HEALTH REFORM: Help For Older Americans

The product of health insurance is to provide you with medical coverage when you need it.
Unlike other businesses that need to provide you with their product in order to make any money, health insurance companies actually make more money for themselves when they restrict and do not pay claims.
In other words, they make more money when they do NOT provide the product that you have paid them for.

Read the 50 to 70 pages of your health insurance contract.
Pay particular attention to the section entitled “limitations and exclusions”.
People’s health is not a product that needs to be left to the whims of money motivated CEO’s and stockholders.
If that is your thinking, you might as well have your police and fire department protection based on insurance premiums you pay.
Then you can go to the police and fire protection insurance page for ‘limitations and exclusions’ on whether or not the police or fire department would come out to your house in the event of an emergency.

The point is, you would never think of discriminating against another citizen if he was the victim of a fire or crime.
So why would you be ok with health insurance companies discriminating against fellow citizens who have pre-existing medical conditions?

I advise on several health insurance boards such as http://www.benefitsmanager.net , http://www.bcbstx.info , and http://www.healthinsurancesource.net. I often quote the Switzerland health care system as an example of tough questions that we as a nation will have to answer someday, if we go down the path of nationalized government health care plan. We’ll have to at some point draw the line in the sand and refuse further care for patients receiving critical illness treatments, intensive care unit, trauma care, acute management services, disease management, neonatal intensive-care unit for newborns and seniors in extended care treatment nearing hospice stage . Did you know that premature babies are not resuscitated upon birth if they cannot draw breath in Switzerland? Did you also know that holds true with “senior care” experiencing system failure or multiple organ failures requiring support? Another example, they don't extend the life of a senior via medical equipment such as intubation or respiration for multiple organ failures. Not to be morbid….they are unplugged and allowed to pass. Anyone in the business of paying claims knows that the single most expensive bill in what carriers call “shock loss” is within NICU for newborns and seniors in acute / intensive care / hospital in the last three months of life.
The Swiss apparently made decisions made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or to define when to incubate, resuscitate a newborn or a senior? Are we ready to define the conditions and rules of medical procedures with organ failure? With a litigious society I think not. This is why we need TORT REFORM. Without TORT REFORM medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. Humana health plans state that their costs of medical liability and defensive medicine accounts for nearly 10 cents out of every premium dollar collected. Compare that to Humana’s reported pharmaceutical claims of 15 cents out of every premium dollar collected. Or better yet, 21 cents out of every premium dollar collected is paid back to physicians for physician treatments. The cost of litigation is only obvious with Humana health plans. I sit on the board with several other health insurance carriers. Their books all show similar costs. They basically insure a shrinking populace that is mostly made up of people that only buy insurance because they need it. So is mandatory participation such a bad idea?
I don't think we are hearing about TORT REFORM because most of the house and senate on the federal level are lawyers and have practicing law firm interest’s. In the healthcare system there is no total innocence. We hear about insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their ER door with no insurance. The lawyers are there to stir the pot and promise lavish fortune at the end of the PERCEIVED misery chain. Am I saying we don’t need them? No, but I am saying there is clear and documented abuse of the legal system that awards outlandish claims in the millions for a questionable mistake. Are ambulance chasers not sociably recognized as being the most abusive? What about those that educate their clients on defraud and then use the legal system to pirate insurers?
I sure wouldn’t want to be on the receiving end of these serious decisions that we will have to make. My senator claims that the government would be held blameless but what about the medical provider that has to make the call? What about the insurance payer that has to deny continued care for an infant that will not survive? Without serious TORT REFORM we aren’t going to get costs down or have good people make headway.