Tuesday, March 31, 2009

PBS Frontline "Sick Around America": how individuals fall through the cracks

Tonight, Tuesday March 31, PBS Nova presented “Sick Around America” with link here. The show talks about the patchwork of private, employer-based, individual, and public Health insurance programs with many wide cracks through which many people fall.

Karen Iganani, CEO of America’s Health Insurance Plans, did much of the talking. She said that we could make the decision to cover everybody and work back from there. (A related PBS documentary “Sick Around the World” will examine just how five capitalist democracies do that.)

The show covered COBRA early, and said that 90% of people who get laid off don’t use it because it is too expensive. I remember getting my first mailing about COBRA at home in the 1980s while I was employed.

The show explained how individual health insurance works, and how “medical underwriting”, supposedly aimed at preventing anti-selection, cuts out many people. There is also a problem with rescission. There was a story of a woman who bought an individual Blue Cross plan and was told than a breast cancer more than ten years ago did not matter. But she did not mention some minor bleeding on an application, which resulted in denial of her claim After litigation, the plans (and the owning Wellstone company) agreed to pay without admitting wrongdoing. Nevertheless, the documentary, in Michael Moore fashion, points out that insurance company employees sometimes were paid bonuses for rescissions and claims denials.

Another man in Texas declared bankruptcy after losing his health care and then having coronary bypass surgery. He moved back in with his mother in Indiana. On the other hand, a woman moved to San Diego after giving up her job to take care of a mother with Alzheimer’s, and then had catastrophic problems with a supposedly desirable “consumer directed health plan”.

Believe it or not, a few health insurers have shown up at jobs fairs looking for "friendly people" who can go out and sell individual policies, after screening candidates. I can't imagine doing that and telling the truth. Actually, the individual long term care insurance market works the same way.

The show went on to discuss the pros and cons of mandatory health participation plans like Massachusetts. The argument was presented that in such plans premiums for everyone are much higher.

This sounds like a mixture of arguments about “personal responsibility” or “moral hazard” with the Biblical idea of being one’s “brother’s keeper”.

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