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marmar

(76,945 posts)
Mon Jul 30, 2012, 12:34 PM Jul 2012

Be Not Fooled, Insurance Companies Still Gaming the System


Published on Monday, July 30, 2012 by Common Dreams
Be Not Fooled, Insurance Companies Still Gaming the System

by Donna Smith


Has your insurance company called you recently to ask you to sign up for a wellness or disease management program? Has that same company told you it’s a free service to policyholders and promised you that they do not share the information with the departments and people who administer your benefits and claims? You – like me and millions of other Americans – are being scammed.

Follow the money, my friends, and do not believe for one minute that the same company that would deny medications, health treatments and care to you would suddenly have your best interests at heart. It’s the money. It’s always been the money.

As soon as the Patient Protection and Affordable Care Act (PPACA) was passed, we were all told that the insurance companies finally would have to spend more of the premium dollars they collect on actual healthcare. Read the nitty-gritty details here.

In short, The Kaiser Family Foundation writes, “The provision requires most insurance companies that cover individuals and small businesses to spend at least 80% of their premium dollars on health care (i.e. medical claims) and quality improvement, leaving no more than 20% for administration, marketing, and profit. Large group plans must spend at least 85 percent of premium dollars on health care. Insurers failing to meet these standards will have to pay rebates to consumers beginning later this year.” .........(more)

The complete piece is at: http://www.commondreams.org/view/2012/07/30-3



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Be Not Fooled, Insurance Companies Still Gaming the System (Original Post) marmar Jul 2012 OP
Absolutely no surprise. enlightenment Jul 2012 #1
I hear this lady. But, my experience with Wellness and Disease Management is that "coordinated" Hoyt Jul 2012 #2
It's their system now kenny blankenship Jul 2012 #3

enlightenment

(8,830 posts)
1. Absolutely no surprise.
Mon Jul 30, 2012, 12:52 PM
Jul 2012

The author of the article sums it up perfectly here:


Health insurance is not healthcare. Health insurance is a financial product sold to you and to me to protect our health and our wealth which may well do neither thing. Health insurance companies do not exist to make you healthy but to make their stockholders wealthy. If you think otherwise, you are not understanding the fundamentals of corporate life or the laws governing what corporate CEOs are to do for their primary customers – their shareholders.

So, if required to provide more actual care that might reduce actual profits, what’s a good health insurance executive to do? Well, go to work changing what qualifies as actual healthcare under the new rules and then find ways to make even more money by providing that while denying more real healthcare services. And that’s exactly what is being done to you and to me.


This is precisely what the insurance companies have been doing since the first word of the debate on the ACA was uttered; raising premiums so they would be grandfathered in 2014 and inventing things like these 'programs' that only improve the 'health' of their bottom line.

 

Hoyt

(54,770 posts)
2. I hear this lady. But, my experience with Wellness and Disease Management is that "coordinated"
Mon Jul 30, 2012, 01:04 PM
Jul 2012

care is a heck of a lot better than "uncoordinated" care which is what a lot of us have gotten under our health care system.

Even, if we somehow end up with Medicare-for-All tomorrow, coordinated care is the way to minimize costs and improve outcomes.

kenny blankenship

(15,689 posts)
3. It's their system now
Mon Jul 30, 2012, 06:41 PM
Jul 2012

they can do what they want.

When your predatory and corrupt leaders said, "They're our system! We have to work through the existing private insurance system! Everyone in - it's the Law now!" what they really said -along with their idiot henchmen- was "You plebes belong to them body and soul, and they can juice you for whatever they can get."

You are all going to be squeezed until shit comes out of your tear ducts.

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