Saturday, March 10, 2012

Having health insurance and still going bankrupt

From the Daily News:

Big insurance companies and some greedy doctors are to blame for the growing number of New Yorkers whacked with ”surprise” medical bills, a state inquiry has found.

Department of Financial Services Superintendent Benjamin Lawsky Wednesday released the results of his probe into the unanticipated bills that are slamming consumers.

"Simply put, surprise medical bills are causing some consumers to go broke," the report states.

His agency reviewed 2,000 complaints from 2011 and surveyed the 11 big insurers and HMOs who cover 95% of the New Yorkers who have health insurance.

The review found that patients who went out of their way to make sure the non-emergency treatment they sought was covered by their plan still wound up with bills from specialists — such as assistant surgeons, anesthesiologists and radiologists — who were outside their plan.

That’s because insurers often don’t make clear who will be involved and how much it will cost, the report found.

Also from the Daily News:

The fix here is pretty simple.

One, the Legislature must cap an individual patient’s responsibility for the cost of emergency care. A heart attack or late-stage cancer discovery should not bankrupt a family.

Two, nonemergency patients must be given reasonable notice if an out-of-network practitioner is scheduled on their case.

Three, the “small but significant number” of out-of-network doctors who the state says are inflating bills for treatment must feel the wrath of state watchdogs.

And — this is absolutely critical — insurance companies must be required to clearly disclose, up front, precisely what they will pay for out-of-network services so consumers can accurately compare health plans.


Anonymous said...

An even bigger, more widely experienced fraud is being dumped by your insurance provider once you develop a so-called chronic condition.

Such instances as smoking related heart and lung disease. They may cover the first manifestation but drop you afterwords and then your only recourse are the Public Hospitals.

I've personally seen this seven runs like clockwork.

Our market-based system has itself become a disease.

Anonymous said...

many citizens do not read the many pages of covered ailments that are sent to them by the companies and medicare . much of it is similar to legal contracts for lawyers to comprehend.

when obamacare is in effect in 2014, the government paper propaganda from the hundreds of new agencies will over whelm us, especially the senior citizens .will the obama appointed I.P.A.D. (DEATH PANEL ) permit our doctor's to treat or force seniors to die?

Anonymous said...

Why bother writing lies Grams. Even the 'genius' Chuck Grassley admitted that there was no such thing.

"Obama-care" as you Fox Parrots call will go into effect, become very popular, and finally get us on the road to universal health care.....It'll be a much rougher road than if we had listened to Pres. harry Truman's proposal in 1945.

The main reason's the right wing is feeding lies to people like you is that they want to protect the rich from higher taxes, and the insurance co's from eventually being driven out of business when a truly universal system takes hold.

Helen said...

We seem to have a shortage of doctors but an over abundance of lawyers.

Helen said...

Anonymous # 3 ~

Obamacare is un-Constitutional. Its "mandate" is a violation of the First Amendment of the Constitution of the U.S.A.

Anonymous said...

The only way to solve all this is to get insurance companies out of our hair, by expanding Medicare to cover everybody, not just those over 65 (who love the program.) Health insurance of workers under 65 and their employers would go to Medicare, whose overhead is a fraction of private HMOs.
Of course, both Democrats and Republicans are addicted to corporate $$ and would never allow it.

Anonymous said...

the congress has offered corrections to the medical insurance problem,before it is too late, for all American's ,under 65 years old, but the left dems. will not work with these representatives. senior medicare would not change at all.the senior plan medicare/B-C/B-S is an excellent plan ,obamacare will abolish it , if is not declared UNCONSTITUTIONAL by SCOTUS this year. or the repeal by a new POTUS IN 2012.

the left dems. just wants to scare the public with commercials that show" republicans pushing a senior in a wheelchair off of a cliff "

Anonymous said...

RE: Helen.....yes two federal courts have already ruled that obamacare is UNCONSTITUIONAL. the dems stretched the 10th amendment to use the COMMERCE clause to justify forcing Americans to buy their medical insurance?

read The" Judicial Activist" Ploy,by Thomas Sowell (Hoover Institute member), townhall .com 2/8/12

S.C.O.T.U.S. will hear the first of obamacare suits on Mar.27,2012. a support rally is being formed by the patriots to visit D.C.

obama has forced us to buy florescent light bulbs,( companies have stopped production of incandescent bulbs). let us hope that the g.o.p prevails in court ,or in repeals when O is defeated.

journalisk said...

Medicare for everyone isn't the solution, as the program is cheap, and only pays doctors fees like $35 for their services, and any doctor who calls to see what services are covered gets to spend hours on hold. Out of network doctors who charge proper fees, on the other hand (and prices are set in the billing software, no one is jacking up anything but cash prices), only have part covered by the insurance company. The company will refuse to pay the rest until the deductible is met, and fields the costs to the patient, who then blames the doctor. The problem is insurance companies. Patients don't know the codes to call up the company and see if services are covered: that's how you end up with surprise services not being covered. Patients buy PPO's then are shocked they have no out of network coverage, and this should just not be. This is the insurance companies. The only good insurance company in NY is Cigna. They are the only one's who bother to pay the doctors, and give coverage to patients. And Helen, please. National Healthcare isn't illegal: the health of the people is the supreme law (Locke). If the constitution says otherwise, it is no longer useful. The whole purpose of government is to finally recognize our collective responsibility to one another. And that means vastly improving the public health care system and medicaid. And this means making medicare payments livable for doctors. The medical industry needs to also stop lying about chiropractic, and the insurance companies need to start covering some preventative care. Medicaid B/C B/S is JUST THE SAME as Medicaid because they refer to your primary insurance to see what they cover: it DOESN'T mean that you get twice as much coverage.