# Health care horror story #13848732 **URL:** \ **Category:** The BBQ Pit\ **Created:** [December 26, 2009, 8:01am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612 "2009-12-26T08:01:41Z")\ **Posts on this page:** 20\ **Page:** 10
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [December 29, 2009, 1:03am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/181 "2009-12-29T01:03:02Z")
I’m not **curlcoat** , so maybe I can get a straight answer… It is assumed that all of the healthy people need to be in the insurance pool and therefore share the costs and help out those less fortunate - it is considered to a duty of the healthy citizen, right? So, do the parents in the OP, under a UHC system, have any obligation to abort a defective baby, one that will eat up health care dollars for years, and may die at the end of it, thereby wasting the “social investment” of the members of the UHC pool? ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [December 29, 2009, 1:24am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/182 "2009-12-29T01:24:12Z")
Healthy citizens have accidents too. You can chop off a finger, get in a car accident, fall off a ladder , blow a knee playing softball etc. Life is a crapshoot. You can get hurt at nearly any time. Because you are in a statistically advantaged group does not mean you will not get hurt or shouldn’t have insurance. ---
**Author:** ![Merijeek](https://avatars.discourse-cdn.com/v4/letter/m/f05b48/32.png) [@Merijeek](https://boards.straightdope.com/u/Merijeek)\ **Post date:** [December 29, 2009, 1:52am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/183 "2009-12-29T01:52:17Z")
> [@What\_the](#): > > Have you heard the one about the guy who goes into a hospital and comes out all better and the insurance company paid everything they were contractually obligated to pay? Not really. I do know the one about my wife who just received a bill for a preventative visit from December 2008. Apparently they just decided that they don’t actually want to pay it. It took them a year to figure it out, it seems. Private enterprise is so efficient! -Joe ---
**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\ **Post date:** [December 29, 2009, 2:04am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/184 "2009-12-29T02:04:32Z")
> [@Johnny\_L.A](#): > > ‘If [the child is likely to] die,’ said Scrooge, ‘[it] had better do it, and decrease the surplus population.’ Or the poor folks could start following Swift’s satirical advice and start eatin’ on all those darned extraneous babies. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [December 29, 2009, 2:30am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/185 "2009-12-29T02:30:34Z")
> [@Sateryn76](#): > > I’m not **curlcoat** , so maybe I can get a straight answer… > > It is assumed that all of the healthy people need to be in the insurance pool and therefore share the costs and help out those less fortunate - it is considered to a duty of the healthy citizen, right? > > So, do the parents in the OP, under a UHC system, have any obligation to abort a defective baby, one that will eat up health care dollars for years, and may die at the end of it, thereby wasting the “social investment” of the members of the UHC pool? Am I the only one who is also seeing this constant “abort it!” attitude a wee too close to eugenics? ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [December 29, 2009, 3:16am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/186 "2009-12-29T03:16:20Z")
No, you’re not. North America and Europe tried eugenics in the early 20th Century. By the time the dust - well, ashes, actually - settled about 12+ million people had been slaughtered like animals. Do people really want to do that all over again? ---
**Author:** ![jayjay](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jayjay/32/6765_2.png) [@jayjay](https://boards.straightdope.com/u/jayjay)\ **Post date:** [December 29, 2009, 3:23am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/187 "2009-12-29T03:23:23Z")
It doesn’t have anything to do with the poor deformed babies. The anti-UHC people are using the poor deformed baby as a stalking horse to try to show UHC as immoral and unworkable. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [December 29, 2009, 3:24am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/188 "2009-12-29T03:24:54Z")
> [@Sateryn76](#): > > …So, do the parents in the OP, under a UHC system, have any obligation to abort a defective baby, one that will eat up health care dollars for years, and may die at the end of it, thereby wasting the “social investment” of the members of the UHC pool? This sort of progressive socialism may have to await the total completion of the Obamist state. But most likely in such circumstances the parents would report to the People’s Reproductive Integrity Board for counseling and discipline. I don’t expect this sort of progress will be feasible until the President for Life Amendment is passed and ratified. ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [December 29, 2009, 3:36am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/189 "2009-12-29T03:36:47Z")
> [@Guinastasia](#): > > Am I the only one who is also seeing this constant “abort it!” attitude a wee too close to eugenics? Not at all. I (sadly) have several loved ones with disabilities, including a cousin missing part of his brain, and a cousin with severe spina bifida. I certainly don’t wish them dead/unborn. I’m just trying to see if some of you on the other side of this can see where I’m coming from. A severe disability is an easy, clear cut example of someone who cannot use the UHC pool “fairly” (for lack of a better word). Another, less severe example would be someone who drinks his/her liver to death, an obese person who refuses to eat healthily, or simply a nervous mother who drags their kid in for every sniffle. There are the kinds of problems that require serious resources, and can also be prevented. I am being required to pay more to cover those people - doesn’t it seem reasonable that those on the “other side” be expected to make better decisions when it effects the UHC pool? ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 29, 2009, 4:03am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/190 "2009-12-29T04:03:44Z")
> [@gonzomax](#): > > Saying they can not deny coverage without cause misses the point. You missed my point. They cannot deny coverage without _legal_ cause. And it is your policy that determines cause, so you would know up front if something is covered or not. If you feel you have been denied without legal cause, talk to your insurance commissioner. Or you could whine on a message board about how awful the insurance industry is. > [@Broomstick](#): > > Yes, I do expect that, because of the type of industry this company is in. And, this may blow your mind, but not every health insurance company is publicly traded, they don’t all have stockholders. This sort of crap is why I think health insurance should be a strictly not-for-profit enterprise as it is the for-profits that are the worst offenders. I don’t know of any not for profit insurance companies that have managed to stay afloat - not even sure that they could. As for expecting that insurance companies will care because yet another person has had some sort of major health issue, well beyond it being unrealistic, if they just willy nilly pay out because they feel sorry, they aren’t going to stay in business long are they? And if they go under, there goes the coverage for all of their other insureds. I snipped a bunch of stuff here that is obviously you choosing to misunderstand what I posted, since your post is long enough as it is… > [@](#): > > And, if I recall, I have been more recently employed in the health insurance industry than you have. I have no idea - my last was Sept 2007. However, if I recall correctly, your experience was limited to Blue Cross? > [@](#): > > Actually… that is not true. Back when I worked in social services we had several women who were barred from having custody of children. One of them continued to produce babies, Which is exactly what I said. What happened to the babies after the babies were born is immaterial to this discussion. > [@](#): > > Once again, we have someone dehumanizing a disabled person, in this case a child, by referring to the person as an “it”. Honey, just because you are sensitive to the term it for a fetus that one doesn’t know the sex of, or even a baby, doesn’t mean it is actually “dehumanizing”. I have heard pregnant women call their fetus it when they don’t know the sex, and I am certainly not going to type out he/she/whatever each time I refer to this baby. Get over yourself. > [@](#): > > **curlcoat** , why don’t you just admit you view the disabled as sub-human - except for yourself, of course. :rolleyes: Calling an unsexed fetus/baby “it” has zero to do with disability. > [@](#): > > You’re disabled, but apparently we’re supposed to give you equal status to the rest of us. Actually, I have better status than the normal abled person (or whatever the PC term is these days) in many areas. Not that I care either way what faceless strangers on the internet decide to do WRT my status. > [@](#): > > And when the parents pass away? Should we just let the disabled starve, homeless on a sidewalk? Is that what you’re saying? Obviously not. > [@](#): > > Since you’re not a tax payer but rather a government money collector why do you care? I still pay quite a bit of taxes - you should look into things before you make an ass shooting your mouth off. Which leads us to this example… > [@](#): > > You’re on the government benefit rolls - you don’t pay for anything. Here is another example of how little you know as to why I am _not_ on any sort of government welfare. I still pay almost all of the taxes that you do, including federal and state income tax. My husband, who is and has always been our major source of income, still pays all the same taxes (and in California, probably more) than you do. My friends, some of whom are on fixed incomes, all still pay taxes. The state of California is going under in a sea of red ink due to all of the taxes levied to give people who don’t pay much if anything in taxes food, shelter and healthcare. And now you want to do that to the whole country? > [@](#): > > Don’t you have Medicare - you know, the _government health system?_ No way. > [@](#): > > Oh, please - no one ever breaks the law? Get real. Oh please, get real. Why do you think we have law enforcement if no one ever breaks the laws? If there was as much graft in the insurance industry as you all try to claim, there would be folks looking into _that_ and not trying to push thru some sort of UHC, which apparently the majority doesn’t want. > [@](#): > > Not everything, but life-saving treatment is almost always covered. Due to this being a third party story, we don’t know for sure, but my impression of the OP was that the baby would live without the care from the other hospital, just not as long. That is not the definition of life-saving treatment. > [@](#): > > Normal childbrith costs money, but it’s a leap to say it’s _very_ expensive. The average new SUV costs more than a _normal_ childbirth. You don’t think the average new SUV is very expensive? > [@](#): > > If the child is covered the health insurance company really is obligated to spend the “hundreds of thousands of dollars” on the child’s care. Regardless of prognosis. Only on those things covered by the policy. > [@](#): > > And can we clear something up? It’s NOT the “policyholder” that will be paying out, it’s the _insurance company_. Didn’t you say you were in the industry and understood how group insurance works? The policyholder is the employer, not the individual employee. And when the employer has an employee that runs up huge bills, or has a bunch of employees who run up big bills, that almost always results in a higher premium the next time around. Or no policy at all. If an insurance company has to pay out significantly more than what they estimated/budgeted for, they are going to recoup that in premiums. And most (all?) employers pay some of that premium, as well as the employees. > [@](#): > > Yes. The insurance company sold a policy promising to cover health care. No. Full stop. No insurance company in the world, even your precious UHCs, promise to cover “health care”. What they sell are policies that cover lesser or greater sections of health care. And this is probably the big problem people have with insurance of all kinds - they assume because they have X insurance, when Y happens they won’t have to pay for it. Whether or not it is clearly stated in their policy that Y is or isn’t covered. > [@](#): > > You also seem miffed someone might staying home to take care of the kid. I said nothing at all about that. I couldn’t care less as long as they don’t try to use that choice as an excuse to be supported. I actually think it is better all around if a parent stays home and raises kids while they are young. > [@](#): > > It’s not “stupidity”, it’s a fact you handed to us. Your belief that SSDI is the same thing as welfare is the stupidity I was referring to. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [December 29, 2009, 4:43am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/191 "2009-12-29T04:43:28Z")
> [@curlcoat](#): > > I don’t know of any not for profit insurance companies that have managed to stay afloat - not even sure that they could. Most of the primary license holders for Blue Cross Blue Shield are still non-profit and they’re doing quite well. Only two of them have stockholders, the rest do not. So yes, you actually DO know of not-for-profit health insurance companies, you were just ignorant of that fact. > [@](#): > > And if they go under, there goes the coverage for all of their other insureds. Right now I think the best thing for this country is for the whole house of cards that is the health insurance industry go belly up so we can get a single-payer system like the rest of the civilized world. But I’m not going to hold my breath. > [@](#): > > I have no idea - my last was Sept 2007. However, if I recall correctly, your experience was limited to Blue Cross? Right - “limited” to a health care system with 100 million lives covered, a system that has been in existence for over 70 years. :rolleyes: > [@](#): > > I am certainly not going to type out he/she/whatever each time I refer to this baby. Why not? I’ve managed to avoid using “it” in this discussion. Typing “he or she” isn’t that great an effort. > [@](#): > > Actually, I have better status than the normal abled person (or whatever the PC term is these days) in many areas. Clearly you think you do - that’s why you feel entitled to collect government money while shitting on the head of anyone else who does. > [@](#): > > I still pay quite a bit of taxes - you should look into things before you make an ass shooting your mouth off. Which leads us to this example… > > Here is another example of how little you know as to why I am _not_ on any sort of government welfare. I still pay almost all of the taxes that you do, including federal and state income tax. My husband, who is and has always been our major source of income, still pays all the same taxes (and in California, probably more) than you do. So, what you’re saying is you don’t even have the excuse of _need_ - you collect government money every month when you actually could survive without it if you had to. Meanwhile, you shit on the head of any who actually _needs_ help. Have I mentioned you’re a hyopcrite? Entirely lacking in human empathy? You are one selfish excuse of a human being. Yes, you DO collect money from the Federal government _every single month_, and that money comes from the Federal taxes paid by _other people_. How in the hell is that different than welfare? > [@](#): > > My friends, some of whom are on fixed incomes, all still pay taxes. The state of California is going under in a sea of red ink due to all of the taxes levied to give people who don’t pay much if anything in taxes food, shelter and healthcare. And now you want to do that to the whole country? No - I just want to see people get an adequate amount of food, enough shelter to stay alive, and sufficient medical care that they don’t die preventable deaths or live in preventable abject misery. I don’t really care for the notion that a wealthy, spoiled suburbanite collects a monthly government payout that she doesn’t really _need_ for actual survival while pissing on those less fortunate than herself. People on fixed incomes pay taxes - boo-fucking-hoo. People below the poverty line pay taxes, too, especially those without children. Cry me a river. If people didn’t pay taxes you wouldn’t be getting your government check every month. Enjoy your welfare payout, hypocrite. If California has become so hellish for you MOVE ELSEWHERE. Seriously, if it’s as bad as you claim why in the hell do you stay? Move somewhere that has a lower tax rate and isn’t as generous in regards to public safety nets. > [@](#): > > You don’t think the average new SUV is very expensive? Nope. I don’t. The average American family is capable of purchasing one and paying it off in five years, should they find that owning own is a priority for them. That’s not _cheap_, but it’s not “very expensive” by my reckoning. I’ve known people who had kids without health insurance and negotiated a payment schedule for the debt and then kept to their agreement and paid it off over a number of years. For that matter, my husband at one point required experimental surgery to prevent the amputation of one of his legs. He arranged a payment schedule and paid for the whole amount over the course of ten years. I’d say, as a rule of thumb, that anything $50,000 or under _could_ be paid off by the average American family over 5-10 years IF they are allowed to set up a reasonable repayment schedule. It may require other things be put off, but it’s doable. However, once you get into six digit medical bills this is no longer feasible. When the debt climbs over a quarter million bankruptcy is almost certainly inevitable. > [@](#): > > Didn’t you say you were in the industry and understood how group insurance works? The policyholder is the employer, not the individual employee. And when the employer has an employee that runs up huge bills, or has a bunch of employees who run up big bills, that almost always results in a higher premium the next time around. Or no policy at all. If an insurance company has to pay out significantly more than what they estimated/budgeted for, they are going to recoup that in premiums. And most (all?) employers pay some of that premium, as well as the employees. The insurance company pays out first. And the policy holder is free to choose a different provider the following year whether or not there have been any large payouts. The insurance company is on the hook for payment for covered services with no guarantee they will recoup that from the policyholder. That’s why health insurance companies are required to keep a certain amount of money in reserve earmarked _only_ for payments for covered services and nothing else, to make sure there is enough money to cover that potential liability. > [@](#): > > No. Full stop. No insurance company in the world, even your precious UHCs, promise to cover “health care”. What they sell are policies that cover lesser or greater sections of health care. And this is probably the big problem people have with insurance of all kinds - they assume because they have X insurance, when Y happens they won’t have to pay for it. Whether or not it is clearly stated in their policy that Y is or isn’t covered. Except it is clear from the OP that there is, in fact, some dispute about whether the needed treatment is in category X or category Y. If it’s a covered service the insurer is obligated to pay - but may well be delaying and trying to get out of it on a technicality since doing so might save a million dollars (or more). That’s quite an incentive to look for technicalities, don’t you think? > [@](#): > > Your belief that SSDI is the same thing as welfare is the stupidity I was referring to. Actually, _nothing_ is called “welfare” any more, nor is “welfare” just one particular program. You may view yourself as a superior person for not collecting welfare, but the fact remains that you accept a check from the government every single month. You justify that by saying that you paid taxes all those years… yet you would deny the same justification for others who have paid taxes, and you “justify” the insurance company in the OP leaving parents and ill baby on the hook _despite_ faithfully paying premiums. You are looking for a technicality - they asked for something not covered, or they didn’t give the right information, or something, _anything_, to “prove” the parents in the wrong. Well, your time in the insurance industry certainly trained you well - the patient needing care is always wrong. Just as you view those receiving a government benefit as wrong. Except for you. Because you’re special or something. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 29, 2009, 4:44am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/192 "2009-12-29T04:44:16Z")
> [@legalsnugs](#): > > \*\*curlcoat \*\*has explained in [this thread](http://boards.straightdope.com/sdmb/showthread.php?t=542914) why she feels entitled to her monthly government disability check: because she paid into the social security system through her 35 year employment. She ignores these facts: I ignore none of that (oh, except that part where I paid into it as a safety net. I paid into it because I was forced to). What you ignore is that everyone that lives long enough gets their social security money back. Why you all think my taking mine as disability rather than as retirement-at-62 is some sort of welfare continues amaze me. > [@](#): > > She would undoubtedly shriek like a bansheee if SS suddenly told her that for whatever reason she will not receive any more benefits. Actually, when they didn’t pay me for three months, all I did was call them three times and go into the SS office once. Didn’t shriek ever. I no more believe that the SS dept can run efficiently and correctly at all times than I believe that any insurance company can. You should try dealing with the government sometime, if you want to see denial without cause in action… > [@Enderw24](#): > > Either way, I think the best solution would have been for the Democrats in Congress to have united back in August and said “you elected us to do a job, we’re going to do it. You simply cannot comprehend how much better UHC will be for this country so we’re just going to go ahead and vote for it against your protestations. If you want to vote us out, vote us out…but you won’t. Because as soon as it gets passed you’ll wake up and realize that you didn’t know what the hell you were talking about and that this was a long overdue overhaul.” Only, you know, more diplomatically. Ah. You want the Democrats to act in an undemocratic way? Force something on us because they (or you?) know better? Instead of, you know, actually going the less damaging route of reforming what we already have in place? Must be nice to know what’s best for everyone… > [@ntucker](#): > > And the fact that it is so absurdly expensive is part of the problem. You see, if there weren’t so many uninsured people, there wouldn’t be so many people failing to pay their medical bills, and the hospitals wouldn’t have to inflate the prices of routine care to outrageous levels to compensate. So, the expense of buying the equipment and drugs, the expense of paying high salaries to specialists, the expense of malpractice insurance and on and on - that has nothing to do with the prices of the “routine care” of you all deciding to have a baby? It’s all of these people not paying their bills that cost so much, eh? I wonder where those folks are, since in all the times I’ve been in hospitals and out patient clinics, I’ve never been able to get past the front desk before my insurance was verified. > [@](#): > > Sure, because when party A fails to uphold their end of the contract, it is party B’s fault for failing to report it to the proper agencies. It’s party B’s fault when all B does is whine about something that happened without taking some responsibility for the issue. > [@](#): > > I might add that having a newborn baby and a wife with two nonfunctional feet leaves one with slightly higher priorities than wading through bureaucracy and will you please forgive me if I express dismay at the state of affairs when the insurance company’s default position is to screw me until I force them to fulfill their obligation. Obviously you haven’t bothered to find out how easy it is to use your insurance commissioner. > [@](#): > > I am starting to get the impression that UHC’s business model is making money on the float they enjoy by delaying payment for as long as possible, with a side benefit for their employees of making a sport out of trying to raise my blood pressure. It could be - as I said I have no love for UHC. However, if folks like you don’t bother to use the recourses that are available, then UHC will be able to continue to do these things. Funny how they don’t do it to me, since I sicc’d our insurance commissioner on them… > [@](#): > > If there were actually a free market, this sort of behavior on their part would hurt their bottom line because customers would be abandoning them for insanely shitty service. Which is one of the things that should be addressed, rather than forcing a UH on all of us. Instead, you want one entity to provide payment for our health care - what will you do then when the government denies your claims? ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [December 29, 2009, 5:19am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/193 "2009-12-29T05:19:31Z")
> [@Fear\_Itself](#): > > Employers are not required to pay for health insurance. It is a voluntary benefit they offer to attract and keep valued employees. Yeah, but as health costs go up fewer are offering them. I think in 1993 about 75% of jobs offered health care. Now it is around 50%. And of the ones that do the policies tend to have higher copays, deductibles and may only cover the employee (and not their family). Part of me wonders how much it’d cost to stop all these rescissions and pre-existing condition denials. I heard Bill Clinton once say that health insurance companies spend $50 billion on overhead denying care. But I assume the cost of the care denied is far more than that. But how much exactly? After you subtract the higher overhead & penalties when caught, how much do health insurance companies save each year by doing this? I would assume it isn’t a giant number. For one thing, about 50-60% of health bills are paid by the public sector. That only leaves about 1.1 trillion in health spending. I have no idea how much of that is done by insurers, but I thought about half of the remaining was done by consumers, half by insurance companies. So insurance companies may only be paying out and taking in $500 billion a year when all is said and done. According to this private health insurance is a $300 billion dollar a year industry. So the savings from these destructive processes can’t be ‘that’ high. They have to be a fraction of $300 billion. [http://sunnyvalehealthinsurancequote.com/tag/individual-health-insurance-plans/](http://sunnyvalehealthinsurancequote.com/tag/individual-health-insurance-plans/) There are denials in the public system too. Medicare and medicaid deny coverage for certain treatments or providers. But all in all, I seriously doubt it’d cost ‘that’ much (in collective terms) to end these destructive processes (not covering pre-existing conditions, looking for technicalities to avoid paying, delaying care, etc). For one thing, insurance companies would save money on overhead by not denying so many cases. It would cost more at the end of the day, but probably not by more than $50 billion or so (as a guess). That kind of money could be had with a 0.33% payroll tax. I’d pay a 0.33% payroll tax to dramatically improve quality of life and eliminate health insecurity. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 29, 2009, 5:33am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/194 "2009-12-29T05:33:43Z")
> [@Polycarp](#): > > I’d welcome a non-polemic discussion of what the distinction is from **curlcoat** ;s perspective. The distinction is this, and it is quite easy. SS is a forced government pension/long term disability plan. Because it has been handled badly since the beginning (by the government? What a surprise :eek:), the money paid into SS now goes right out to pay those who are retired/disabled. Because of that little fact, some people here think that SS is the same thing as all of the taxes I pay to support people who don’t work, have never worked and don’t intend to work. Or, who do work but find having three kids and a couple of SUVs to be more important than getting insurance. Or, they do work but because they couldn’t be bothered to finish high school they can’t get a decent paying job. We already have Medicaid for those people who simply don’t have the money to get insurance or health care on their own. Then we have all of these people, usually dubbed the working poor, who have made their own choices on what to buy that doesn’t include insurance. So we are supposed to create this new government money hole to provide cheap insurance to people who have already chosen not to pay for it at full price because they wanted to buy other things. All of this taxpayer supported payment of various things over the decades has just created an ever growing entitlement minded section of our society. Too many seem to think they deserve whatever they want, whenever they want it, whether they can actually afford it or not. If anything bad happens, somebody - i.e. the taxpayers - will take care of them, right? > [@legalsnugs](#): > > Her posts show absolutely no sympathy for the insureds who, like her, paid into a system and expected the system to be there for them when they needed it - whether their child was born healthy or not - only to be disappointed. The OP’s people don’t want Medicaid; they want their insurance to pay for the necessary healthcare they thought they were entitled to by virtue of paying into the system for years. You don’t know that at all. For some bizarre reason, you seem to think that if our _government_ was running health care, things like denying extraordinary care to a baby that is most likely going to die anyway wouldn’t happen. You have no way of knowing, based on the information in the OP, that the second hospital is giving that baby _necessary_ health care, or it could just be a Hail Mary. And if you want to compare it to SSDI, you could do it only if I had expected to get my full benefit when I applied for disability, instead of the essentially half benefit I get because I didn’t wait until retirement age. But I didn’t expect to get my full benefit, nor did I expect to be paid for the time I was on state disability - I followed the rules of that contract. It appears that the people in the OP didn’t. The fact that they paid into that system has nothing to do with anything if they didn’t follow the rules of their contract. Having health insurance doesn’t mean you can go get any and all medical care you want. > [@](#): > > What if the government discovered on review that under their policy she really wasn’t disabled enough or they decided not to cover her specific disability any more, and cut off the monthly checks? Which is always possible as they do review. If it happens, I’ll do whatever I can under the law, and then deal with the result. > [@](#): > > Maybe we should ask her directly if she is expecting the entire U.S. government to care that she became disabled? No - why would I expect or even want the government to care either way about my disability? I don’t expect them to care and I really doubt they do. > [@Nava](#): > > And I’d like to hear why does she think that she’s entitled to not be euthanized, while that child had to be aborted for no other reason than to save money. Who said that the child should have been aborted _for no other reason than to save money_? As for euthanasia, it’s illegal. Many folks with one of the medical issues I have end up committing suicide - I’ll let you know if I decide to do that. :rolleyes: ---
**Author:** ![Idle\_Thoughts](https://avatars.discourse-cdn.com/v4/letter/i/838e76/32.png) [@Idle\_Thoughts](https://boards.straightdope.com/u/Idle_Thoughts)\ **Post date:** [December 29, 2009, 6:11am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/195 "2009-12-29T06:11:25Z")
Curlcoat will now have the last word in this thread. Give it up now, everyone. It’s inevidible. She’s got her claws in this one. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 29, 2009, 7:40am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/196 "2009-12-29T07:40:43Z")
> [@Broomstick](#): > > Most of the primary license holders for Blue Cross Blue Shield are still non-profit and they’re doing quite well. Only two of them have stockholders, the rest do not. So yes, you actually DO know of not-for-profit health insurance companies, you were just ignorant of that fact. Am I? According to [this](http://www.consumersunion.org/conv/conversions_101/nonprofit_health_sector_history_and_trends/index.html), the BX’s of California have been for profit since 1996, and that started “a domino effect on other Blue Cross and Blue Shield plans”. Perhaps it is only the private coverage part of BX/BS that is still mostly non-profit? > [@](#): > > Right now I think the best thing for this country is for the whole house of cards that is the health insurance industry go belly up so we can get a single-payer system like the rest of the civilized world. But I’m not going to hold my breath. I’d say that I hope you don’t really mean that, but since you have said so many ridiculous things, I fear you really do think this would be a good idea. For the whole country to be without insurance, with the majority unable to pay for health care for however many years it would take to get something up and going to replace the loss of those insurance companies. Shall we start now, with you, with the expenses you have coming up? Are you willing to wait for a couple of years for medical care? > [@](#): > > Right - “limited” to a health care system with 100 million lives covered, a system that has been in existence for over 70 years. :rolleyes: Which means it is likely you have not seen as many different policies as someone who has worked for several large national companies. > [@](#): > > I’ve managed to avoid using “it” in this discussion. Typing “he or she” isn’t that great an effort. One reason why your posts are too long. It’s your hangup, don’t expect that everyone else will share it or be willing to adapt to it. > [@](#): > > So, what you’re saying is you don’t even have the excuse of _need_ - you collect government money every month when you actually could survive without it if you had to. A goodly number of people could survive on less than they are bringing in now, yet they still take their money because they earned it. Just as I earned the SS from paying into it for those 35+ years. > [@](#): > > Yes, you DO collect money from the Federal government _every single month_, and that money comes from the Federal taxes paid by _other people_. How in the hell is that different than welfare? You consider all money that comes from the Federal government welfare? All retirees are on welfare? > [@](#): > > No - I just want to see people get an adequate amount of food, enough shelter to stay alive, and sufficient medical care that they don’t die preventable deaths or live in preventable abject misery. Huh. Sounds like the programs we already have in place! Oh, unless you don’t have kids, then society will let you die. > [@](#): > > If California has become so hellish for you MOVE ELSEWHERE. California is an example dipshit. California is already doing what you want to do to the whole country. But it is typical of you to say that we should seriously lower our quality of life in order to support people who haven’t been bothered to be responsible for themselves. > [@](#): > > Nope. I don’t. The average American family is capable of purchasing one and paying it off in five years, should they find that owning own is a priority for them. That’s not _cheap_, but it’s not “very expensive” by my reckoning. Wow. Just…wow. Five years of payments on something that isn’t at all necessary, and you don’t consider that very expensive? The cheapest Ford SUV according to their site starts at $20K and over five years it’s a bunch more. It’s at least $400 a month, which is just under a quarter of our monthly bills, including mortgage. That must be an example of how so many people get themselves into financial trouble. Can’t afford it? Buy it on time. > [@](#): > > I’d say, as a rule of thumb, that anything $50,000 or under _could_ be paid off by the average American family over 5-10 years IF they are allowed to set up a reasonable repayment schedule. It may require other things be put off, but it’s doable. However, once you get into six digit medical bills this is no longer feasible. When the debt climbs over a quarter million bankruptcy is almost certainly inevitable. This has what to do with anything? > [@](#): > > The insurance company pays out first. And the policy holder is free to choose a different provider the following year whether or not there have been any large payouts. The insurance company is on the hook for payment for covered services with no guarantee they will recoup that from the policyholder. That’s why health insurance companies are required to keep a certain amount of money in reserve earmarked _only_ for payments for covered services and nothing else, to make sure there is enough money to cover that potential liability. This has what to do with anything? (Other than you’ve suddenly remembered what policyholder means). > [@](#): > > Except it is clear from the OP that there is, in fact, some dispute about whether the needed treatment is in category X or category Y. It’s clear in the OP that the parents _think_ there is a dispute, except it is about where the treatment is to be done. They were told they went out of network, which is a pretty cut and dried thing if they have an HMO, which is what this appears to be. > [@](#): > > That’s quite an incentive to look for technicalities, don’t you think? Going out of network is hardly a technicality. > [@](#): > > Actually, _nothing_ is called “welfare” any more, nor is “welfare” just one particular program. :rolleyes: Whatever. You pick a term you like and I’ll try to remember to use it. > [@](#): > > yet you would deny the same justification for others who have paid taxes, No, I don’t. I have been very clear that I am talking about those people who expect to get cheap medical insurance from the taxpayer when they could have afforded it themselves if they hadn’t purchased those SUVs that you think are so easy to afford, or had those 2-3 kids, or bought a house they couldn’t afford, or or or. I have no trouble with extending Medicaid to those who cannot qualify for insurance or who have been maxed out. I am just tired of paying so that the irresponsible can have their kids, houses and SUVs. > [@](#): > > and you “justify” the insurance company in the OP leaving parents and ill baby on the hook _despite_ faithfully paying premiums. No, I didn’t. I merely bring up the point that not everything is covered just because one has insurance. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [December 29, 2009, 9:41am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/197 "2009-12-29T09:41:30Z")
nm ---
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [December 29, 2009, 11:27am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/198 "2009-12-29T11:27:04Z")
And now we’ve had the “there’s Medicaid for truly poor people and everyone else is just an idiot who makes bad choices” lie and therefore the thread is officially murdered by the barrage of typical Curlcoat inanity. ---
**Author:** ![legalsnugs](https://avatars.discourse-cdn.com/v4/letter/l/45deac/32.png) [@legalsnugs](https://boards.straightdope.com/u/legalsnugs)\ **Post date:** [December 29, 2009, 2:09pm UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/199 "2009-12-29T14:09:06Z")
Curlcoat, you blow my mind! You disdain the government for “making” you pay into SS, but if it hadn’t, you wouldn’t be getting any disability benefits now or retirement benefits at 66. You should be thanking the government each and every month for thinking ahead so you could be taken care of! You do realize that you will, if you live your actuarial lifespan, receive far more in benefits than you personally ever paid in. Your employers matched those contributions, you know. And the rest of us tax-payers are making up any shortfall right now. And yes, they were and we are forced to do that - for YOUR benefit. How about some gratitude? What happens if (God forbid) your husband loses his job? Do you go on the hated and despised Medicare (_shudder_)? Or do you pony up for the private COBRA health insurance? I’m betting Medicare will suddenly become a lot more palatable to you. Your pro-insurance company arguments have been all about healthcare vs. money, ala why should the healthy pay for the care of a child who will probably die soon? Okay, why should my tax money go to someone who’s disabled? If we just stop providing for them, maybe they’d die sooner and stop using up money that could go to someone who’s not disabled who can really enjoy their earned retirement benefits. Puh-leeze. We do not begrudge people Medicaid or Medicare or SS or SSDI because we care about people. We care about sick children and sick adults who expect their health insurance company to pay for their healthcare! We care about poor people, people who cannot take care of themselves for whatever reason and we care about people like you who need help. We want a healthy society. We can see clearly who you care about and your attitude is just sad. My feeling is that if all those CINOs out there really behaved like Christians ought - according to the words of Jesus - healthcare reform would never have become necessary. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [December 29, 2009, 2:31pm UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/200 "2009-12-29T14:31:47Z")
> [@curlcoat](#): > > Who said that the child should have been aborted _for no other reason than to save money_? No other reason has been given. [Previous page](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612.md?page=9) [Next page](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612.md?page=11)