Money Won't Buy You Health Insurance

Chico David, BSN, RN · Mar 6, 2011

So here's my story, in the same vein: I am super healthy cardiac rehab nurse who practices what I preach to patients. Normal weight, low cholesterol, never smoked, etc. A few years ago, I had reached the point in my life where I could afford to work less, so I went per-diem. Of course, I did my homework ahead of time and found out that I could buy a high-deductable plan for a price I could afford. All good. So I want ahead and did it and as I went through the underwriting process with the insurance company, I discovered that because I had had a little tiny basal cell skin cancer taken off my nose recently, no one would sell me insurance at any price for a year. Then after a year, they charge me twice the normal price because that makes me "high risk".

There is virtually no one over 50 who can go out and buy individual insurance - ever take a prescription med? you're out. Ever been treated by a doctor for anything? You're out. I know someone who was denied insurance because he had been treated for tinea cruris - jock itch for you ladies - the same fungus that causes athletes foot.

We should not blame the insurance companies for this. They aren't in business for their health - or ours. You can't make a profit insuring sick people. So they attempt to only insure people who will never need to use their insurance. Which is, up until now, perfectly legal and perfectly logical - if you accept the logic of a for profit insurance system.

elkpark · Mar 6, 2011

I keep hoping that, if enough people see enough articles like this one (and have bad experiences of their own regarding health insurance), they'll eventually wise up and we'll be able to move toward a single-payer (or, at least, non-profit) system. Continuing to live with a system that leaves the for-profit insurance companies in control is simply throwing good money after bad.

WIN007 · Apr 22, 2011

So here's my story, in the same vein: I am super healthy cardiac rehab nurse who practices what I preach to patients. Normal weight, low cholesterol, never smoked, etc. A few years ago, I had reached the point in my life where I could afford to work less, so I went per-diem. Of course, I did my homework ahead of time and found out that I could buy a high-deductable plan for a price I could afford. All good. So I want ahead and did it and as I went through the underwriting process with the insurance company, I discovered that because I had had a little tiny basal cell skin cancer taken off my nose recently, no one would sell me insurance at any price for a year. Then after a year, they charge me twice the normal price because that makes me "high risk".
There is virtually no one over 50 who can go out and buy individual insurance - ever take a prescription med? you're out. Ever been treated by a doctor for anything? You're out. I know someone who was denied insurance because he had been treated for tinea cruris - jock itch for you ladies - the same fungus that causes athletes foot.
We should not blame the insurance companies for this. They aren't in business for their health - or ours. You can't make a profit insuring sick people. So they attempt to only insure people who will never need to use their insurance. Which is, up until now, perfectly legal and perfectly logical - if you accept the logic of a for profit insurance system.

I'm sorry for your experience. I'm in good health and couldn't find a meaningful plan worth the paper it was written on if I really needed it for under 600 a month. And then if I did God forbid need it they promptly raise my premiums till I can't afford it at all.

This is the reason I'm vehemently against Ryan's idea of ending Medicare with voucher programs. There's no way in hell a senior is going to buy health insurance for 8k a year. Theyd' be lucky to do it for triple that.

I also don't appreicate the idea of the people so quick to scream 'Socialism" with infusing the private payor industry with a big windfall of taxpayer cash. Truly I don't like the health insurance companies at all. The premiums , the reason they exist, are paid to them to pay for HEALTH CARE services, pooled by a composition of people of all ages and health with the idea the money is for HEALTH CARE. They act like the money is THEIRS and then do all they can to use as little of it for healthcare as possible. It's ludicrous when you think about it.

Chico David, BSN, RN · Apr 22, 2011

I'm sorry for your experience. I'm in good health and couldn't find a meaningful plan worth the paper it was written on if I really needed it for under 600 a month. And then if I did God forbid need it they promptly raise my premiums till I can't afford it at all.
This is the reason I'm vehemently against Ryan's idea of ending Medicare with voucher programs. There's no way in hell a senior is going to buy health insurance for 8k a year. Theyd' be lucky to do it for triple that.
I also don't appreicate the idea of the people so quick to scream 'Socialism" with infusing the private payor industry with a big windfall of taxpayer cash. Truly I don't like the health insurance companies at all. The premiums , the reason they exist, are paid to them to pay for HEALTH CARE services, pooled by a composition of people of all ages and health with the idea the money is for HEALTH CARE. They act like the money is THEIRS and then do all they can to use as little of it for healthcare as possible. It's ludicrous when you think about it.

I can't really blame the insurers for doing what they do. They are for-profit companies and exist for one reason only: to make money. The directors of such a company are required to do all they legally can to maximize return to shareholders. If, in the process they kill a few patients and deny coverage to many more, that's just part of business. We ought not to blame them for that any more than we blame a lion for killing to eat. But putting companies with that motivation in charge of our health care is sort of like letting a lion loose in your kids school. If you are foolish enough to do it, you ought not be surprised when a few kids get eaten. Unfortunately, our political class, of both parties, is more interested in protecting the lions than the children.

WIN007 · Apr 22, 2011

I can't really blame the insurers for doing what they do. They are for-profit companies and exist for one reason only: to make money. The directors of such a company are required to do all they legally can to maximize return to shareholders. If, in the process they kill a few patients and deny coverage to many more, that's just part of business. We ought not to blame them for that any more than we blame a lion for killing to eat. But putting companies with that motivation in charge of our health care is sort of like letting a lion loose in your kids school. If you are foolish enough to do it, you ought not be surprised when a few kids get eaten. Unfortunately, our political class, of both parties, is more interested in protecting the lions than the children.

I'm inclined to agree with you as inherently it seems like a conflict of interest to me to have for-profit companies deciding who gets heatlh care. I can see it as feasible where there is sensible regulations and watchdogs to ensure that they aren't allowed to run amok.

The problem is we haven't had that for 30 years and as they've monopolized they've bought state and federal legislations with their profits. That hospitals have to have entire departments of people who do nothing but monitor that level of care and orders comply with a strict bluebook and entire departments of people handling denials proves it. I'm not advocating patients getting more care than they need but a claim denied because someone was on telemetry a day beyond what the insurance company decided is ludicrous.

StNeotser, ASN, RN · Apr 22, 2011

It's not an issue of socialism or political ideology. In Germany they manage to have private health insurance and a public option and nobody gets stiffed. The insurance companies still make money and the citizens can still get health insurance and treatment.

Unless enough people are affected by this, there won't be any change. It drove me crazy to hear the charges of "death panels" and Keep The Government Out of Healthcare - really do people trust private companies to take care of them better than a government they can vote in and out?

I had a child only policy for my daughter because the small church based rehab facility I work for charges nearly $400 per month for me to add her to my policy. I had private health insurance for her through Aetna for $180 per month. However, they are terminating the insurance at the end of the year because now no health insurer will offer a child only in my state.

Unfortunately she has exercise induced asthma which is a pre existing condition and I will probably end up paying that $400 or more (they will increase the charges for 2012) through my employer because nobody will insure her.

Edited to add, I had no idea my daughters health insurance company was going to drop her at the time of posting the original thread.

WIN007 · Apr 22, 2011

It's also ironic that people want government out of health care when govt is already paying for about 70% of in-patient admits. Throw in the uninsured or underinsured in ED and inpatient and it's likely very much higher.

Everyone wants the govt out of healthcare but don't touch mom and dad's service, right?

Unfortunately asthma is considered by payors to be a riskier item, ie, one of the conditions they pay a lot of money for (ED visits, et al). If you can get her covered for 400 a month that's a bargain actually in these times.