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More than one-third of the people in the United States under the age of 65 had no health insurance for some or all of 2006 and 2007, according to Families USA, an advocacy group representing the uninsured. The most recent census data pegs the number of people in the U.S. without insurance in 2006 at 47 million people, but this is an annual snapshot that does not count those who had no health coverage for only part of the year. Families USA research shows that the number of episodically uninsured people in the U.S. has gone up by 17 million since 1999 and 2000, with the rising cost of health insurance the biggest factor driving the trend. So if you’re self employed or work for a small business that does not offer coverage, health insurance companies will try to offset the financial hit they are taking from HIPPA by charging you as much as they can based on your health status (rather, the underwriter’s determination of your health status) medical history, genetic information (meaning a parent, sibling or child who has any condition attributable to a genetic defect, even if you, yourself, are healthy) or disability. Health insurers have another nasty trick they like to pull to ensure that they’re not paying out more in coverage than they make in premiums: post-claims underwriting. Since the 1980s, attorney William Shernoff has been filing lawsuits on behalf of plaintiffs who discovered that their health insurance policies had been revoked just when they needed coverage the most – roughly 70 of them last year alone. Typically, policies are cancelled on the pretext that the application omitted or falsified important details about health history. Most of Shernoff’s suits are either dismissed or quietly settled. But The Recorder reports that more such cases may go to trial if the plaintiff in Hailey v. California Physicians' Service succeeds in convincing the 4th District Court of Appeal that under the state’s Health and Safety Code §1389.3, “health care plans are responsible for resolving all reasonable questions about an application before entering into a contract.” Plaintiff Steven Hailey was involved in a serious car accident shortly after he and his wife enrolled in a health plan with Blue Shield, which rescinded his policy on the grounds that he “lied on his application about his weight and concealed information about a recent hospital visit and a host of medical conditions.” Because his Blue Shield coverage was cancelled, Hailey was forced to sign up with a new insurer and wait six months for surgery with a torn urethra and other injuries. Blue Shield contends that coverage is subject to being revoked when someone has misrepresented facts that are material to the company's decision to insure him. Attorneys representing plaintiffs in cases like Hailey’s counter argue that an insurer should show willful misrepresentation before pulling the plug on coverage. Blue Shield has an uphill battle, considering that Blue Cross of California recently agreed to the willful misrepresentation standard in a proposed class action settlement. However, it will be business as usual for Blue Cross should Hailey lose in court. For his part, Shernoff filed an amicus curiae brief in the Hailey case, claiming that the MO at Blue Shield was to rescinded coverage without investigating whether there was an intent to deceive the company. He tells The Recorder that if these decisions were made in bad faith, there are grounds for punitive damages. The Stiletto opposes swapping employer-provided health insurance with taxpayer-provided health insurance (second item). But the number of middle class Americans who can’t afford to buy health insurance for themselves and their families is a clear indication that the current system is broken. www.thestilettoblog.com Victoria Knox (AKA The Stiletto) blogs about politics and ... you name it, since these days everything has become politicized..
Victoria Knox (AKA The Stiletto) blogs about politics and … you name it, since these days everything has become politicized..
Yes, it's a completely corrupted system None of the presidential candidates have a clue about what is really wrong and how to fix it. And Bush's tax offset (which is way too small to help a family afford private coverage, as this article shows) merely rewards the egregious behavior by insurance companies by shifting tax dollars to them. Yours truly went without insurance when her dot-com employers went belly up - not once, but twice. Maybe spent a total of four years uninsured. by
The Stiletto (37 articles, 0 quicklinks, 3 diaries, 30 comments)
on Wednesday, September 26, 2007 at 10:21:00 AM
gotcha beat! I think I went one stretch of 10 years without any real health insurance.. NOW, I only purchase the catastrophic type of policies... Reality is that being an athlete in a constant state of training, I don't need a doctor, unless something REALLY bad happens! The kind of thing that will cost an ludicrous amount of money.. I have a $1500 deductable, but the sort of thing I would use this for would be if several bones were broken in some sort of accident... I considered and bought regular health insurance, but after I went to the doctor, had the doctor tell me something I already knew, I started wondering why I went in the first place! LOL Anyway, there was another poster, and I hope he reads this... I would really like to know what government programs are successful.. That is actually saves money and offers better service... the DOE is an example of failure, the DOT is a HUGE DINOSAUR that has no idea where money is going or for what, and that is a job that the government was set up to do in the first place! need I go on? Ciao, CZ by
steve scheetz (4 articles, 0 quicklinks, 2 diaries, 693 comments)
on Thursday, September 27, 2007 at 9:22:25 AM
A concerned citizen and former mathematician/engineer now retired and living in rural Maine.
Vote for Bad Government and (Surprise) That's What You Get. It is a big stretch to say that ALL government programs are bad just because particular government leaders have had poor judgment. That the government often does things we don't approve of is not a fault of the notion of government, but the because we have allowed our particular government to slip into a failure mode. The present administration has proven to be particularly incompetent in almost everything (except infringing on constitutionally guaranteed rights and making the world hate and fear us), but this is not surprising since we elected(?) this leader on the basis of him being a good guy to have a beer with. We have a president who has a life-long proven record of incompetence so it is not at all surprising that government is failing. Some earlier U.S. administrations have been quite successful and have done quite remarkably good things. Social Security is, as an example, a very well-run program that operates with an overhead that is a fraction of what any commercial insurance company charges. It is true that government is borrowing irresponsibly against that fund, but that is in large part because (if you believe that Bush won election) we elected a president who campaigned against putting Social Security funds in a lock box. We used to have a health care system in this country that worked fairly well and it was based on non-profit hospitals and on doctors who had an orientation to public service. Unfortunately, the non-profit hospitals have been privatized and government has de-regulated insurance companies and has allowed drug companies to do as they please. This transition has occurred because of an undeserved faith in an unregulated private sector. It has happened because bad government over several decades allowed this transition to happen. That still does not say that government is intrinsically bad. Bad government has made a mess of health-care, but this is only an indication that our recent governments have made some grievous errors in judgment. The healthcare system is now in such bad shape that there seems to be no alternative to government intervention in a big way, but with good leadership this could be a very good thing. We could, with good leadership, again have a health care system that other countries would envy, not laugh at. by
PrMaine (11 articles, 9 quicklinks, 2 diaries, 395 comments)
on Wednesday, September 26, 2007 at 10:16:06 AM
Some fact on Canada's system Yes the US government has been highly corrupted by corporate and religious interests. And yes it is also quite bad in running social services. So fix it before get yourself wrapped up in the stupid government=socialism ideology. If government in general is the problem, why don't you propose cancelling the Medicare program? I offer some facts on Canada's health insurance program: - It is funded at both the federal and provincial levels, but each provincial government runs its own health insurance program as well as the hospital system. Thus there are 10 such systems, each different. - The federal government does not run any health programs, but it defines coverage and quality standards under the force of legislation. - Private health insurance in the areas where public insurance covers is banned. Public health insurance is given only to legal residence who needs to apply for a health card under strict rules. Insurance covers all services dispensed from hospitals and clinics. It does not cover drugs dispensed from clinics, dental care, nor any cosmetic health care. Most of what public health insurance not covered is covered by private insurance issued by business. - The quality of medical care is controlled under legislations. Hospitals are funded by tax money but run by executives. The amount of money to be allocated to health care, and how it is to be spent, is an open book subject to review, audit and investigation by an independent officer. In elections, people has a say in how much money is to be allocated to health care, priority and quality. So you see, Canada does not see its governments as some sort of evil. It uses government to run certain social services but under strict quality and financial oversight. It uses democracy to regulate it. But the core matter between US and Canada is one of the value of a human life. Canada sees the health of a human being as intrinsic to what society and country is all about, above and beyond commercial trade. America sees human health as just another commodity to be traded, profited from. It is a business. It uses market forces to regulate it. But the goal of business is to maximize profit, NOT necessarily to make the product, i.e. your health, better! Now America has been brainwashed to see any non-commercial trading of human health as 'socialism'. Well, then, pay for it in the NY Stock Exchange. by
TomK (0 articles, 0 quicklinks, 0 diaries, 235 comments)
on Wednesday, September 26, 2007 at 1:18:14 PM
57Yo m I'm a "been there, done that! Bought the tee shirt,to hide the scars!" type of person Ive worked�many jobs from�a chicken slaughterer to managing a branch of a multinational and many jobs in between.Raised in colonial PNG Left School 16,Grad Hi school 22 Night School, University 36� BBus (majored in Psyche and Marketing), Dip Comp prog and project Mmnt.at 50 I've been in 48 different community org ,23 on board with 18 prez or deputy prez.First social campaign at 17 for the aborigine...
Must read for US citizens on Health care alternative Not that Australia is the shining example of Universal Health Insurance but what I read of the US's shambolic and corrupted system perhaps we've something to offer. We have a system in which everyone has basic medical coverage. - The Federal government subsidizes and controls the Health insurance contributions. - Under Medicare the federal system everyone is entitled to basic care. It has a system of prescribed Scheduled rates for each medical procedure. - Medical practitioners can either charge the rebate fee (70% of the scheduled fee) direct from Medicare or charge an extra fee then the patient claims back up to scheduled or rebated fee. Some practitioners charge more than the scheduled fee. In this case the patient picks up the difference. - The Federal Govt issues health care concession cards to the means tested lower income. Many practitioners only charge the rebated rate (70% of the Scheduled fee) to them. This means no out of pocket to the poor. - Card holders and people who present to Hospital Medicare patients receive free treatment in public hospitals. The disincentive is that if the treatment is "elective" the patient joins a waiting list which may be quite lengthy. Secondly the patient gets the house doctor or specialist. Private insurance is encouraged in two ways. - The govt gives a tax rebate towards the insurance premiums of up to 30%. - The insurer have a sliding scale for different ages (i.e. Risk) however your rate is fixed at that which applied at entry time (i.e. If you join at say 21 on rating "A" providing you say covered your rating level remains "A". if you join at 40 your rating level might be "B" et sec). -The drug prices are negotiated between the Government and the Drug companies. Other non scheduled drugs are available but with 95% common ailments covered by scheduled medication those not on the list aren't big sellers. - In the case of health care card recipients their medication is price fixed at $4.95 regardless of the cost. The govt picks up the difference between the patients' payment and the agreed price. No pensioners waiting until the new year here. - There is a Safety Net on this too once the patient has spent a prescribed amount per year all prescribed scheduled medications are then free until Jan 1 when the counter starts again. That target is lower for Health Care Card holders. It's biggest opponent are those who want to make more money including the missnamed Liberal Party ( right wing capitalist first party our religious zealots tend to come from with in) our equivalent to your Republican Party only not quite so extreme .....yet. Drug Companies often run the furphy about drugs development costs etc but according to information available this is largely spin as most of the drugs are older and have well and truly recouped development cost and profit. Most of their arguments centres around them trying to isolate each drug to maximize profit. Needless to say Drug companies are NOT LOSING MONEY from dealing with Australia or they simply wouldn't. Again it is about more profit and to hell with the patient unless he/she is prepared to fund the Drug companies' excessive profit. They have even claimed that US patients are subsidizing Australia...This is patently rubbish. by
Andris (4 articles, 0 quicklinks, 0 diaries, 531 comments)
on Wednesday, September 26, 2007 at 8:55:27 PM
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