted Kennedy (for NCLB). Obama’s comparable achievment? Sometimes the Ladies from Maine vote with him.
EBJ (2fd7f7) — 8/20/2009 @ 12:52 pmIt is within the contestability period.
Contestability periods typically run for abour two years.
If there were price controls on health care, there would be fewer bankruptcies.
What do they have to gain by lying?
The malfeasance is real,, as the L.A. Times article I linked to show.
And malfeasance must be punished.
Michael Ejercito (833607) — 8/20/2009 @ 12:58 pmIt doesn’t come down to any one element of the various proposals. The root of the problem is that Obama seriously misunderstands how Congress operates, and how America reacts to massive government proposals. He also completely misunderstands his own political position. Jay Cost drew a wonderful visual description of how screwed up Obama is on Congress and on Healthcare.
MTF (551a4b) — 8/20/2009 @ 1:39 pmOne quick link for all to read, to Nate Silver. He claims that Democrats are catching a second wind on ObamaCare, and suddenly Pelosi/Reid may be gaining confidence. Polling must be at the root of this, given that it’s Nate Silver writing it, but I have no idea what he’s seeing. We may have political momentum in our favor right now but confidence on the part of Democrats is bad for our freedom. We cannot let up the pressure!
MTF (551a4b) — 8/20/2009 @ 1:49 pmMichael, everyone here appears to agree with you that if an insurance company breaches their agreement, they deserve some kind of punishment.
It’s just that we’re not taking the huffpo at their word, because in today’s climate, there’s no reason to trust them.
you ask what they have to gain by lying, and I know you are fully aware that many, on both sides, have proven they are willing to lie just for political points. This is a trillion dollar deal, so many have incentives beyond that.
Regardless, you haven’t really proven a problem exists. Many people probably do hide preexisting conditions that insurance companies discover. Sadly, this means the insurance company, to be fair to all its clients, must investigate a lot of honest people, too. That can’t be pleasant for someone who just got cancer. But we have a court system, we have a UCC, etc. The mere fact that insurance companies have been able to cut members and save money is not proof that something is wrong. For all we know, the number of innocent people cut off is drastically smaller than the number you cited. Why? Because your guy didn’t do his homework.
Juan (bd4b30) — 8/20/2009 @ 1:52 pm“If there were price controls on health care, there would be fewer bankruptcies new drugs, doctors, saved patients, etc. “
Juan (bd4b30) — 8/20/2009 @ 1:53 pmThe problems people are complaining about with insurance companies are precisely the reason we can’t have the government run health care. If the government is deciding coverage and what claims to pay or not pay, then there is no one to appeal to when you feel the system has failed and you have been treated unfairly. The government needs to be separate and not have a financial interest in the decision.
Moooose (14e94a) — 8/21/2009 @ 4:56 amMichael,
Would you believe every anecdote you read on a conservative website? Well, I don’t believe every anecdote I read on a leftist website, particularly when those anecdotes just so happen to support their political policy preferance. Indeed, I don’t even believe every anecdote I read on a conservative website. When people are posting to such sites they tend to be willing to lie and/or exaggerate for affect.
And, people lie about their predicaments all the time. People lie to insurance companies about pre-existing conditions, and then when they are caught, I somehow doubt they come clean to family, friends and strangers that they lied. Instead, I’m willing to bet that they claim the opposite.
And, price controls don’t do anything regarding rescission for fraud. That is a separate issue from cost of insurance.
And, please prove to me where the issue is the cost of insurnace versus the cost of health care. You seem to believe that the issue is the cost of insurance premiums, when the real issue is the cost of health care, which is what drives insurnace premiums.
I understand that the new left talking points are to paint the insurance comanies as the villians who must be defeated and punished, but where is the evidence that the insurance carriers are so evil? If we reduce insurance premiums it does not reduce health care costs. In contrast, if you reduce health care costs, premiums will go down.
There are some ways to reduce health care costs, the most notable being medical malpractice lawsuit reform.
Now, as to rescission specifically, I believe there are probably abuses by insurance companies. However, I don’t think the “health care reform” being proposed will make anything better.
That is for a number of reasons.
1) the proposed plan(s) will ultimately lead to single-payer. That is their implicit goal, and the provisions can lead to nothing else. Single-payer will mean rationing of care as well as long waits for care. In other words, rescission times 100.
2) it will likely be much more difficult to successfully appeal any gov’t decision to deny care than it is to appeal an insurance company’s decision.
monkeytoe (e66874) — 8/21/2009 @ 5:46 amThat article showed no such thing. The article had conclusory allegations, but offered no evidence to support such conclusory allegations. If I write in a paper that Obama is a communist – does that make it so?
Really? First, data indicates that less than 1% of all bankruptcies are caused by health care costs. Second, where is your evidence to support this? As I stated above, price-controls have nothing to do with rescission.
Also, Price Controls will lead to bankruptcies of insurance companies, which I would geuss is actuaully a good thing in your book, but it is not a good thing for America.
monkeytoe (e66874) — 8/21/2009 @ 5:50 amYou continue to fail at economics. Price controls NEVER WORK! The market ALWAYS SUFFERS AS A RESULT!
She needs to contact the hospital, and ask to talk to the people in billing. she needs to explain the situation. she will be asked to sign forms and provide copies of paperwork, and to prove assets (tax forms, usually), and there is a very good chance she’ll receive a reduction in what’s owed.
Scott Jacobs (d027b8) — 8/21/2009 @ 7:03 amThere certainly is significant abuse of recessions, as most people with health industry experience know. Cathy Seipp, a much more credible source than the Huffington Post wrote about it before her death.
Recessions made in bad faith are a breach of contract. We need penalties strong enough to make them uneconomical.
Brother Bradley J. Fikes, C.O.R. (0ea407) — 8/21/2009 @ 7:17 amAnd just to be clear, I am not talking about price controls on health insurers. I just want severe enough penalties on illegal recession so as to remove the profit motive.
Brother Bradley J. Fikes, C.O.R. (0ea407) — 8/21/2009 @ 7:23 amI have no problem w/ putting severe penalties on illegal rescission.
Monkeytoe (e66874) — 8/21/2009 @ 7:25 amNor do I. Price controls, however, aren’t punishments on the insurance companies. In fact, they would reward the companies, since they would reduce the amount the companies would have to pay.
Scott Jacobs (d027b8) — 8/21/2009 @ 7:38 amMy interpretation of what Michael is saying is put a price control on the amount the insurance company can charge in premuims, not on the amount health care providers charge. If he is saying the latter, he has not explained why he wants to “punish” health care providers.
Monkeytoe (e66874) — 8/21/2009 @ 7:48 amAnd, I am still intrigued in this whole debate how we are only really talking about the insurance aspect.
Nobody (including the dems) is talking at all about actual health care costs – i.e., doctor bills, hospital bills, x-ray, mri, cat scan costs, etc. [except for some vague statements about “bending the curve” – which means not offering certain health care treatments/tests, but does not in any way go to the costs of those treatments/tests].
Everyone is focusing entirely on the cost of health insurance, which to me is odd. it is attacking the symptom and totally ignoring the disease.
Monkeytoe (e66874) — 8/21/2009 @ 7:52 amShe needs to contact the hospital, and ask to talk to the people in billing
Try performing that feat while you’re sick 24/7 – try waiting to speak to one person for over 4 hours, only to be told you have to speak to someone else, and that they’re not available, could you please come back next week?
And guess what happens after you’ve finally resolved that situation? Well pardner, you’re going to have to go through the exact same Japanese water torture routine for at least two other departments in the same hospital that treated you, because the two other divisions are not linked in by computer and have no formal operating arrangement in the first place. The doctors and radiologists have incorporated their separate practices for tax and income purposes. This is the reality of almost anyone dealing with a private insurance billing dispute and the hospital that you went to for treatment. IOW, it sounds nice in theory, but a nightmare in reality.
Dmac (e6d1c2) — 8/21/2009 @ 7:54 amWith over 50k (I think it was closer to 100k) in medical bills, my sister did it, and ended up at less than 10k (significantly less).
If they are unwilling to do what they have to in order to reduce what they owe, then there is little I am willing to do to help them.
Cold? Yup. But I take the general idea of “personal responsibility” fairly seriously.
Scott Jacobs (d027b8) — 8/21/2009 @ 8:04 amScott Jacobs,
Was your sister pumped full of nauseating chemo, irradiated until her immune system was destroyed, then given a bone marrow transplant?
Personal responsibility is good, but what about the responsibility of an insurer to honor a contract?
Brother Bradley J. Fikes, C.O.R. (0ea407) — 8/21/2009 @ 8:15 amNo, she merely had two or three surguries, a cross-state medical transfer, discharge and the admittance here in central IL, all for full-body, scream-inducing pain that made even laying down of the slightest touch anywhere incredibly painful.
And my sister plays rugby. If she’s at level 10 pain, for a normal person it would be somewhere around level “Sweat Jesus God in heaven, shoot me now”.
And no, they never did actually figure out what was wrong.
Scott Jacobs (d027b8) — 8/21/2009 @ 8:23 amI don’t think anyone is disputing that improper rescissions should have a stiff penalty so as to encourage insurers not to rescind w/o a legitimate reason.
But, what is anyone going to do when the gov’t simply refuses the treatment under nationalized health care? My guess is that there won’t be much that can be done. And, there is no way for gov’t to controll all of health care w/o rationing.
Monkeytoe (e66874) — 8/21/2009 @ 8:35 amAnd my sister plays rugby. If she’s at level 10 pain, for a normal person it would be somewhere around level “Sweat Jesus God in heaven, shoot me now”.
Well – then she’s obviously a superior person as compared to the rest of us (btw, Bradley is probably referring to what I went through, if I had to guess). Everyone deals with serious illnesses to the best of their ability, but making the assumption that because your sister could do it more capably than others should be transposed on the rest of the population is not only ridiculous, but far outside the realm of reality. I’ve witnessed many folks who are not only severely disabled from their illnesses (look up the common condition known as “chemo brain,” then get back to me), but also have limited cognitive ability to decipher their vast and confusing arrays of medical bills – and if you think the billing departments of most hospitals are only too happy to help them with these problems, you’re living in a fantasy world.
I’ve been threatened with bankruptcy and the ruination of my credit rating – and all for the unforgivable sin of my insurance company making one small error on a bill, which lead to their refusal to pay the hospital, who then sent their lawyers on me in less than 60 days from the bill being past due, and so on. It took me months to figure out what the hell was wrong, and no one was willing to “help me out.” They just want their money, they want it now, and they’ll go to great lengths to make you pay up ASAP, whether you have the monetary resources or not.
Dmac (e6d1c2) — 8/21/2009 @ 1:23 pmScott Jacobs,
Congratulations to your sister, whose toughness must be genetic.
What I was referring to, and didn’t make clear, are cases when an insurance company illegally denies coverage. In such instances, the insured has obeyed the contract and has taken responsibility. It is the company that has violated its responsibility.
Bradley J. Fikes, C. O.R. (a18ddc) — 8/21/2009 @ 1:32 pmI absolutely agree, and would be more than willing to see crushing fines levied against a company when that happens.
However, it remains that your ordinary citizen has a number of options when dealing with medical bills. If the person themselves can’t do it, get a generic power of attorney and make the calls on their behalf.
Scott Jacobs (d027b8) — 8/21/2009 @ 1:46 pmI don’t think it’s that simple – for the primary reason that no one in the hospital will actually mention that option in the first place.
Dmac (e6d1c2) — 8/21/2009 @ 2:16 pmI should add that I’ve been serving on a patient advisory board of the very same hospital that treated me – I joined it at their behest. But I’ve gotten nowhere with these types of issues – and Northwestern is one of the largest medical institutions in the country. They’ve made it clear that unless a patient can prove without a shadow of a doubt that they’re indigent, they’re going after their assets with hammer and tongs, period. No excuses are accepted, they assume that everyone is lying to them (and truth be told, a fair number are indeed lying about their financial destitution). So I’m a favor of new regs that prevent hospitals from taking pre – emptive actions such as these on honest patients.
Dmac (e6d1c2) — 8/21/2009 @ 2:21 pmThe solution is price controls.
Price controls are a great step forward.
If companies do not want to honor their contracts, they should be driven to bankruptcy no matter what the cost.
One more reason to place price controls on insurance companies and hospitals. They must be made to pay for their wrongdoing, no matter what the cost.
Michael Ejercito (833607) — 8/22/2009 @ 10:08 am“Price controls are a great step forward.”
Michael – Price controls don’t work. Those lessons have been demonstrated over and over again. They create the wrong incentives.
On the issue of rescissions or breaches of warranties, there is a real issue, but it is a matter of contract law as others have commented above. I’ve never purchased individual health insurance, although I looked at it when COBRA coverage from a prior job ran out. As I recall, unlike life insurance, it didn’t involve a physical exam, only an application with representations and warranties from the applicant. Correct me if I’m wrong on this. The first time an insurer gets a look at detailed medical records of the insured therefore can be when they review a claim.
Insurance is nothing more than a promise to pay if certain conditions are met. Covered risks are part of the conditions, but also accurate representations of warranties of the policyholder. It’s a two way street. Insurance fraud raises costs for everyone.
daleyrocks (718861) — 8/22/2009 @ 11:21 am[…] now have reason to believe that Pres. Obama ultimately expects that Congress will settle on a healthcare reform bill that lacks a government-run health insurer, but includes an individual […]
The Greenroom » Forum Archive » ObamaCare: Can the “center” hold? (e2f069) — 8/25/2009 @ 7:03 am