Frakking insurance scam-artists

[littlelolligagged]

They adopted a child to make sure she wouldn't end up in the system.
Now, a Gainesville couple says their little girl is being punished.
Though Al and Karen Hollander are willing to pay for the girl's insurance, they said they have been told no insurance will cover her.
The Hollanders have cared for 6-year-old Teri since she was just a few months old.
The Hollanders are in their late-60s and the parents of five biological children and 10 grandchildren.
They took Teri in when they learned her biological mother, who is not a blood relative, could not care for Teri. Karen Hollander told Channel 2’s Diana Davis, “Rather than have the state step in and put her into the system, we took guardianship of her. It’s not something I planned on doing at this stage of the game, starting all over, but life happens,” she said.
When the Hollanders legally adopted Teri three months ago, they were hit with a bombshell.
They said they learned that no insurance company in the United States will cover her.
The insurance companies she wrote to and called blamed it on new federal health care legislation.
The Hollanders said both the insurance commissioner’s office and their state representative told them once insurance companies were required to insure kids with pre-existing conditions, they stopped writing new policies for healthy kids like Teri. It infuriates the Hollanders. “I think that is an absolute crime that someone can do this in America,” said Karen Hollander.
The Hollanders have Medicare -- the federal insurance program for Americans over the age of 65. It doesn't cover kids. Though the Hollanders aren’t rich, they're not poor either.
Teri doesn't qualify for the state's Peach Care program or Medicaid.
“I knew that once we adopted her she would no longer be eligible for Medicaid, but it never ever occurred to me she wouldn't be eligible for any insurance,” Karen Hollander said.
In an e-mail, the state insurance commissioner's office said it was unaware of any insurance company in Georgia writing policies for kids and said state law doesn't require it.
The Hollanders told Davis they can handle Teri's day-to-day doctor bills, but Al Hollander said if Teri gets a serious illness, they would be wiped out. “Of course if she got a real illness, it would put us in bankruptcy. It doesn’t make a lot of sense after you have been working all your life and saving for retirement” said Hollander.
The Hollanders said they’ve been told Teri will be eligible for insurance in 2014 if and when the new federal health insurance legislation takes effect.

http://www.wsbtv.com/news/27284059/detail.html

That's just a load of crap if I've ever seen one. I'm particularly fond of how the insurers are using the healthcare legislation as a scapegoat for their being douchebags. I have lots of problems with what we got (in relationship to what was expected), but finally...

there needs to be a fucking public option.

[Flixy]

once insurance companies were required to insure kids with pre-existing conditions, they stopped writing new policies for healthy kids

I don't get this?

Over here insurance companies can't deny anyone, unless they have a history of defrauding insurance companies.

[Loki]

You have the government create warped incentives for private firms and then act surprised when the firms respond to those incentives.

[Dreadnaught]

Need more info here. I can't find any substantial information on this from doing a few quick searches. Really curious what the reason actually was.

Also seems like they could have fallen into a donut hole -- Obamacare requires insurance plans to cover kids under the age of 26. But I believe the plan exempts unions and Medicare. The Medicare exemption isn't a big deal for most because most people who are 65+ don't have kids below the age of 26, but obviously this may be a corner case.

[GGT]

....there needs to be a fucking public option.

I've come to the same conclusion. There's no reason in the world why a country like the US should continue to allow this stranglehold and monopoly from insurance companies.

I'm guessing Peach Care is Georgia's version of SCHIP? Looks like their only option is to stop paying for Medicare and find another private family plan, one that will accept their minor child.

One flaw in the new healthcare law for plans to include chilldren up to age 26 seems to be one of Grandfathering. At least the way I've read it, anyone over 18 yrs old and not full-time students can only be added back on to their parent's plan if they'd been cancelled after that 18th birthday. That happened to us. I couldn't just add my 19 yr old son to my plan, because he'd never been on it.....but he could be returned to his dad's plan that covered him until he turned 19 and was no longer a full-time student. *After a 6 month waiting period*

[Dreadnaught]

Yes, we need a government piggy bank that doctors can send their bills to forever and ever.

This news story is worthless without even the slightest details of why the kid was rejected.

[GGT]

Yes, we need a government piggy bank that doctors can send their bills to forever and ever.

No, we need a better way to provide this First Class Health Care that many Americans still believe we have, even when it's been proven we fall short and charge more than any other industrialized nation in the world. We need something to break the Insurance Industry monopoly.

This news story is worthless without even the slightest details of why the kid was rejected.

She can't be covered under Medicare, Medicaid, or Peach Care. She was not turned down because she has some pre-existing condition, but because she has elder parents (on Medicare) that make too much money to qualify for state programs. And apparently no private insurers are underwriting policies just for minor children, not even as supplemental policies. Insurers want to make more money by demanding that her parents buy a family policy, and pay them higher premiums, even when they've already got their own insurance through Medicare.


Edit: This gets even more outrageous when you consider those insurers would definitely demand the parents declare their Primary carrier as Medicare. For when they get sick and make a claim. They'd expect the parents to utilize Medicare first, so they don't have to reimburse the lion's share of expenses. Just the crumbs. They want the premiums, but don't want to pay claims. That, indeed, is their whole business model.

[Lewkowski]

No, we need a better way to provide this First Class Health Care that many Americans still believe we have, even when it's been proven we fall short and charge more than any other industrialized nation in the world. We need something to break the Insurance Industry monopoly.

What monopoly? There are multiple insurance companies. Do you know what a monopoly is?

[GGT]

What monopoly? There are multiple insurance companies. Do you know what a monopoly is?

Is there an alternative for healthcare payments to compete with Insurance companies, besides what you'd call government subsidies or Welfare? Paying out of pocket is their competitor? Don't make me laugh. Wait, that's laughable.

[Loki]

Is there an alternative to sodas other than soda companies?

[Lewkowski]

Is there an alternative for healthcare payments to compete with Insurance companies, besides what you'd call government subsidies or Welfare? Paying out of pocket is their competitor? Don't make me laugh. Wait, that's laughable.

So Health Care is a service/good just like all other service/goods. Health Care Insurance spreads risk and helps people pay for health care. The idea being that not everyone is going to need a heart transplant, chemo, kidney transplant and or expensive medications. You don't know if you will be one of the unlucky ones so you go ahead and pay into the Health Insurance plan.

If you feel confident that it will be less expensive to pay for medical care out of pocket then you can choose to forgo health insurance. (Or at least you could before). Now often times due to tax benefits employers will set up health insurance for their employees as a benefit. This really skews the relationship but that is what happens when you have government meddling. So yes there is an alternative to dealing with insurance companies until Obama Care mandated insurance coverage. It is now more monopolistic in nature then it ever was before. But still no monopoly because there are more then one company offering the service in a competitive market.

I'm just curious GGT how health care should be paid for. Either out of pocket or via private insurance or via government. Those are the only three real options.

[GGT]

So Health Care is a service/good just like all other service/goods.

No, it's not. Don't try to make this sound like buying health care is the same as buying a tank of gas or a bag of chips.

Health Care Insurance spreads risk and helps people pay for health care. The idea being that not everyone is going to need a heart transplant, chemo, kidney transplant and or expensive medications. You don't know if you will be one of the unlucky ones so you go ahead and pay into the Health Insurance plan.

Sounds good so far, pooling risks, helping pay for those who may need dialysis or chemo or transplants, even when we personally may not. Not knowing, of course, if we could one day BE in that needy group, but fearing that we MIGHT?

If you feel confident that it will be less expensive to pay for medical care out of pocket then you can choose to forgo health insurance. (Or at least you could before). Now often times due to tax benefits employers will set up health insurance for their employees as a benefit. This really skews the relationship but that is what happens when you have government meddling. So yes there is an alternative to dealing with insurance companies until Obama Care mandated insurance coverage. It is now more monopolistic in nature then it ever was before. But still no monopoly because there are more then one company offering the service in a competitive market.

This has nothing to do with the Obama administration, or "Obama Care". Only the uber-wealthy can pay to have premiere illness coverage. Everyone else is either beholden to their employer helping to pay premiums, beholden to the underwriters if they pay OOP as individuals, or beholden to government programs. None of that speaks to our excellence of care for everyone. Far too many go uninsured, can't find affordable coverage but also can't qualify for government help, or land in medical bankruptcy.

I'm just curious GGT how health care should be paid for. Either out of pocket or via private insurance or via government. Those are the only three real options.

It should be a combination of all of the above.

You couldn't afford to pay OOP for your family's total care. Only the uber-wealthy can. You also couldn't afford comprehensive insurance coverage and its premiums without your employer's group subsidy, based on your family's history and pre-existing conditions. Try it, I double dare ya.

[Lewkowski]

No, it's not. Don't try to make this sound like buying health care is the same as buying a tank of gas or a bag of chips.



Sounds good so far, pooling risks, helping pay for those who may need dialysis or chemo or transplants, even when we personally may not. Not knowing, of course, if we could one day BE in that needy group, but fearing that we MIGHT?



This has nothing to do with the Obama administration, or "Obama Care". Only the uber-wealthy can pay to have premiere illness coverage. Everyone else is either beholden to their employer helping to pay premiums, beholden to the underwriters if they pay OOP as individuals, or beholden to government programs. None of that speaks to our excellence of care for everyone. Far too many go uninsured, can't find affordable coverage but also can't qualify for government help, or land in medical bankruptcy.



It should be a combination of all of the above.

You couldn't afford to pay OOP for your family's total care. Only the uber-wealthy can. You also couldn't afford comprehensive insurance coverage and its premiums without your employer's group subsidy, based on your family's history and pre-existing conditions. Try it, I double dare ya.

So Health Care is more important then chips (ie food?) Without food you can not eat. Should we regulate all food marketing, production and distribution?

Health Insurance spreads risk, which is a good thing. That makes sense since no one know for sure if they will have the need for extensive health care. No arguments there.

Sure it has something to do with Obama Care. Obama Care *changed* many things about how health care is provided.

Goods/services are scarce. They are finite and there must be some system to ration it. Now for most goods and services this is rationed by money. You believe that we should not ration health care by cost. Correct me if I am wrong here but I get that vibe that rich or poor everyone should have the same care? Right? So in that case how do we ration care? European models (and Canada!) have rationed it via queues.

Its simply impossible to envision a system where everyone has instant access to the "best" care at any moment. Something most give, either waiting period, cost or some other way ration it. Unless you want to have the bulk of GDP spent on medicine?

[GGT]

THAN

I'd rather give a larger portion of our "GDP" into education and healthcare, THAN spending Trillions on weapons or wars that don't make much sense.

Health Insurance sounds like a good thing for spreading risk, until you realize that insurance companies want to make a profit, not provide health care. They profit by either over-charging premiums, excluding certain "risky" people, *denying claims, rescinding coverage, or refusing to underwrite new policies*.

[Khendraja'aro]

I don't get this?

Over here insurance companies can't deny anyone, unless they have a history of defrauding insurance companies.

Same here.

The real WTF is, of course, that they're not required to - but any actual human being should insure children even without being required to. Which of course means that those spokespersons and their ilk are subhuman. I mean, the lack of a requirement doesn't mean that you're forbidden from doing so regardless!

[Dreadnaught]

If the article is to be believed, the insurance companies did insure children but it's become prohibitively expensive due to Obamacare.

[Being]

If the article is to be believed, the insurance companies did insure children but it's become prohibitively expensive due to Obamacare.

That's not a fair interpretation. The fact that insurance companies stopped issuing policies for children without pre-existing conditions should clue you in. That is throwing money down the drain just so they can stick it to Obamacare for pure spite. They don't even care that they lose money on it.

[Dreadnaught]

Have you considered that Obamacare could contain mandates for any children's insurance that could make it unaffordable? The article was [badly] paraphrasing something. This is basically fourthand info, we have no real idea what happened.

[littlelolligagged]

I didn't get much more by watching the news last night, and haven't seen anything come up on any of the other stations or their websites.

I do think this is just the insurance companies being political, though. Make people angry enough and they'll vote for the people the insurance companies want - the ones who will do away with this completely.

[LittleFuzzy]

That is throwing money down the drain just so they can stick it to Obamacare for pure spite.

That strikes me as unlikely, considering the constant refrain we hear from you and the other anti-corporate types on their short-sighted profit-over-everything mentality. It flies directly in the face of what you consider their standard abusive practices.

[Being]

That strikes me as unlikely, considering the constant refrain we hear from you and the other anti-corporate types on their short-sighted profit-over-everything mentality. It flies directly in the face of what you consider their standard abusive practices.

No it doesn't. Spite does not preclude hope of financial gain. They probably see the money they let go down the drain as a bet on what Lolli said...

I do think this is just the insurance companies being political, though. Make people angry enough and they'll vote for the people the insurance companies want - the ones who will do away with this completely.

[Khendraja'aro]

If the article is to be believed, the insurance companies did insure children but it's become prohibitively expensive due to Obamacare.

Uh, what? The procedures don't suddenly cost more, the children don't become more sick - unless your private sector has become even more shitty than before. If that is even possible.

Ah, I understand. It's the "forced to insure children with pre-existing conditions"-part. Yeah, okay. Eugenics are okay, man. Better let those cripples die out before they reach procreation age than to pay for them and their weak-bodied offspring.

[Loki]

Uh, what? The procedures don't suddenly cost more, the children don't become more sick - unless your private sector has become even more shitty than before. If that is even possible.

Ah, I understand. It's the "forced to insure children with pre-existing conditions"-part. Yeah, okay. Eugenics are okay, man. Better let those cripples die out before they reach procreation age than to pay for them and their weak-bodied offspring.

Why don't we have the government force you to provide insurance to sick kids? You don't support eugenics, do you?

[GGT]

I think insurance companies want a broad mandate for the industry, so they all have to provide coverage for children. Same way it worked when they lobbied for ending exclusions for pre-existing conditions.

[Lewkowski]

THAN

I'd rather give a larger portion of our "GDP" into education and healthcare, THAN spending Trillions on weapons or wars that don't make much sense.

Defense is like what 4% of our GDP? Sure we could probably do with a bit less but even if we completely scrapped the military we are still looking at massive deficits due to entitlement programs.

[Khendraja'aro]

Why don't we have the government force you to provide insurance to sick kids? You don't support eugenics, do you?

I'm not an insurance company. Say, did you take some kind of drug to lower your IQ to room temperature or why do you make such a moronic argument?

[GGT]

Defense is like what 4% of our GDP? Sure we could probably do with a bit less but even if we completely scrapped the military we are still looking at massive deficits due to entitlement programs.

Iraq alone was projected to cost over 3 TRILLION, including veteran's health care needs. A few TRILLION here, a few TRILLION there. Pretty soon we're talkin' real money.

We also have military top dogs saying our populace isn't healthy enough to provide the strong soldiers needed.

[Being]

I wonder what Lewk considers to be entitlements?

[LittleFuzzy]

No it doesn't. Spite does not preclude hope of financial gain. They probably see the money they let go down the drain as a bet on what Lolli said...

So you're now saying that instead of seeking the easily-realized short-term profit maximization, their real motivation is simply to hurt and screw others, even when there's a good chance it won't make them any money. Yeah, sure. This is why Dread still has more credibility than you do.

[Ominous Gamer]

maybe I'm missing something, but the important line seems to be:

The Hollanders said both the insurance commissioner’s office and their state representative told them once insurance companies were required to insure kids with pre-existing conditions, they stopped writing new policies for healthy kids like Teri.

The kid doesn't have a condition, this is simply the insurance companies not writing new policies because if they wrote for some, they would have to write for all. If the kid did have a pre-existing condition the kid would have been denied anyway (and they still would have blamed the new law somehow I bet).
So for me, I see this as a short sighted way to save money. The underage devision is no longer as profitable as it once was, so instead of letting that effect stockholders, they drop it completely. Which in the long term means fewer customers transitioning over from child to adult policies....


Just another side effect of this country putting more faith into health insurance instead of health coverage, and letting the whole thing destroy its usefulness based on calls for profits. Imagine that, for profit insurance companies are only willing to allow us to pay them for coverage when they already know ahead of time that they will be coming out richer for it.
And our country has nothing to catch those that aren't considered profitable for the insurance industry. awesome.