Health care advocates The Access Project have released a big fat report saying the obvious: That you can have health insurance and still go broke with medical debt if you get sick. Sometimes it’s the co-insurance and deductibles, and sometimes it’s just straight-up deception from the insurance companies. Here’s one particularly damning anecdote:
In 2005, Linda’s husband suffered a heart attack that required quadruple cardiac bypass surgery. The total charges came to about $60,000; Linda expected the insurance to cover 80 percent after they paid the deductible. However, they soon found that the insurance covered only a fraction of the bill. “[T]hey have this clause that refers to miscellaneous charges, and almost everything that involves your care, other than just simple room and board itself,?basically had a $4,500 cap.” The insurer even refused to cover some services to that limited extent. With one bill, she said, “They just keep changing the coding on the bill. First they said it was outpatient, even though he was admitted. And then when I complained about that, they changed to coding to day surgery, which they don’t cover.” When Linda later researched the company on the Internet, she found that it had been sued many times for these kinds of practices.
Basically, the health insurance system is there to take lots of money from you in premiums, then bewilder you into paying more once you actually use the system.
And with regard to our situation:
Before relying on the private insurance market as the vehicle for expanding coverage for the uninsured, it is important to understand how well it currently functions in achieving its primary purpose-offering affordable and quality products to its customers and providing them with reliable customer service. Where problems exist, they must be rectified. Otherwise, we will simply replace the problems related to lack of health insurance with the problems related to inadequate insurance, with its similarly devastating health and financial consequences for individuals and their families.
If the state is going to require people to buy insurance, it’s absolutely entitled — required — to regulate the heck out of the industry. That’s a reasonable trade-off for an industry that’s about to reap a windfall of a lot of new required business. If health care is a “social good”, as we seem to have decided, then it needs to be regulated as such, like a utility.
… yeah, I wanted to get a Warren G reference in there, but I decided it wasn’t really, you know, appropriate.
G.
a single-payer, universal system is something we desperately need in this country. I’d look to some of the scandanavian countries, or maybe a netherlands to get a good model.
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In the end, I think we’re going to see businesses pushing for this.
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We have the most expensive health care industry in the world, per capita… by far. Yet, we also have some of the worst coverage in the world for a good chunk of people who actually have insurance… and another 45+ million people don’t have it at all. Getting health insurance through employers has proven to be an incompetent system.
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By all means, if people want advanced coverage, whatever. But we need to set some healthy level of minimal services and just do it.