Three months. Give the insurance company a max of three months from the date of application for coverage to conduct its due diligence and uncover fraud; then after that the contrast is no longer subject to rescission on such grounds. Sound fair?
And the default setting is that they pay, medications and procedures will not be held in abeyance awaiting court action.
Devoid of any frame of reference, I’d have to say that it seems fair to me.
Dopers who’ve bought houses: how long is a title search expected to take?
- Yes.
- I am not tolerating any fraud. I would not, however, allow an insurance company to rescind coverage for cancer because a patient was treated for acne.
- 90 days sounds fair.
- We are protecting the rights of patients who have paid premiums in good faith. Punishing greed is just gravy.
I see, you think we can legislate responsibility? That if we really harshly punish a couple the rest will fall into line? Maybe if we hang those that are guilty of insurance fraud that would stop too.
Sounds expensive and time consuming. I had to pay for the title search, and I had to wait for the title search before I could live in my house. I remember when I got car insure in Toronto about 15 years ago, I had to take my car to an approved mechanic whole checked the body work for damage before I could be fully ensured.
320million Americans each requiring a thorough vetting of their applications. Now you’ve added an extra cost for everyone, and also delayed their coverage until they are vetted. These revues are lengthy and expensive, which is why I assume companies only select a few.
Imagine if the IRS had to audit every single tax return before you got your refund.
And because of the 3 month (actual time is irrelevant) a company would never offer coverage until they can be 100% sure.
Like I said before, think this through: A bone marrow transplant is between $100,000 and $250,000. Your suggesting that insurance pay that out, allow the procedure, then wait for the court action. When the court determines it was fraud, how is the insurance company going to get that money back? I’m being serious here, that money is gone.
Now you’ve required both home and auto insurance to also thoroughly vet each application. Where you work, how far it is, what road you take… Every question on your application now has to be verified. Pull up an online quote for auto insurance and imagine how long each question would take.
I haven’t read the article, but if there was a question that said, “were you treated for acne.” and she said no, that’s fraud. it sounds stupid when compared to cancer, but the form asked her a question, and she answered falsely then signed her name.
I know it would make a lot more sense to you if the question had said, “have you been treated for cancer.” But the point is (in the general sense) that the insurance company asked her questions, they found out she lied, then they dropped her.
Now that I think about it, she still would have gotten cancer. Under the proposed guidelines they would have found her lie (assuming she didn’t get cancer in the year it took to vet her). And then either refused her coverage, or charged her more. She’s shown that she can’t be trusted, so I assume her premiums will reflect that.
.
This example really bothers me (even though I didn’t read the article) because this was the woman’s fault. Not the cancer part, that’s just our vengeful God. She knowingly lied on her application. Having never filled one out, I’m pretty confident it says something like, “List all of the medical treatments you have received in the past 10 years.”
It doesn’t say, “list the ones you think are relevant to the condition you think you might need insurance for.”
I’m going on too long here, but at least consider, if she needed skin cancer treatment, would it have been relevant?
See above. What ever time frame you pick just means that insurance companies can’t offer policies until they have been vetted for fraud. I assume that process will take more than a couple of days.
Yes, but at the same time you are protecting the patients that paid (lower) premiums under false pretenses.
Essentially, you’ve forced the entire insurance process to mimic passport applications and tax audits. Since we’ll start with a full verification of identity, then move on from there. (I picture some dude with a clip board driving to work with me like during my driving test)
Next, you’ll need agents keeping tabs on you. Your policy says you don’t smoke, so you’ll need to go in every 3 months for a swab.
This is why in between bouts of voting, I laugh through these debates.
You’ve got all these holes in your wall and wondering why your hammer isn’t working (hooray it works 85% of the time). Now you think if you “hang a few” it will act more like a screwdriver. This is default insurance behavior and has been as long as I can tell. It is not in any way unique to the US.
Please note that I’m not advocating any position here. I’ve already established my views on the matter. But to toss around a lot of essentially anti-business paranoia doesn’t help anyone other than S.A. who is compiling your statements and will use them to show what you want to do to private business.
ETA I’ve read the article and am wrong about a few of my points there. Please accept them in a more general case, not that woman specifically.
ETA wait, no, i was right, she lied all over her application. that’s fraud as far as I know
You can’t bring that shit in here. If you posted that as a pit thread, you would be at the bottom of the same outhouse as S.A..
“The reason? In May 2008, Beaton had visited a dermatologist for acne. A word written on her chart was interpreted to mean precancerous, so the insurance company decided to launch an investigation into her medical history.”
She developed cancer, after having what appeared to be something “precancerous.” That was the right thing to do.
“Beaton’s dermatologist begged her insurance provider to go ahead with the surgery.”
Begging isn’t how to get insurance coverage, but it does start with being on your knees.
“Still, the insurance carrier decided to rescind her coverage. The company said it had reviewed her medical records and found out that she had misinformed them about some of her medical history.”
“Beaton had listed her weight incorrectly. She also didn’t disclose medication she had taken for a pre-existing heart condition – medicine she wasn’t taking when she originally applied for coverage.”
There is no way this woman deserves to be covered. All she had to do was answer the application correctly.
Note that she had private insurance. Had she disclosed this information she wouldn’t have been covered in the first place.
This is an example of an insurance company acting exactly the way it’s supposed to.
If they had to vet her, she wouldn’t have gotten coverage in time to diagnose the cancer.
And she wouldn’t have gotten coverage at all (or that she could afford) because they would have found the acne case, and the heart condition.
If you’ll excuse me, I need to go vomit.
And so of course, it’s impossible to regulate insurance company behavior so as to eliminate this sort of malfeasance. Nope, the only answer is for the federal government to take over the nation’s health care. :rolleyes:
The fact of the matter is that insurance company malfeasance of the type you and elucidator and a few others around here love to point to (and why is it cherry-picking and meaningless anecdotal evidence whenever I talk about problems with UHC in other countries and/or here, but you guys can do it with insurance companies ad infinitum?) is relatively rare when compared to the number of claims filed and paid.
Parameters need to be set that don’t allow insurance companies to decline coverage for relatively minor reasons, but that can be done through force of law. There is absolutely no need to have the government take over the country’s health care in order to eliminate problems with insurance companies.
And besides, the government itself will be declining coverage and treatment when it feels that it’s appropriate to do so. There is no health care system in the world with unlimited funding, and unlimited funding is what would be required in order to provide coverage for everything for everyone.
And then we deaths due to wait times. In UHC countries where even patients with urgent heart conditions and at the top of the list for care may have to wait weeks for life-saving surgery, deaths most certainly will occur due to wait times from urgent conditions that aren’t treated in time or because they became urgent during wait times when their conditions were considered less urgent.
No, all of this is simply a smoke screen for what liberals in general want, which is for everybody to be able to go bopping into the doctor’s office whenever they want without a financial care in the world, and they are perfectly happy to trade quality and immediacy of care, months of suffering and deaths due to wait times and bureaucratic red tape in order to do so.
But of course those deaths and that suffering will be okay, because it will be the government causing them rather than some evil “for profit” company. And as we all know, government is loving and beneficent and has our best interests at heart and so if we suffer months or years with painful conditions because more urgent cases keep getting shuttled into the system ahead of us, or die because we’re having to wait weeks or months for treatment that we could now get immediately, well, the government is doing the best it can…and besides no one lives forever.
So in other words, people will still be getting denied, and they’ll still have nowhere to turn, and they’ll still be dying as a result, but because it is all being caused by a collective type of system that you favor, it will all be okay and considered an unavoidable consequence of life.
Time and again in my life I’ve seen liberalism promote things that are going to have bad or harmful consequences, and time and again I’ve seen liberals deny not only that no such things will happen but that only an idiot would think otherwise. Then, once things happen just as predicted, the liberal response is “So, what? Nobody cares about that. Besides, things are better now anyway.”
Yeah, well, that’s your opinion, and it’s a considerably different one than you had to begin with. So I’m sure you’ll pardon me if I take your claims about the wonderment of UHC with more than a few pillars of salt.
Again, in my opinon what needs to be done is that programs need to be institued to provide care that is urgently needed to the relatively small number of people among the uninsured who happen to need it, and to write restrictive legislation to prevent insurance companies from denying coverage based on trivialities, and let the 85% of the population who’s happy with their coverage continue on with it.
P.S. - It isn’t greed that creates the system in which insurance companies investigate for fraud or misinformation at the time coverage is requested rather than during the first ninety days or so. For one thing, you’re talking about detailed investigation of every applicant at the beginning of their coverage, which of course means that an investigation is done on one hundred percent of policy-holders rather than the relatively few during the years who file claims or request coverage.
And you are also completely leaving the door open for policy holders to affect changes in the way they live which would have resulted in higher rates or perhaps disqualified them from coverage at the beginning.
How on Earth does it make sense to say to people and insurance companies that it should be okay to set coverage prices and limits based on current circumstances, but that any and all future needs, regardless of policy-holder lifestyle changes and/or whatever condition they may develop, should be covered whenever it should be needed. Do you expect that you should be able to go to an automobile dealership and plunk down money for a small car based on prices now, and then be able to come back ten or fifteen years later and pick up a luxury car with all the options because you’ve already paid them for a car? Of course not, but that’s exactly what you’re proposing that insurance companies allow their policy-holders to when you propose that they take money based on current conditions but then extend coverage in the future no matter what. I wouldn’t go so far as to say that such a view is insane, but it certainly doesn’t make any kind of sense.
I honestly don’t know why you bothered writing all of that. You already wrote it, and were already shown it is wrong. The first half of your post contains zero factual content. You need to re-read it, recognize that what you wrote was factually incorrect, and then try again.
As an example: it is not possible to regulate the insurance industry to the point that it stops being an insurance industry. that’s not regulation, that’s creating something other than insurance.
“Parameters need to be set that don’t allow insurance companies to decline coverage for relatively minor reasons, but that can be done through force of law.”
No it can’t. If you did, it wouldn’t be insurance any more.
“And besides, the government itself will be declining coverage and treatment when it feels that it’s appropriate to do so.”
No it won’t, that’s not how government run health care works,: doctors decide individual treatment, not the government. I guess you could set up a system like that if you wanted to, but it would be fucking retarded, don’t do that.
“There is no health care system in the world with unlimited funding, and unlimited funding is what would be required in order to provide coverage for everything for everyone.”
There is no health care system in the world that NEEDS unlimited funding. Stop saying that. In any population, there is a fixed number of patients that need a bone marrow transplant. Unless you are suggesting that when it’s free people will choose to get one, but that you make you fucking retarded.
The simple, and demonstrated, solution is to provide needed treatments for free (heart surgery, except if its decided to be medically unnecessary by a physician), then charge for the things not needed (nose jobs). (except when the nose job was decided to be medically necessary by a physician).
That’s why all the problems that your 10 year old report highlighted haven’t destroyed their systems. Canada is still chugging along.
Notice that we have a public education system that doesn’t need unlimited resources. There is a fixed number of 8 year olds. And once done they aren’t eager to go back and repeat grade 3 (or 4).
Ask yourself, what is stopping you right now from going and getting a bone marrow transplant?
The rest of your post is full of equally retarded statements. That I haven’t quoted and commented on them is should not misconstrued as validating them. What you wrote was as fucking retard as Sarah Palin.
What an awesome offering, Starkers! Truly, you have outdone yourself, this is a Matterhorn of mendacity, an Everest of horseshit! Its like you hope to win your way by sheer verbiage. Never mind the Infinite Burrito, can God make a shovel big enough to dig through your crap?
Time and again, you are offered cites and evidence to substantiate these claims, solid proof that these outrages are not mere accident, but a matter of established policy. Which evidence you ignore. Then in almost the next breath you offer half-baked crapola from a propaganda arm of the Republican Party, ten years out of date!, without an iota of substantiation beyond itself, and expect that it should trump all others. With the “calm confidence of a Methodist with four aces”*, you offer us utter crap and expect us to reel away in confusion and dismay!
Astonishing.
Then, time and again, you claim to peer into the minds of others and ascertain motives hidden even from God, you know what liberals are up to, you don’t need proof, you don’t require evidence, you expect to banish all doubt because You Say So.
People with actual direct experience tell you what they know, people who actually live there tell you that you don’t know what you are talking about…and you tell us that they are all Yurpeens, brainwashed by a nanny-state and corrupted by socialism, so their opinions are worthless. Because You Say So.
You are a black hole of stupid, you have an event horizon of ignorance, information falls in and can never escape. Against such brainless certainty, mere truth is powerless, simple facts have no value, its like throwing popcorn at a brick wall.
You are a wonder for the ages, crystalline and adamant certainty, based on sheer emptiness, a vacuum as diamond.
*The Master
FUCK you are stupid. Those hypothetical deaths will NOT be okay. Neither are the deaths caused by insurance companies. Do you get that, NOT okay.
Fine
Time and again, I’ve seen conservativism blah blah blah
Good, you both suck, time to let the Canadian show you how it’s done. Neither of you are capable of raising the child, it will be cut it half.
You are so fucking stupid. How can you not realize how easy it is to argue against UHC?! But you can’t, you fucking suck so bad that you can’t argue against something so obviously flawed.
And while you think that justifies not using it you are once again wrong. UHC sucks fucking donkey balls. US style health care is worse.
YES
You for the first time ever just accurately described UHC. THAT is what we are trying to give you. Not the bullshit you describe where the government denies people. What you just wrote is UHC as practiced everywhere else in the industrialized world.
yes, thanks genius, we’ve already covered that. do try to keep up
One can’t help but feel, in the face of such sputtering condemnation, that one must be scoring points. It’s been my experience that when people come upon things they truly believe to be nonsense they largely blow it off, but when they think that valid points are being raised by their opposition, accusations of stupidity and shrieks of outrage follow as surely as the night the day.
And what are you trying to say about the Heritaqe Foundation piece, luci? That in the last ten years all the UHC countries have managed miraculous turnarounds and now find themselves functioning perfectly and utterly without problems? Or are you screeching because substantiation was offered to support it? Funny, I could swear that the least excuse for a cite is accepted unquestioningly and regarded as incontrovertible proof around here whenever it happens to disagree with me on something.
And what of the VA link which, contrary to endless claims around here to the effect that the VA is a paragon of excellent government care despite its decades-long reputation as “poor” to say the very least, and which illustrates perfectly my impression of how things operate in government offices?
People around constantly complain that I don’t post cites or offer evidence, and then when I do it gets called “cherry-picking” or that the authors were “looking for problems”. Well, duh! What do you think, that everybody should turn a blind eye to them like you do? Illustrating the problems with UHC is exactly what needs to be done when people are considering adopting it, don’t you think? Oh, wait…nevermind. Problems are only valid when it comes to the private care solution. What WAS I thinking. :smack:
And why are your anecdotal insurance company incidents probative, while mine count for nothing because they are…wait for it…anecdotal!?
No, the fact of the matter is that you are far more full of shit yourself than I could ever be, and IMO it is this fact that leads you to react in such a hysterical and yet amusingly impotent way.
Doctors don’t ask permission of the government (or the provincial health care plans) before treating patients, so the government doesn’t have the opportunity to “decline coverage” on an individual basis, at least in Canada and I presume in other UHC countries. Yes, some things aren’t covered, but that applies to everyone, just like your health insurance presumably does not cover all possible situations.
Why, bless your little heart, of course you do! You have declared victory several times already, just after admitting that your OP is going to straight your collection of The Dumbest Things Starkers Ever Said (11 volumes, 12,456 pages, Remainder House, not available in stores…) You are like a drunken blindfolded man, swinging away at a piñata fifty feet over his head, and each time he gropes around on the floor feeling for the candy that must have fallen after he totally pulverized it with that last swing! Hoist on your own retard.
“Trying to say”? I said it, in clear and uncertain terms: its a load of rancid whale dreck! You even apologized for it as you offered it, its woefully out of date, but you offer it anyway, apparently being too lazy to find anything more recent.
One wonders which is worse: that you could have found something better, but don’t respect your audience enough to bother, or you couldn’t find anything better, and this is the best you can do. Oh, wait, you were busy! Right? Well, are you busy now?
Aside from being the output of a decidedly partisan source (you do know that, don’t you? One worries, your poverty of fact gives one pause…), aside from that, its not really a study, is it? A study does not offer bald statements without substantiation, it simply doesn’t. One searches in vain for the surveys and studies referenced to support such statements.
Now, of course, it is typical for such studies to include their references at the end, like a scholarly book will have pages upon pages of references and citations. What does this study offer?
If offers you the opportunity to click on a link which will then reveal the exhaustive research. You did, of course, click that link, yes? Shirley you would never have put your sterling reputation at risk without checking? And what do we find?
Well, at least the exchange rate is verified! Did that convince you sufficiently? Did you say to yourself, “Well, they verified that fact, therefore all the rest of it must be equally well founded!”
And this gem, as I noted previously, which seems to have escaped your notice…
What in the name of Bleeding Og is that doing in something that wants to pretend to be a scholarly study? Are you kidding me, or are they kidding you, and you are too blind to see it? That isn’t data, that isn’t fact, that is a bald statement supported by nothing more than your credulity. And furthermore, an insult to those people who, like you and I, stand on the threshold of Later Youth.
How could you not have noticed it, having read the report entire? Further, how could you not have noticed that for all the bald statements of fact offered therein, there is not a shred of supportive evidence offered. Well, one, they got the exchange rate right. Credit were credit is due.
Please tell us that this is a joke, a droll bit of irony to show how not to make an argument. Please offer us some assurance that we are not arguing with a maundering old fool who has slipped prematurely into his dotage.
Or, alternatively, you could squat in your corner bleeding, Roberto Duran style, muttering “No mas! No mas!” and hoping we think that means “Victory is mine! Huzzah!”
Heck, I said something like that - the Heritage Foundation piece uses the perfect as enemy of the good, repeatedly trying to make the case that since the European systems aren’t problem-free, they should not be considered.
I’d’a thought a dispassionate, thoughtful, unbiased analysis would uncover problems with the various European systems but also solutions that could be applied to the American system, if one was looking for such. Frankly, my spidey-sense started tingling early on with this passage:
[quote]
Some Lessons
For Members of Congress and state legislators, there are some valuable lessons from the European experience that should be less surprising.
[ul][li]If you insist on government management of the health care system, do not expect freedom from waste, inefficiency, or inequity in the delivery of care (look at France). [/li][li]If you want to promise citizens a national or state program of universal insurance coverage, don’t expect that you will be able to deliver universal access to high-quality health care. You won’t and you can’t (look at Britain). [/li]If you want to fix prices for medical services, prescription drugs, or other medical devices, don’t expect demand for these goods and services to be met or investment in research and development to continue apace. It won’t (look anywhere).
[li]If you insist, with a straight face, that in a government-run health care system, all of your fellow citizens will be treated equally – regardless of their class, station in life, or disease condition – you are not merely enthusiastic or well intentioned. You are lying.[/ul][/li][/quote]
This and the other “lessons” sections assume a hypothetical person promoting that the U.S. adopt some kind of European system is a starry-eyed idealist (and/or a liar) who is utterly indifferent to or ignorant of reality. It’s unclear how HF feels about a person who has pragmatically concluded that some form of generalized government insurance is needed. Possibly HF can’t imagine such people actually exist. I don’t know - I’d never heard of them before reading this article.
The naming of specific countries in the above section raises my eyebrows, too - it suggests that in trying to discredit European-style health care overall, the authors chose the worst country in each case, i.e. cherry-picking, as I said earlier.
If this makes me, in your eyes, impotent or full of shit, so be it.
Yes. An insurance company, just like any corporation, is loyal first and foremost to its shareholders, NOT its customers. To show mercy and not rescind a policy whenever they are able to do so would be failure on their part to maximize shareholder profits.
Um, this is a bit awkward, so late in the game, but I didn’t realize that’s how we’re scoring things.
Is it too late to say that I truly believe everything you have said to be complete and utter nonsense?
As for the Heritage Article, I’m quite confident everything they found is true (including the old people that like to talk.) The reason it isn’t a valid cite (although an interesting read) is this:
If you insist on government management of the health care system, do not expect freedom from waste, inefficiency, or inequity in the delivery of care (look at France).
If you want to promise citizens a national or state program of universal insurance coverage, don’t expect that you will be able to deliver universal access to high-quality health care. You won’t and you can’t (look at Britain).
If you quoted that to me initially, my assumption would be that Britain has freedom from waste, and that France has access to high-quality care. And since they list only France, I am left to assume that all the other countries were free of waste, or else why just list France. If it was all of them, they’d say all of them. Why not say, France is an example of a system burdened with waste and inefficiency, but [insert country] has managed to all but eliminate it by [insert something].
Oh, and I think everything you’ve said so far is completely and utter nonsense, especially this:
"That in the last ten years all the UHC countries have managed miraculous turnarounds and now find themselves functioning perfectly and utterly without problems? "
I was thinking about the problem of wait times in Canada. The reason YOU know about this is because they got really bad, people freaked out, so the government made a push to correct it.
Why I think this is funny: in a few years, we’ll have dramatically reduced our wait times, but you’ll still be stupid.
BTW did you know Canada has essentially had a balanced budget since 1998. I believe they went into the red last year for stimulus spending.
I’m reminded of Bill Bryson discussing a Dodge commercial, which basically went “Rated #1 against Car X for running costs. Rated #1 against Car Y for reliability. Rated #1 against Car Z for standard equipment”, etc.
The logical conclusion, of course, being that the Dodge must have been worse than the cars it wasn’t rated #1 against in each category.