Why nobody likes health insurance companies

President Obama has started saying "health insurance reform" instead of "health care reform." Smart move.

My post title is slightly inaccurate. A few people in the United States like health insurance companies.

Namely, people who are employed by them.

As for the rest of us, when's the last (or first) time you had a wonderful customer service experience interacting with a provider of health insurance? They seem to have replaced lawyers as the most maligned profession in America.

Yesterday I went into my doctor's office to get copies from the "chart," now electronic, of my last two physical exams.

As related in an earlier post, I've been fussing with Regence BlueCross of Oregon over their denial of my application to switch from one plan to another. Though I'm in excellent health for a 60 year old, or any age for that matter, a couple of minor pre-existing conditions are being used as an excuse for Regence's "No" to my request.

At first I was told the denial was because I'd been prescribed two medications for an enlarged prostate, and that showed I was at higher risk for surgery.

I wrote back to Regence, enclosing evidence that Avodart and Flomax, when taken together, are more effective than either alone. So logically that eliminated this reason for denial. However, I got a phone call from the individual underwriting head honcho. Now she talked about my "heart problem," the sum total of which consisted of a mildly elevated cholesterol reading in 2005.

She asked for the physical exam records, partly to check my blood pressure (which is normal, by the way) as that is a risk factor for heart disease. I sent the records off to her today, saying in a cover letter:

It’s difficult not to come to the conclusion that Regence is casting about for a reason to deny my application, rather than fairly assessing my health status. I hope this isn’t true, but that’s how it seems to me. Recently I made a change to our State Farm auto insurance and found that the agent’s assistant was dedicated to customer service. Meaning, I didn’t feel an adversarial insurer-insured relationship as I do with Regence.

What happened to "the customer is always right"?

With health insurance companies, providers and patients are made to feel that something is wrong with them if, god forbid, someone actually wants to use their insurance for some health care.

I was curious to see what the receptionist in my doctor's office thought about health insurance companies. I told her that opponents of health insurance/care reform keep saying, "We don't want the government to come between us and our doctor..."

Before I could continue with that thought, she replied with considerable passion:

"Health insurance companies already do that! They tell people what doctors they can see, what services they can and can't get, what health conditions are covered and which aren't. They interfere in patient care a lot."

She and I agreed that if someone has to come between a patient and his or her doctor, it'd be better to have government do it.

Insurance companies aren't accountable to anybody. Underwriting and coverage decisions often are made secretly without transparent publicly available criteria, as in my case. So it's no wonder that health insurance companies have few friends among both health care providers and consumers.

They do, however, fork out a lot of money for lobbyists.

Who are trying to convince Congress that a public option which would compete with insurance companies is bad, bad, bad -- even though polls show that a public option is favored by a clear majority of Americans.

Hopefully their scare tactics won't work -- which are being aided and abetted by the usual crew of right-wing talk show wackos, such as Portland, Oregon's own Lars Larson, who has never met a fact that he couldn't mangle in service of his arch-conservative world view.

Here's a great example: Lars complelely distorting Rep. Earl Blumenauer's proposal for Medicare to reimburse doctors if patients request a visit to discuss living wills, end of life care, and such. 

It's amazing that Larson is able to bill himself as being on the side of "values voters." This interview shows that one of his core values is lying. He knows damn well that no government bureaucrat is going to demand that Medicare cut off care to an old person in order to save money.

But he spouts the lie anyway. Just as so many others are doing when it comes to denying the facts about health insurance reform.

Comments

[Rain]

It is absolutely maddening and commentators like Larson should be embarrassed but shame doesn't seem one of their 'emotions'. They sure milk the rest. They get talking points or all go to the same source for their mind set and off they go.

It's like the Democrats want to kill old people shtick. How could that work? How could old people (in which category I fit) fall for it and yet they do. It is absolutely insane and yet nearly half our country are buying into it and maybe more than half.

Republicans need to make up their minds as to what they want to teach for fear-- it's going to bankrupt us or it's going to kill off everybody to make it cheap. They throw both out and hope one sticks. They ought to be ashamed.

If there is no public option, there will just be a tide of money flowing to those insurance companies who already have had 400% profit increase over the last 8 years. There has to be more than temporary regulations that *wink wink* are forgotten the next year.

They say government can't run it efficiently as insurance companies and in the next breath say the insurance companies can't compete. Medicare, Veteran's insurance, and Congress's policies prove they can run it and if the insurance companies aren't forced to compete, they will not.

Americans of both parties need to wake up and smell the coffee. Their emotions of fear and anger are once again being stoked to keep the money and power right where it is. And if Democrats aren't also pressured to do what is right, they won't do it either.

[tucsoN]

the receptionist said:

" 'Health insurance companies already do that! They tell people what doctors they can see, what services they can and can't get, what health conditions are covered and which aren't. They interfere in patient care a lot.' "

--So, why do we want to go to the trouble and expense of switching this problem from the private sector to the government? On what basis can we assume government will do a better job?

Maybe it would be simpler and cheaper to create new laws that prevent private insurance companies from engaging in unfair, unethical and discriminatory practices.

[Brian]

tucsoN, we do need those laws to better regulate the health insurance industry. But here's another issue:

There's Blue Cross of Oregon. And of Washington. And of every other state, so far as I know. We have a vastly duplicative system of health insurance companies, each with highly paid executives, managers, and other staff.

I suspect that a nationwide public plan, whether government run or non-profit, would have considerably lower administrative costs owning to an economy of scale.

We have a decentralized health care delivery system, because no one can get care from someone far away. But there's no reason why the health insurance system has to be so localized, which, again, leads to lots of inefficiencies.

Someone in Chicago could pay my doctor's bills just as well as Regence BlueCross in Portland, Oregon. This is why a single payer plan makes so much sense. Health care should be local; paying for health care should be centralized.

[tucsoN]

I am insured with a shitty company called Assurant. They really ARE assholes and make everything difficult every step of the way. It seems they are so invested in difficulty that they even make it difficult for themselves. They wallow in difficulty. I wonder if they even know there is something other than difficulty.

Anyway, the reason I got hooked up with them is that they ARE a central rather than local company. They are one of the few companies I know of whose medical insurance policies are transferable from state to state without having to go through the underwriting process. This appealed to me because we tend to move a lot and have pre-existing conditions that would likely make it hard to get coverage from a new company (I got a blister on my toe in 1972). I have experienced no advantage in efficiency of service from Assurant despite their "central" administration.

When I lived in Oregon through the 90's Lifewise was a good company. I got good service from them and no hassles at all. I have heard they have gone downhill since then.

Assurant used to be called Fortis when I signed up with them. Fortis had a very good reputation, but they got out of the insurance business and now these creeps manage the show. An evil pall fell upon the industry and it needs an exorcism no doubt, but I don't think government should be in charge except to create laws that prevent insurance companies from operating as they do.

[SAVANNAH BAUTISTA]

Does anyone know where I can find a blank "Sheriff Personal Form" to fill out?