The Ailments that put you on the Insurer’s Drop List

(9:00AM EST – promoted by Nightprowlkitty)

If you’re going to need Health Care anytime soon, make sure you don’t “get” any of these more “costly” conditions:

breast cancer, lymphoma, pregnancy, or high blood pressure.

If you do, it will put you on the Insurer’s Radar, for possible Policy Cancellation …

Having the audacity of “Getting Sick”, can instantly turn you into a “Bad Investment” for “Big Insurance” … according to the latest info coming out of Senate Hearings into Insurance Company practices … So if you’re not wanting this to possibly affect you or a family member you might want to look into a cancer care insurance plan, that actually covers the more “costly” ailments.

Well, Well … Going to Healthcare Hell …

by Donna Smith – June 18th, 2009 – Common dreams

While here in the United States, we let insurance companies not only get in between our doctors and patients but actually block them ever seeing one another. This week we heard testimony in a Congressional committee that the insurance companies our President and Congress want so desperately to protect have no intention of stopping the practice of policy rescissions. Insurers failing to payout is becoming extremely commonplace and causing individuals huge stress. Fortunately, the likes of Attorney Doug Terry are fighting back on behalf of mistreated individuals.

Rescissions happen when you get sick, file an insurance claim and then the insurance company searches your records to find reasons they would have denied you coverage before your illness and then retroactively drops your coverage. And their favorite targets? The committee found, according to the Los Angeles Times, “WellPoint’s Blue Cross targeted individuals with more than 1,400 conditions, including breast cancer, lymphoma, pregnancy and high blood pressure.” Ugly stuff. And talk about getting between you and your doctor

(emphasis added)

http://www.michaelmoore.com/mu…

Additional source: LA Times — June 17 2009

How can this be legal?

How can Insurers target you for “retroactively dropping your coverage” simply because you “got sick”?

Isn’t that what Health Insurance IS FOR?

Don’t try telling the average Health Insurance Exec about “What Health Insurance is for” — because chances are you won’t be speaking any language he or she understands. (ie. you won’t be speaking “Legalese”! )

Just listen to the Legalese, those Exec’s are asserting to the Senate Committee, regarding their position on “Cancellation Practices” after being challenged to change them:

Insurers Refuse To Stop Canceling Some Sick Patients’ Policies

18 Jun 2009

The House Subcommittee on Oversight and Investigations found that “policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.” One executive said rescission is intended to stop fraud and abuse.

The [L.A.] Times reports that the executives “would not commit to limiting rescissions to only policyholders who intentionally lie or commit fraud to obtain coverage, a refusal that met with dismay from legislators on both sides of the political aisle.

(emphasis added)

http://www.medicalnewstoday.co…

Why would they want to “kill the Golden Goose”?

Unless, of course, that “Goose” is just a “former” policy holder, who happened to get one of those “expensive ailment” (one with a high Payout-to-Premium Ratio). Then in those cases, “what the hey!”

In those cases, some “unlucky Goose” may soon, out on their own! … without the insurance coverage, they were counting on to be there, in times of crisis.

SO how is the House Subcommittee on Oversight and Investigations finding out this shocking information about “inner workings” of the Insurance Industry? Simple — one of the Industry’s former Execs, actually “grew a conscious” — and is telling the truth about how these “Privateers” really operate:

Health Insurance Exec Speaks

Testimony of Wendell Potter before the U.S. Senate Committee on Commerce, Science and Transportation

by Wendell Potter, Date June 24, 2009

My name is Wendell Potter and for 20 years, I worked as a senior executive at health insurance companies, and I saw how they confuse their customers and dump the sick–all so they can satisfy their Wall Street investors.

I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry. Insurers make promises they have no intention of keeping, they flout regulations designed to protect consumers, and they make it nearly impossible to understand–or even to obtain–information we need.

[…]

In the 15 years since insurance companies killed the Clinton plan, the industry has consolidated to the point that it is now dominated by a cartel of large for-profit insurers.

(emphasis added)

http://www.tnr.com/politics/st…

[continuing pg 2]

[…]

To help meet Wall Street’s relentless profit expectations, insurers routinely dump policyholders who are less profitable or who get sick. Insurers have several ways to cull the sick from their rolls. One is policy rescission. They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment.

[…]

They also dump small businesses whose employees’ medical claims exceed what insurance underwriters expected. All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year’s premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether–leaving workers uninsured. The practice is known in the industry as purging. The purging of less profitable accounts through intentionally unrealistic rate increases

(emphasis added)

http://www.tnr.com/politics/st…

Wendell Potter’s complete Senate Testimony (pdf)

As disturbing as that internal Private Sector “so-called competition” is — there is also a more “human side” of those boardroom profit equations. An unacknowledged pathos, that helped turn Wendell Potter, from one of the “Industry Hucksters“, into a strong advocate for Single Payer:

The Health Care Industry vs. Health Reform

by Wendell Potter – 06/25/2009

What I saw happening over the past few years was a steady movement away from the concept of insurance and toward “individual responsibility,” a term used a lot by insurers and their ideological allies. This is playing out as a continuous shifting of the financial burden of health care costs away from insurers and employers and onto the backs of individuals. As a result, more and more sick people are not going to the doctor or picking up their prescriptions because of costs. If they are unfortunate enough to become seriously ill or injured, many people enrolled in these plans find themselves on the hook for such high medical bills that they are losing their homes to foreclosure or being forced into bankruptcy.

As an industry spokesman, I was expected to put a positive spin on this trend that the industry created and euphemistically refers to as “consumerism” and to promote so-called “consumer-driven” health plans. I ultimately reached the point of feeling like a huckster.

[…]

Nothing could have prepared me for what I saw when I reached the Wise County Fairgrounds, where the expedition was being held. Hundreds of people had camped out all night in the parking lot to be assured of seeing a doctor or dentist when the gates opened. By the time I got there, long lines of people stretched from every animal stall and tent where the volunteers were treating patients.

That scene was so visually and emotionally stunning it was all I could do to hold back tears. How could it be that citizens of the richest nation in the world were being treated this way?

(emphasis added)

http://guaranteedhealthcare4al…

Good Question, Wendell!

How could it be? … How can it continue to be?

Why can’t OUR Representatives intervene in a system, that counts its Profits, according to the number of Patients it casts aside?

Until they have an “honest broker” as a Competitor (ie the Public Option), we will just continue to see

insurers routinely dump policyholders who are less profitable or who get sick.

Take it from an Industry Insider.

Whatever you do, don’t “get” any of these more “costly” conditions:

breast cancer, lymphoma, pregnancy, or high blood pressure.

or any of the 1400 others that would make you a “Candidate for Cancellation”.

Afterall those Insurance Exec have to keep “Purging the less Profitable Policies”, if they’re going to keep their Shareholders-bosses happy! (or so they just told the Sub Committee)

Best bet, just Don’t ever get sick, period!

7 comments

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    • jamess on June 29, 2009 at 5:51 am
      Author

    for Industry Whistle-blowers,

    if only more of them, had a heart …

  1. were responding to all of this?

  2. As Molly Ivins would have said, “bidness as usual.”

    I refuse to buy health insurance (& hope that I don’t get sick, lol, sob) because I don’t take sucker bets and it’s all a huge scam.  It might be a legal scam: but, health insurance as practiced in this nation is nonetheless a scam, no different in kind from all those spam emails from Nigerians offering you a million bucks if you send them a few thousand.

    I don’t take sucker bets.  Never bet against the house, never draw to an inside straight, and never let some CEO and his minions determine that your health insurance can be cancelled at any time, for any reason, after you’ve paid them many thousands of dollars you never recouped while you were healthy, just so they can deny you coverage when you actually need it.

    It’s a scam.  And it needs to end, like, yesterday.

  3. http://www.hhs.gov/aspr/barda/

    The idea is that government HAS to protect that infrastructure which makes the drugs of choice, tested or not, as “protection” against “terrorist” “attacks”.

        Orwellian doublespeak terms enclosed in quotes.

    http://www.healthfreedomusa.or

    http://www.pbs.org/wgbh/amex/i

    Plus genetic testing and you!

    http://news.google.com/news?hl

    Your world is digital, their world is digital.

    You can access your own credit report.

    Can you access your medical report?

    http://www.patientprivacyright

    See ya’ll in the next life!

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