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Roland99's Journal
Posted by Roland99 in General Discussion (1/22-2007 thru 12/14/2010)
Tue Aug 25th 2009, 11:08 PM
Consider these facts in health insurance:


  • Switch jobs, lose old health insurance and have to apply for new insurance.
        - This brings up the point that a new application often means a waiting period for "pre-existing conditions". Better hope not to have one as it means paying 100% out-of-pocket for a few months!

  • Lose a job, pay 2-, 3-, 4-times as much via COBRA to maintain the same policy. Good luck paying those exhorbitant premiums WITHOUT A JOB!

  • Work for a small company, pay a higher premium.
        - A smaller company can't negotiate a lower premium. No "economies of scale". Doesn't matter if everyone is healthy and hardly ever files a claim.

  • Be healthy, pay a higher premium.
        - This can easily happen at a smaller company that has a couple of employees whose families have had major claims (cancer, for instance).

  • Company executives decide to switch insurance companies for whatever reason (CEO doesn't like carrier, CFO knows someone at carrier B, company can save money, etc.)
        - Forces employees to verify physicians used are members of the new plan. If not, pick a new physician. Physician may be a member of the plan but hospital used may not be (see the situation in Louisville, KY this summer between Norton Hospitals and Anthem insurance.) This can mean the delay or even cancellation of much-needed procedures, including surgery. So much for being able to always choose your own doctor or hospital!(This applies to the first point, too.)

  • Find out insurance carrier B has a great plan at a great price but is not licensed to sell in the state. Stuck with carrier A. This really sucks in metropolitan areas that straddle state lines.

  • Insurance company provided via corporate benefits raises deductible and increases co-pays.
        - Switch to another carrier but pay much higher premiums due to not being a member of a larger group. Or...put up with higher out-of-pocket expenditures on each claim.



How can *anyone* defend an infrastructure so stacked against the consumer?? How is it fair to be healthy and pay a higher premium simply because one works for a smaller company? How is it fair to pay a higher premium simply for living in a different state?


As an aside, it reminds me of the way the cell phone carriers work here in the U.S. Want a particular phone? Have to go with a specific carrier. Vice versa, if you want a particular carrier, you're stuck with the phones provided by them. (This doesn't take into account people acquiring unlocked phones but the great majority of cell phone users won't go through that trouble.)



HR 676!!!
http://www.pnhp.org/docs/nhi_bill_final1.p...
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