Home > Duluth.Talk > Archives > 2006 > June > 21
Wednesday, June 21, 2006
Insurance companies choose wealth over health
The Atlanta Journal-Constitution
Have you been following the battle between Blue Cross Blue Shield of Georgia and Piedmont Healthcare? It’s the latest saga in the story of insurance companies attempting to manipulate the market.
First, a brief history on the origins of insurance.
The practice of insurance was perfected by Marcus Licinius Crassus, a wealthy businessman and general who financed the reign of Julius Caesar. Crassus owned a bunch of slaves, all skilled builders.
He would go to the wealthy and middle class people of Rome and offer them his slaves to put out fires - for a fee, of course. If they didn’t pay and a fire broke out, Crassus would stand outside the burning building with his slaves, lamenting the homeowner’s decision not to hire him.
Then, he would offer to buy the burning/destroyed properties and neighboring buildings. He’d rebuild them and either keep them to rent or sell them for a huge profit. Some say that he and his crew even managed to start a few of those fires at “opportune” moments. If the property owners did pay - well, you get the point.
Fast forward to today.
Blue Cross took out a full page ad in the paper not too long ago telling people, in effect, that they must all switch doctors immediately if Blue Cross and Piedmont couldn’t reach a deal on a new contract.
There was no mention in the ad that Blue cross is obligated to allow patients to continue to see their doctors in certain situations (for example, pregnancy and terminal illness). They only said that people had to do something now.
Blue Cross further neglected to tell senior citizens that Medicare folks didn’t have to make the switch. “Patients are being held hostage by Blue Cross and their misleading communications,” Nina Montanaro, a spokeswoman Piedmont Hospital, told the Atlanta Journal-Consitution.
I’m singling out Blue Cross because they are the latest insurance company to publicly display the tactics perfected by Crassus some two thousand years ago. Almost every health insurance company has been or is now guilty of this kind of behavior.
We all know people who have had one horror story or another. Here are a few examples from around the country that the media has reported:
There was the man who had heart attack and had to be rushed to a hospital, but had to pay an exorbitant amount of money because the ambulance took him to a hospital not covered under his insurance plan.
Because the man didn’t ask to go there - the fact that he was unconscious and near death appears to have been irrelevant - the insurance company said they were free from obligation. They ended up settling in the patient’s favor, but only after a time-consuming battle. This is typical of insurance companies officials who hope the appeal process is too much for their clients to endure.
Then there’s the woman who has a brain tumor but can’t get the operation prescribed by the doctor because the insurance company says there haven’t been enough of them performed to be “accepted standard procedure.”
Everyone has a story.
My brother had a stroke several years back and his battles with the health insurance company included: Calls from creditors, reading documents that would challenge a lawyer, hours of anguish talking with insurance company employees who weren’t helpful and knew nothing about his condition.
The goal of a business is to maximize profits. I understand that. I also understand that there are people who take advantage of the system. But too often it seems that the goal of health insurance companies is to maximize profits, not the best treatment for clients.
Research the McCarran-Ferguson Act that explains an insurance company’s exemption from federal antitrust laws (yes, they play by different rules than most businesses). Learn about actuarial tables, and how they will help determine what kind of treatment your health insurance provider will recommend for you.
The bottom line is, as wealthy as this nation is and for all of our advancements in medical technology, we are not getting anywhere close to the kind of care for which we have worked. And somewhere, Crassus is laughing.
Do you have any suggestions as to how to improve our health care system?
Permalink | Comments (9) | Post your comment | Categories: Bill Allen
