Anecdotal Evidence on Health Care

June 26, 2009
Posted by Jay Livingston

Opponents of government involvement in health care seem to have two strategies. One is name-calling – “socialism” and “European-style” are two of their favorites. The other is to repeat anecdotes to illustrate the horrors that people in Europe and Canada have suffered – delayed treatment, denial of treatment, and so on. There’s a third strategy – spending huge amounts of money in lobbying legislators directly – but that’s less visible.

The Obama Administration has asked Americans for their own stories about their experiences with the insurance industry. Stories have poured in by the thousands. You can read them here, read them and weep.

Some people report on their experiences with socialized European-style health care, and the US does not come off on the plus side (here, for example). Others compare experiences with private insurance against public plans in this country Again, the private system comes off as inferior.
I’ve blogged before (here and here) about the utter hollowness of the claims that socialized health care will mean that “bureaucrats” rather than doctors will be making decisions. In fact, the bureaucrats are already doing that. And a few of them have contributed their stories to the Obama website. Here’s one from Barbara in Barbara, Deer Island, FL
I worked for United Health Care in small group customer service. If a company was more than 5 days late in their monthly payments, United would "terminate" their coverage. When they were terminated the group administrator from the "termed" company would call me to reinstate their coverage. I would take their phone number, go to my supervisor's office and get a computer disk showing all small groups "loss ratios." If the company I was working with was in the high risk ratio, I was not to reinstate their coverage. This meant people in the hospital or scheduled for surgery would never nave coverage with any company because of pre-existing conditions if their coverage was less than 90 days. Sometimes a new group misses payments in the first few months before they get on a payment schedule. This is how United Would "weed out" the high claims group. Their actions were not illegal, but were IMMORAL!
That term “loss ratio” refers to the ratio of premiums that the insurance company pays out. When your insurance company pays a claim to your doctor or hospital, that’s a loss.

Barbara’s story was amplified recently in Congress. Wendell Potter, a former executive at Cigna, testified before the Commerce Committee.

"They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment."
(Potter’s full testimony, thanks to Ezra Klein, is here.)

1 comment:

Lorne said...

The basic problem is you can never have 100% quality health care, no matter what kind of system you have. But I believe there should be at least the basic level for accessible for anybody...