Monday, June 8, 2009

What private health care did for me

a letter from ALICE: 

"I've been listening to a lot of commentary on a new health care bill. . . and I'm getting angry.  It doesn't matter who the pundits are.  They talk about 2 choices --- government run care or choice of patient & doctor.  My experience is there is a big, big elephant in the room that RARELY, I mean RARELY gets mentions.  If it does it is in passing.   The beaurcrats in the Insurance industry are deciding what care we get and when. 

I had 3 Saginaw doctors tell me last year that I could not go back to work. However, an "insurance doctor" in NEBRASKA decided I could take on a 35 student class and I was denied my banked sick days plus any disability.   A month after I was told that by the insurance company, my [private charter school] company in Lansing wrote to tell me I was not going to be hired back because they weren't sure of my ability to work in a class because of my health.  I received none of my health benefits and I'm still recovering!.  I truly believe that the insurance companies have done to health care what speculators did to wall street."


Irene said...

There's little doubt that the insurance companies are a major player. Private insurance companies do not make money by paying for health care. They make money by collecting premiums, but NOT paying for health care. I recommend Paul Krugman's book The Conscience of a Liberal. To paraphrase his work, in the insurance industry, payment for claims are literally called "medical losses". Insurance companies can hold down losses through controlling who they will cover (screening people) and by looking for ways not to pay. So,they try to cover low risk clients, or they try to get out of paying claims however they can. It's the nature of the system - if you were a nice insurance company you would soon go out of business. However, it sets up a system that doesn't look after those in genuine need and adds to health costs due to the adversarial nature.

scot s w said...

To Alice:

It's obscene that your employer could simultaneously deny you disability pay and fire you over a medical inability to work.

It sounds to me like you have an extraordinarily good legal case.