Sunday, May 5, 2013

Why Are People with Health Insurance Going Bankrupt? ? naked ...

Paul Jay of the Real News Network interviews Dr. Margaret Flowers, a pediatrician from Baltimore who advocates for a national single payer health system, Medicare for all, and Kevin Zeese, co-director of It?s Our Economy, an organization that advocates for democratizing the economy. Originally published at Real News Network.

Both Zeese and Flowers are long-time activists; I remember when Dr. Flowers got herself arrested in Max ?Train Wreck? Baucus?s Senate hearing room because he?d scheduled no testimony from single payer advocates; and here they both say some things on health insurance and ObamaCare that are new to me.

First, health insurance companies could actuallly be even more perfidious than I thought:

FLOWERS: [B]efore 2005, I think, looking at our Blue Cross program here. And what they found was that about one out of every five claims was denied just randomly. Like, if five claims come in, they just pull one out and say, we?re not paying this one. ?

And we have evidence of this in New York from people that worked in these claims offices that if there was a certain level area of the city, lower-income area, they would deny those claims because they knew people didn?t have the resources to fight back.

Now, I?d like to see the study. However, Yves has written about her battles with her health insurance company, which ?loses? her claims and then denies care, which fits into this picture. (Readers, have any of you had this experience?) And it sounds like the health insurance companies are acting just like the mortgage servicers who ?lose? your paperwork, or even your check, and then foreclose on you.

Second, Obamacare?s Platinum/Gold/Silver/Loser Bronze plans are actually worse than the plans available already in some states:

ZEESE: [T]here?s several levels of insurance coverage [available under ObamaCare:] ?90/10, where the insurance company pays 90 percent, consumer pays 10 percent; 80/20; 70/30; 60/40. The subsidy provided by Obamacare to people who can?t afford insurance will only cover 70/30 plans. So when you get a serious illness, you?re paying 30 percent of the cost of that health care.

Now, what?s really bad about this is that prior to Obamacare, some of the state insurance regulators were pushing insurance coverers to a higher level, where they would provide more coverage rather than less. Obamacare has now put it into law that 60/40 is okay and 70/30 is what the government will pay for. And so the 80/20 and 90/10?s become less common. So you?re going to see more and more people with under-insurance and not going to see lack of insurance completely go away.

Having to pay 30% for a really serious illness is ?Lose your house? territory. Yikes! And maybe I?m old-fashioned, but when the Feds step in to set a standard, I tend to expect them to improve on what the states are doing, and not degrade the situation.

Not that all this matters very much; ObamaCare?s only projected to cover 7 million in its first year, 23% of the 30 million total optimists say it will cover (leaving 26 million uncovered). The mountains have labored and brought forth a mouse?

Finally, I?m finding color-coding Obama?s presser on the Affordable Care Act heavier going than I expected, so Flowers and Zeese can serve for a teaser.

NOTE Readers, I?ve been trying to track the IT issues behind the health insurance exchanges at the state and local level, which I believe prompted Baucus?s ?train wreck? outburst. If any of you have linky goodness on this topic ? or even direct knowledge of it ? could you please leave your information in comments?


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