Tuesday, April 26, 2011

Health Insurance - oxymoron, actually.

In my mind, the health insurance I pay for should be something, in the case of catastrophic but necessary medical intervention and treatment, that is available to me to ease my mind of any financial concerns during that medical crisis. Isn't that what it's there for? When I stumbled upon an article in the New York Times, I found out that I was apparently wrong.

According to their chart, if someone required an organ transplant, only 45% of insurance providers would cover the procedure in their plan and even if they covered it, it was not a guarantee they would actually PAY for the required procedure or all of the other costs associated with that procedure. Immediately, I checked my policy and whew!... I'm covered.  But wait, if it stemmed from a pre-existing condition that had been documented before this policy went into effect, it actually wouldn't be. So really, I won't know until the time when I'm actually going to need it whether they would pay for it or not! Those poor 55% who aren't even covered but are paying health insurance, who need an organ transplant... they're completely screwed unless they have the money in the bank to pay for it. Wow... that just blows my mind.

Having worked at a doctor's office and being responsible for processing insurance claims, I know a little about this game called health insurance. From that experience, I've come away being more thoroughly convinced that the insurance companies don't give a rat's ass about who they insure. And also, that I've learned entirely more than I never wanted to know about this racket. We have no choice but to play this game, but the insurance companies are the only ones who are winning.

Our household is self-insured since the company my husband works for doesn't offer coverage and I am currently unemployed. The cost for our family coverage is $490 per month.The deductible is $3000 per person and coinsurance is another $5000 per person. So we are paying $5880 per year in premium payments and then, additionally, at the very least, another $8000 per policy year before they will pay 100% of whatever medical emergency I might encounter. So, in reality, what I'm paying is $13,880 in the year that something truly catastrophic happens for the privilege of having the insurance company take over the cost on the rest of it. That's what I hope, but what if it isn't covered? Well, then it looks like a line of credit and/or robbing our savings will be the only road we can take.

With the sky-rocketing cases of diabetes now and the current high-level of obesity in this country that will contribute to increasing those cases of diabetes, it was shocking to see that only 27% of insurance providers would even cover diabetes care management. This is where they have gotten ahead of the upcoming medical crisis and are guaranteeing their next windfall profits. So that it makes a pretty picture in your minds... Premiums come in, no payments go out = profits.

That is what I mean by health insurance being an oxymoron. The very definition of health insurance is to provide a guarantee of compensation for illness in return for payment of a premium. It really doesn't seem to be what the insurance companies are doing when they don't cover or pay for everything during catastrophic medical situations that create exorbitant costs to the average person who doesn't have that kind of money at their disposal. Health insurance, I'll say it again... it's an oxymoron!

The insurance industry does an injustice to the community they say they are serving. Their profits are climbing at an astounding rate while the people they insure are losing their health, their possessions and literally, their lives. It boils down to one thing only and that is greed. Greed for the almighty dollar is more important than people, once again.

It's the "What's in it for me?" mindset that is prevalent in the insurance industry and also, permeating every industry and every level of government in the United States. That is not to say there aren't good companies or organizations out there, but seriously, when you look at the disparity between rich and poor... how can you not see that this mindset is what needs to radically change in this country?

Every human being must breathe, drink water and eat to survive, as well as, to maintain their health and quality of life. Why would or SHOULD we all not be entitled to get or be able to afford the fundamental things we need to survive or sustain our lives?

I hope that in the future, the near future, people would ask themselves that same question and figure out a way to help change the mindset to go in that direction and make the necessary changes in how we do business and how we run our government. Let's hope that we all make an effort to agree that the things we need to survive are something that is deserved by everyone. And that includes health insurance that actually does what it says it will do.

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