March 8, 2010
Opponents of reforming any industry always say regulation isn’t the answer. Well, absent meaningful regulations, how are the health insurance companies doing at keeping costs down (and profits up)?
Adam Linker, blogger at The Progressive Pulse, the NC Policy Watch blog, has put together a list of their Top 10 Favorite Health Insurance Company Innovations. They’re spot on, all of them, but here are some ‘highlights’:
10. The “in-network” and “out-of-network” doctor. Want to choose your own doctor? Sorry, not with private insurance. To get covered you have to go to the right doctor and the right hospital. If you guess wrong and go to an unapproved hospital you could get stuck paying thousands of dollars in medical bills. To keep things exciting sometimes a hospital will be “in-network” but the doctor who treats you at the hospital will be “out-of-network”. It’s all part of the fun.
8. The for-profit nonprofit. Blue Cross and Blue Shield companies across the country are mostly nonprofit, but they act like for-profit companies. Blue Cross and Blue Shield of North Carolina owns subsidiary for-profit entities and pays its CEO more than $4 million per year. But BCBSNC does not have any real oversight from shareholders or the Securities and Exchange Commission.
3. Rescission. We can all agree that people with sloppy handwriting or those who lie about acne medication don’t deserve health insurance. To help fight this scourge, insurance companies developed something called “rescission”. If you get sick then insurance companies will pore over your application to find mistakes or omissions. If you forgot to include something then you can get booted off of insurance and the insurance company can even pursue you for back payments. That’s innovation at its best!
“This is the king of insurance industry innovations. Medicare will cover you even with a preexisting condition, but why would a private company that is trying to pad its bottom line want to offer coverage to someone who might get sick? Insurance companies want to collect money, not pay it out. So if you’ve ever had an illness insurance companies will refuse to offer you coverage. Or better yet, the insurance company will offer coverage for a mere $2,000 per month.”
Click here to get the full list of all these distinctly American innovations (we’re the only country that allows this stuff, folks).