Sunday, April 23, 2006

Insurance and the marketplace

By law, insurance companies aren't allowed to adjust your monthly premiums just because you get sick. But they can raise the out-of-pocket cap for all of their members anytime they like, which amounts to the same thing because it affects only the unvalued sick members.
One of the reasons America spends so much more than any other country on healthcare is because upwards of 30% of our expenditures are for paper shuffling by insurance companies doing their best to deny treatment whenever possible. By contrast, administrative costs in countries where there's only one paper shuffler — and it's not trying to make a profit from its shuffling — are closer to 10%.


And a few other things...

By what reasoning does the term "uninsurable" figure into market rules governing insurance?
This is similar to the puzzle about "pre-existing conditions" not being covered. If pre-existing conditions cannot be covered, then what is the purpose of insurance?

And when the message is that your claim is being DENIED why do they call it an Explanation of BENEFITS? Shouldn't that be a Explanation of NON-benefits?

By what reasoning is insurance not available to the unemployed, who have a hard enough time with food, housing and transportation? With the basics one can always cut back...cheaper food, cramped quarters and walking. But with insurance the low-end alternative is to get sick and die. (Yes, yes I know. No one has to pay for emergencies if he cannot pay. Why do you suppose those of us who are paying roll our eyes at $100 aspirin and other clearly inflated items on the bill?) (And WHY, come to think of it, do insurance companies continue to pay such things while complaining about "usual and customary charges" for other charges?)

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