These stories come from the real people who live with a broken health care system. Some have health insurance and some do not. Many of these stories suggest potential solutions* that lead to quality, affordable health care we can count on. One thing we all agree on is that the we cannot trust the insurance industry to fix themselves. To learn more about what Health Care for America Now stands for read our Statement of Common Purpose.
We wanted to give you a chance to speak for yourself, in your own voice, about the need for Health Care for America Now. Do you have something to say? Tell us your story.
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Michael
Shorewood, WI
I have involved in the provision of health care for 24 years both as a practitioner and in administrative capacities. When my son was about to graduate from college, our family was aware that he would no longer be covered under a family's employment related policy at the end of the calendar year. He is relatively health, exercises regularly, eats a healthy diet, and he has worked 40 plus hours a week since he graduated.
We applied for individual health insurance for our son from 2 large companies, one the same as that our family has our group insurance with and which covered my son's health care prior to graduation. Neither company requested any copies of my sons medical records. Our current carrier merely reviewed billing codes on insurance claims that they received. My son had one treatment for back stiffness after sitting for his last set of final exams prior to graduation. He received one treatment manual therapy at a cost that was less than the average single prescription for an anti-inflammatory. His symptoms resolved and he did not need to treat again. He had no injury, no arthritis, no sciatica, no ongoing condition; his last previous treatment for back pain was almost 10 years previous.
HIPPA law states that an insurance company cannot go back more than 6 months when writing a pre-existing exclusion, that they must decrease the length of the exclusion by the length of prior coverage with the same insurance company, that the pre-existing exclusion cannot last for more than one year, and that they cannot discriminate against an individual based upon a health condition.
The insurance carrier that sold my son his indiviual insurance was the same company my son had his insurance from through our family and there was no lapse of insurance. They refused to cover my son, unless he signed a "waiver" that said he would have no coverage for his spine or neck related to any condition including injury, cancer - any condition. They told us over the phone that the waiver was temporary and would last 18 months. They sent us a copy of the HIPPA laws after he signed the waiver and policy, and then told us the waiver was permanent. They went back more than 6 monghs to write the pre-existing exclusion, they provided no credit to the length of exclusion based upon the 17 months he had prior and continuous coverage with the same company. They also had him sign a waiver for a condition based upon a skin condition that he never had because there was an error in a diagnostic code on the insurance claim.
The insurance company charged my sign the same premium after they arbitrarily and substantially reduced their risk and cost by changing the work pre-existing condition to the word waiver. They also in the own brochure advertised those costs and said that pre-existing conditions would be eliminated after 18 months.
So went to to the state office of the commissioner of insurance. They had us write 3 letters to clarify our complaint, much of it repeating the same infomation.
They said they did not enforce the HIPPA laws, and when I have referenced complaints related to the laws on the internet, it was reported that the U.S. justice department has been ordered not to enforce it, rendering only 2 minor fines related to privacy complaints of which there are 1000s; they does not even appear to be any public awareness of the portability provisions in the law related to insurance issues. The insurance commissioner's office also stated that the HIPPA law only regulates purchase of insurance as part of a group, which makes absolutely no sense, because there are rarley any pre-existing exclusions written for individuals insured as part of a group.
We have a situation where 45-47 million people have no insurance including 22% of all women and 33% of all men between the ages of 18 and 25. I wonder what our high school and college graduates, one of our most precious resources, must think when their greeted with this sort of gift as they graduate? And there is absolutely no tracking of the 1000s of people who arbitrarily are have body parts and systems excluded from access to insurance coverage, while insurance companies charge the same premiums or higher deductibles for inferior policies. It would not be legally acceptable to sell an indivual a product such as a TV or a car, and then to deliver a less valuable model for the same price. But someone when we it comes to access to quality of health care and life, this sort of standard has been permitted.
*Health Care for America Now is not responsible for the content of these stories. These stories are submitted by individuals in the online audience and have been edited in some cases. Health Care For America Now does not endorse any of the solutions or policy positions suggested in the content of these stories. Health Care for America Now is a coalition of organizations that agree to the Statement of Common Purpose.
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Read the Statement of Common Purpose.
