This is the reason we need healthcare reform in this country. Crystal Lee Sutton has died at age 68 because her insurance company diddled and dawdled over whether or not it would pay for the medicine necessary to save her life.
Don’t know who Crystal Lee Sutton was? She was the real-life inspiration for Norma Rae, Sally Fields’ excellent portrayal of a small-town union organizer who went to bat for workers’ rights.
This kind of thing should not happen. When profit—or overhead, however you wish to consider the problem—is placed ahead of life, those arguing against reform should hang their heads in shame. They cling to an ideology about free markets and consumer choice as though such things are part of the Ten Commandments (which most of them don’t follow either) and always at the expense of lives.
Dammit, people, we’re talking about a system which should operate for people’s benefit, not for its own. A system is simply a method of approach, a way of doing something, and if it can be changed once, it can be changed again if the reforms are found insufficient! It is no argument to reject reforms on the basis that the reforms might cause harm, since the present system is already causing harm.
It is a foulness to our present system that many people find that in order to vouchsafe their own health or the health of their loved ones they must fight for the very thing they were told they had purchased in the first place. This is in no way different from lending predators who lied to people in course of borrowing money to buy a home. The average person has neither the time or expertise to understanding every clause and addendum in a complex contract and must rely on what he or she is told. Either you have insurance coverage or you do not. It should not come as a surprise after you are already sick and discover that there are codicils which protect the insurance company from having to pay out what in principle they obligated themselves to do if not by the letter of the policy then by the spirit of agreement with a customer. Yet thousands, millions of consumers daily learn to their dismay that they don’t actually have what they thought they had bought.
This is not a game. If the private sector is more concerned over profit margins than providing service, then they should lose the privilege of offering said service.
I've dealt with denials of service more times than I'd like to remember, and have watched the health of loved ones take a hit because the insurance companies like to overrule the doctors' recommendations regarding tests, procedures, and prescriptions. There's no question that the system is not about providing health care, but about profiting from limiting it. Often I've said that I actually miss my old 80/20 plan, even with all its stupid paperwork. I miss getting tests right in my doctor's office, I miss paying $35 for a visit (less than my current co-pay, now that my insurance "covers" doctor visits), and I miss getting the prescription that was written instead of a surprise substitute that the insurance company says is "just as good" or no prescription at all because they decide I don't really, truly need it. I can't think of a single thing that my "expanded coverage" has improved in my medical care or my life in general. I know I'm not alone in this, either. How anyone who has lived through the changes in medical insurance over the past couple of decades could want to keep things the same is completely beyond me. To be honest, if we can't have a universal health care system, I'd be happy if we could just dismantle what we have and go back to just indemnity coverage again.
Mark:
On average, what percentage of the insurance industry's revenue constitutes profit? What, if anything, prohibits citizens from paying out of pocket for medical care, perhaps from accumulated savings? Why is it not morally acceptable to expect citizens to pay out of pocket for medical care when we expect citizens to pay out of pocket for higher education costs that sometimes exceed one or two hundred thousand dollars?
I'm not familiar with Crystal Lee Sutton, but question why she would not just pay for medical care with credit cards and declare bankruptcy like many citizens do?
I do not question the need for refomrative measures but do find your cause and effect argument questionable.
Scarlet:
Health insurers' SEC filings are showing around 3 percent profit margin. But that doesn't tell the whole story.
For example, one well known health insurer reported about $30,000,000,000 in earnings in one year, and claimed only a 2.2 percent profit margin in the same year.
We all understand that the profit margin is the profit after expenses as a percentage of the earnings. But what most people fail to understand is that those expenses include salaries and bonuses. It appears that as much as 15 percent of the earnings goes to paying the top 1000 executives (that's about 4.5 billion out of 30 billion.) another 10 percent pays the rest of the help. In all, it appears that about 60 percent of the earnings go to pay on claims.
The problem is that the entire system encourages fraud by the insurance company employees. I have a problem with some asshole (with an MBA but not an MD) in another state deciding if I should get treatment based on a comparison of costs and benefits to the company, especially when that asshole may get paid extra for finding an excuse to deny my claim.
Scarlet Letter writes:—"I’m not familiar with Crystal Lee Sutton, but question why she would not just pay for medical care with credit cards and declare bankruptcy like many citizens do?"
You're kidding, right? You don't see a moral problem with that process? Because declaring bankruptcy basically is a legal default on your debt, which means other people are left holding the bag.
Here's the issue: if a doctor says "You need this to live and it will cost this much" and you say, "Oh, dear, I can't afford that, so I guess I'll just suffer and die" that is odious but ethical. If, however, the doctor says "You need this" and a third party says "Well, you can't have it because we don't think you need it and it's too expensive" that verging on murder. Especially when that third party has already been engaged by you to act in concert with your doctor and cover those costs.
Everyone is terrified that with public health care there will be rationing. But no one seems to be aware that we already have rationing, through this kind of third party intervention. But because taxes aren't involved, everyone (at least those defending the status quo) thinks it's sad but somehow "natural."
At his blog, Bob Cesca has offered some shocking statistics regarding the cost of health insurance, today and in the future. http://www.bobcesca.com/blog-archives/2009/09/the…