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Comments

Steve Fallon

This article is very misleading. In order to protect itself in malpractices suits, the health care industry has seen to it that case law provides that people who lack formal medical training are incapable of reaching medically valid conclusions. Insurance applications reflect this reality; people are only required to disclose conditions which have been diagnosed by a licensed physician. In the eyes of the law, a medical condition or symptom of a medical condition simply does not exist unless it has been diagnosed as having a pathologic cause.

This gentleman is clearly engaging in fear-mongering by spreading false infomation.

Tara Hines

Who can we turn to?
My cousin Sienna Zertuche has to get an umbilical cord blood stem cell transplant, they say it is her only hope for survival, and her insurance are refusing to pay! She has 2 types of Leukemia, and they found no bone marrow match in the entire bank, and her family. The transplant and a 4 month stay at The Mayo Clinic in Minnesota will cost over $500,000! Does anyone have any ideas as to who we should contact and what we can do? Thank you...Please check out website also, www.savesienna.org

Tim H

Mr. Fallon's comment claims "false information" is in the article, but his explanation of legalities and malpractice does nothing to rebut the alleged tactics of the insurers. For these legal protections to kick in, the people being treated as described in the article would need to employ a lawyer to fight the tactics insurers use. I think the insurers cover the spread by screwing enough people that don't engage lawyers to cover the costs of honoring policies for those that do.

Barbara B

I have so much to say but let just comment on the NJ single payer/small group situation. Here in NJ they regulated the industry in the 90s and made it illegal to charge premiums based on preexsisting conditions. Additionally, it is illegal to kick anyone off due to a major illness. Sounds good, right? Wrong. As a result all competition hit the road and only two major players remain. The premiums for my healthy family of three is nearly 800 a month with a 2,500 deductable PER PERSON plus high co-pays and very little outside of standard doc visits is covered. This past fall my husband and I decided to get some checkups from our dermatologists (we both had suspicious spots and he has a family history of melanoma) and he got a colonoscopy (39 years old with a serious family history on both sides). As a result, we have been slammed with charges and Horizon NJ refuses to pay for most of them. They are telling me that the contract that I have in my hand is different than the contract they have and that I don't have all the details of my benefits so, in fact, I DO owe money according to THEIR copy. This would never hold up in a court of law but who is going to hire a lawyer and pay court costs for a 2,300 grievance. No one, and they know it. There is a pervasive passive agressive approach to any custmer service claims call you make. 95% of the time, I am put on hold to be transfered and whoops, I get disconnected. When I call them out on a clear example of them not honoring the terms of the contract, they then claim that my doctor didn't file the claim correctly (this is after 5 previous calls on the same matter where I was just told "nope, it goes to your deductable" no mention of a clerical error those other times) and then they refuse to call my docotor for a correction, they tell me it is my job. When I ask then exactly what I'm supposed to tell him what to do, they won't give me any specifics because that's between him and myslef. Yeah, ok. Today I called and spoke with a supervisor after two disconnects and 20 mins on hold. She tried to claim that my correction *could* result in the hospital sending me higher bills after I get the benefit coming to me because "you see the higher number on your claim and then the lower number that we pay....?" She was tring to suggest that that number has to do with my deductable, when in fact the lower nember is just the contracted number agreed upon by the hospitial and Horizon BCBS and has NOTHING to do with my deductable. She was purposely vague and when that scare tactic didn't work, she tried to have me believe that the other half of the routine Dr's visit charge that they pay out after my 30 dollar copay goes toward my preventative care allowance. No it does not, I called her out on it and she tried to change the story again. Duck, jab, duck, jab. So why do I pay? Because I will be getting pregant this year and in the back of your head there is always the "what if." What if someone gets into an accident. gets ill? One injury and they could seize all our assets. Its psychological torture. I'm so frustrated, these premiums that buy us nothing but angry afternoons and more bills are killing us.
Anyway, just wanted to say that NJ regulated to prevent a lot of the horrors that are talked about here and it still is a mess, in fact, its worse. Regulation won't work. Medical care cannot be a for profit buisness, its just that simple. I'm a moderate, very conservative fiscally on many issues but not this one. Imagine if we privatized out fire depts or police depts? It would be considered crazy talk. Privatized healthcare is just as crazy. Human life in peril is not a for profit buisness. Nationalize it.

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Bill S.

The part about premiums being raised is misleading. Individuals cannot be singled out for a premium increase based on their own health experience. An insurer would have to ask for an increase on an entire class of covered individuals based on their collective experience. Depednding on the state, the insurance company would have to document the reasons for the increase and then wait for approval before implementing the increase.

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Can I be put back on my parents health insurance if I am under the age of 26?
I am 23 and I was working full time so I had my own insurance through my company. However, I recently quit (to change occupations) and I am looking for a job. Can I be added back on to my parents health insurance? Thanks!

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Reports of treatment breakthroughs for a variety of medical conditions seem to appear in the media daily. Applying the results of such research findings to personal health decisions can be challenging-especially for older men and women. This book attempts to make older people more informed healthcare consumers by helping them understand the potential benefits and risks of common healthcare practices such as physical exams and routine lab tests. Murphy, medical director of the Senior Citizens Health Center at Presbyterian/St. Luke's Medical Center in Denver

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The insurer, therefore, has limited options, if they are to maintain profitability on your policy. They can jack your rates through the ceiling when it comes time to renew your policy (typically either every six months or every year).

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So why do I pay? Because I will be getting pregant this year and in the back of your head there is always the "what if." What if someone gets into an accident. gets ill? One injury and they could seize all our assets. Its psychological torture.

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on behalf of the insurance and healthcare companies he worked for for 20 years. After our interview, I asked Lee if he would be willing to write a series of columns for HonestMedicine.

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Mr. Fallon's comment claims "false information" is in the article, but his explanation of legalities and malpractice does nothing to rebut the alleged tactics of the insurers. For these legal protections to kick in, the people being treated as described in the article would need to employ a lawyer to fight the tactics insurers use. I think the insurers cover the spread by screwing enough people that don't engage lawyers to cover the costs of honoring policies for those that do.

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I hope this allowed, I have never used this website before so I wasn't really sure what this was going to do. So this is just a test post. I really like this forum, it has some excellent discussions that take place.

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