Tue
Oct 1 2013
04:09 pm

Or how the US spends tons more on health care than other countries.

(link...)

A good grasp on why we should have single-payer without raising taxes.

reform4's picture

Another Reason we should have had Single Payer.

A family with an autistic child was told by BCBS that they were dropping their fairly affordable plan because "they could get coverage through Obamacare."

Unfortunately, because Tennessee didn't have an autism insurance reform law on the books when ACA was passed, families with an autistic child get screwed:

(link...)

Of course, BCBS did NOT *have* to cancel their policy because of Obamacare. They could have continued their policy, and even offered them a chance to renew December 1 of this year and continue the plan without any ACA guidelines or oversight for another year. That's what United asked our company to do "to avoid a large premium increase." (Well, they just hit us for a double-digit premium increase anyway)

No, they chose to do it because they were losing money on the policy.

And BCBS got a chance to bad mouth the ACA at the same time and poison this family's mind against the ACA. It's what we call a "two-fer".

It makes me want to stab insurance executives in the eyeball with a #2 pencil.

CE Petro's picture

Sheesh

It makes me want to stab insurance executives in the eyeball with a #2 pencil.

I don't blame you, I'd be right behind you.

Anecdotes like these are exactly why we need to get rid of the middle men/women. At some point, all these stories and the REAL people behind them have got to mean something more than just having a Free Market that tries to squeeze every last penny from us all.

KC's picture

You all think a govt

You all think a govt bureacrat will be better than an insurance industry bean counter? You all are in for a helluva surprise.

B Harmon's picture

Patient Protection

KC:

The Patient Protection and Affordable Care Act is named such because of what the "bean counters" have done in the past by denying insurance or coverage for care to those that need it the most.

At one time I worked as a case manager for a very large insurance company. I was the health care professional that would tell a physician that a service would not be covered. I handled the appeal, requiring the physician to send in medical records that would then go to our medical director (a physician) for review. I had to make sure that the letters were sent to everyone involved. The decision was final, no more appeals were allowed.

The ACA and the marketplace plans (here in Knox County we have Blue Cross/Blue Shield, Humana, and Community Health Alliance) are all private insurance companies that have contracted to provide health insurance and pay the bills for those that enroll in their plans.

They will be setting the guidelines for what is covered and what is not (except for those 'essential health benefits' written into the law). I am sure they have an appeals process and a medical director to review each case.

What we now have, that we did not have before the ACA, is the next step. We can now call or write our elected officials and tell our story to get our case heard. If there are items not considered "essential" that should be, or if the private insurance companies are just not living up to their contract, the government (a "govt bureacrat" [sic] ) will be making sure that the issues get addressed.

For the past 2 years I have been helping Medicare recipients with their coverage options. I can attest that Medicare, a government run program, is working very well. The Centers for Medicare and Medicaid Services provides oversight to all the insurance companies that have been contracted to provide services.

While I would have preferred a single payer program, the ACA is a good first step. I am doing my part to make it work for those that need it the most, the uninsured.

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