LAT: Health insurers deny policies in some jobs-Common medications can also be deemed too risky in C

[RamboLiberal]

http://www.latimes.com/business/la-fi-reject8jan08,0,5668276.story?coll=la-home-headlines

Health insurers in California refuse to sell individual coverage to people simply because of their occupations or use of certain medicines, according to documents obtained by The Times.

Entire categories of workers — including roofers, pro athletes, dockworkers, migrant workers and firefighters — are turned down for insurance even if they are in good health and can afford coverage, according to the confidential underwriting guidelines of four health plans.

Although Blue Cross of California, the state's top seller of individual policies, does not exclude applicants based on occupation, three others do: Blue Shield of California, PacifiCare Health Systems Inc. and Health Net Inc. Actuarially speaking, they say, certain workers pose too big a risk.

All four health plans look at prescription drug use to decide to whom they will sell individual policies. Dozens of widely prescribed medications — including Allegra, Celebrex and Prevacid — may lead to rejection, according to the underwriting guidelines that the health plans provide to insurance brokers but not to the public.

In fact, eight of the 20 top-selling prescription drugs in the U.S., including No. 1 Lipitor, a cholesterol fighter that racked up $12.9 billion in global sales in 2005, make the lists of two health plans.

[Liberty Belle]

1. Gee, maybe those drug co ads should say "warning: may cost you your insurance"

along with the laundry list of other harmful side effects!

[depakid]

10. Those ads should never have been allowed on TV at all

We can thank the Clinton administration for that....

I'm not the biggest Edwards fan, but one HUGE thing he has going for him in my ledger is that he mentioned pharmaceutical ads during the 2004 VP debates.

(Hint: He'd roll back the rule to the way it was before- and the way it still is in every single other Western country).

[Tandalayo_Scheisskopf]

2. It's time to gut the health insurance companies where they stand.

Strangle them with their own entrails.

Nationalized Health Care.

[area51]

3. agree 100%.

It's inhuman to continue with our current pro-profit/anti-life healthcare system.

[aquart]

6. I like the way you think.

Cut their greedy guts right out of the health equation.

And give them the uninsured price for the surgery.

[w4rma]

9. Agreed. These middle men do not belong. (nt)

[Occulus]

4. The insurance industry is what is wrong with this nation's health care n/t

[Gman]

11. It's two-fold

the insurance industry AND the corporatization of health care. HMO's must increase shareholder value. They do this by jacking up prices.

[madrchsod]

5. they have to find the money somewhere

to build their hundreds of million dollar corporate palaces...the latest healthcare design magazine had at least 7 billion dollars worth of new major hospital/clinic constrution. palaces to the best medical system in the world-if you have good insurance

[aquart]

7. Really? Then why are people going to Thailand and India?

[madrchsod]

8. i`m 16,000 dollars in debt

for one nights stay in icu and a stress test. my wife and i could have flown first class to asia,four star hotel,and she and i could have had everything fixed that ails us.we probaly would have has money left over. i have no insurance now so i live every day hoping that nothing happens because there is no way i`ll ever be able to live with the debt.

[Warren Stupidity]

12. On the other hand single payer UHC would not have this problem.

Of course market based insurance is going to avoid risk.

[Vinca]

13. The creeping blob of refusing to insure is expanding.

It's already eaten up the middle aged and anyone previously diagnosed with an illness. Now it's afraid a roofer might nail his thumb or fall off a roof. At least the California insurers are being honest and admitting they don't want you unless you're 20 years old, healthy as a horse and fit their job/Rx criteria. Most companies just quote a premium only Bill Gates can pay in order to keep you away from their insurance. THIS HAS GOT TO STOP!

[Nevernose]

14. It's not just the insurance companies' fault

There's plenty of room here for the Big Pharma Bastards who charge so much.

UHC would fix both of 'em.

[OhioChick]

15. This is pathetic

on the part of insurers and of course, big pharma.

[mainegreen]

16. Soon they'll refuse to insure people who may die at some point in their lives.

:rofl:

[elehhhhna]

17. Workers Comp covers work-related injuries. This rule makes NO SENSE.

[rcdean]

18. Under the present system, insurers would be nuts not to do this.

When you have a system that permits cherry-picking, competitive pressures will lead all insurers eventually to cherry-pick.

Yes, UHC would solve the problem. But UHC will not come about soon or easily. The forces against it are phenomenally strong, as Hill & Bill learned.

When a proposed plan seeks to shift billions in premiums and profits away from insurers, they will fight it with every resource at their disposal. We liberals proclaim the wonders of UHC, then fall silent as these vested interests start running their devastating Harry and Louise commercials against them.

So we need an intermediate solution to cherry-picking and other problems of providing health care through insurers.

That solution would be to require all insurers to offer a specifically defined "Standard" coverage, to put in writing their premiums for all classes, including what occupations and/or drugs the insurers red line or rate-up (e.g. cover with a surcharge), and make this information freely available to the public.

This is a relatively simple proposal that will force insurers to compete fairly and openly on the basis of price, and provide regulators, employers and individual buyers with the information they need to know about which ones are engaging in what practices.

[formercia]

19. And you thought illegal drugs were dangerous

They don't do it to be mean. A lot of the junk that Big Pharma sells will kill you if your body doesn't react well to it. I stopped taking Lipitor after my Insurance company's drug plan sent me counterfeit Lipitor and I became ill. They said they would replace it if I would just send in the remaining tablets. I still have the bottle. If some day it turns out what they sent makes me permanently ill, I will have the evidence to take those assholes to court.

I worked hard all Summer getting into shape and now I don't need statins.


Get off your fat asses and quit eating those Bavarian Creme Doghnuts. What you eat can kill you.

[hedgehog]

20. Sad to say, being in shape doesn't do it for everybody, some

people do inherit a high cholesterol. But you're tight - eating right and working out should be the first step.

We stopped using our company's mail pharmacy when they sent my daughter Parkinson's drugs instead of the prescription she's been taking for six years. We thought it was a generic substitute until she vomited twice in two days after taking the drug. I felt guilty for not double checking the medicine name, but then I remembered that in the old days, the pharmacist used to do that!

[formercia]

21. Now they have some flunkie to fill the bins

on the computerized drug dispensing machine. It saves a lot of labor.

[hunter]

22. My wife and I can't get individual health insurance.

Pre-existing conditions...

It's group insurance through work, the state's high risk pool, or nothing.

We've been through COBRA hell too.

This can happen to anybody. The United States is not a first world nation because we have such a crappy health care system. Even people with money and good health insurance can have inappropriate healthcare that causes more harm than good.

I think this is among the first problems the new legislature should face. This nation badly needs universal healthcare of some sort, and it would be good for business too. The current healthcare system is ruining the U.S. economy.

[Odin2005]

23. Private insurance is the greatest scam on Earth

It is like a guy who lets you borrow his unbrella for a fee when it's sunny, but then asks for the umbrella back when it starts raining. It's about getting those who need it the least to buy it and keeping the people who need it the most from buying it.