A Few Things the Right Needs to Know About Rationing Health Care.
Thursday, September 17th, 2009What the leaders and talking heads of the right will not tell you, or will down play if it is brought to light, is that we already have rationing of health care. The problem with the rationing of today is that it is motivated by profits, and rewarded with large bonuses to those that can make the Corporations more money by denying claims and canceling policies for technical reasons. Rationing is occurring today. Right now someone is examining a health insurance application to find any reason to drop you if you become ill. Then once you are dropped, now with a preexisting condition, good luck finding health care that will meet your needs if you are not in the top 5% of wage earners.
Monday the South Carolina Supreme Court ruled that Fortis Insurance, now known as Assurant, must pay 10 million in damages to a man dropped shortly after being diagnosed HIV positive. In the ruling, the Huffington Post notes Chief Justice Jean Hoefer Toal wrote:
We find ample support in the record that Fortis’ conduct was reprehensible … Fortis demonstrated an indifference to Mitchell’s life and a reckless disregard to his health and safety.
In a memorandum dated June 16,2009 the House Committee on Oversight and Government Reform discussed their findings during investigations into problems with the individual health insurance market. The first part of the study discusses the issue they call “post claims underwriting”.
Rather than reviewing individual medical histories at the time applications are submitted, some insurance companies award policies quickly to begin collecting premiums. If thepolicyholders subsequently get sick and file expensive claims, these insurance companies initiate investigations to scrutinize the details of the original application materials and medical records in order to find discrepancies, omissions, or misrepresentations. This practice is known as “postclaims
underwriting.”
Based on the results of post-claim investigations, insurance companies may rescind coverage, retroactively cancel policies, return premiums, and refuse payment for medical services. Rescinding health insurance policies has implications not only for policyholders and their families, but also for physicians, hospitals, and other health care providers that seek reimbursement for their services. A Mississippi court described why this practice is controversial:
“An insurer has an obligation to its insured to do its underwriting at the time a policy application is made, not after a claim is filed. It is patently unfair for a claimant to obtain a policy, pay his premiums and operate under the assumption that he is insured against a specified risk, only to learn after he submits a claim that he is not insured, and, therefore, cannot obtain any other policy to cover the loss. The insurer controls when the underwriting occurs…. If the insured is not an acceptable risk, the application should [be] denied up front, not after a policy is issued. This allows the proposed insured to seek other coverage with another company since no company will insure an individual who has suffered serious illness or injury.
The way the private sector is handling the issue of denying coverage today is immoral. One of the scare tactics we hear today against Government paying for health care is that rationing would deny you a hip replacement because it would not improve your remaining quality of life. So say the government did deny you and you had to walk with a cane. You would still be covered if perhaps you got pneumonia, had a bad case of the flu, or needed emergency care. Under the current system, once you are denied and dropped by the insurance companies, the only thing you have covered is bankruptcy, or death.