Sunday, July 5, 2009

Private Health Insurance Companies are dumping the sick who must file for bankruptcy: SADISTIC LIMITED BENEFITS PLANS

I think we can pretty much conclude that this country is too far down the drain to recoup. The powers that be associated w/ the private insurance companies are going to drown us in the bathtub with most everyone looking on and seeing what is happening and there will simply be a stunned sense of 'there was nothing we could do.'

Just because you have health insurance doesn't mean you cannot go bankrupt depending on the DETAILS & FINE PRINT of your PRIVATE health insurance.

There is no better reason than this for the public option. Give it to us, or we'll die.

NYT: http://www.nytimes.com/2009/07/01/business/01meddebt.html

Insured, but Bankrupted by Health Crises

Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to confuse their customers and dump the sick.

The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance, Wendell Potter, the former Cigna executive, testified.

Mr. Yurdin learned the hard way.

At St. David's Medical Center in Austin, where he went for two separate heart procedures last year, the hospital's admitting office looked at Mr. Yurdin's coverage and talked to Aetna.

St. David's estimated that his share of the payments would be only a few thousand dollars per procedure.

He and the hospital say they were surprised to eventually learn that the $150,000 hospital coverage in the Aetna policy was mainly for room and board. Coverage was capped at $10,000 for other hospital services, which turned out to include nearly all routine hospital care the expenses incurred in the operating room, for example, and the cost of any medication he received.

In other words, Aetna would have paid for Mr. Yurdin to stay in the hospital for more than five months as long as he did not need an operation or any lab tests or drugs while he was there.

Aetna contends that it repeatedly informed Mr. Yurdin and the hospital of the restrictions in policy, which is known in the industry as a limited-benefit plan.

The company says such policies offer value by covering some hospital expenses, like surgeons' fees or a stay in the intensive care unit. Aetna also says all of its policyholders receive significant discounts on the overall cost of hospital care. But Aetna also acknowledges that a limited-benefit plan was inappropriate in Mr. Yurdin's case because his age and condition an irregular heartbeat made him likely to require more comprehensive coverage....."

No comments: