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Acebass Donating Member (926 posts) Send PM | Profile | Ignore Tue Apr-18-06 09:29 AM
Original message
Health Insurers Are Near-Monopolies
Healthcare is a right! not a priviledge...



Study: Health Insurers Are Near-Monopolies Mon Apr 17, 6:01 PM ET

http://www.sltrib.com/ci_3721530?source=rss

SAN FRANCISCO - Consolidation among health insurers is creating near-monopolies in virtually all reaches of the United States, according to a study released Monday.


Data from the American Medical Association show that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under U.S. Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.

The study also shows that in 166 of 294 metropolitan areas, or 56 percent, a single insurer controls more than half the business in health maintenance organization and preferred provider networks underwriting.

"This problem is widespread across the country, and it needs to be looked at," said Jim Rohack, an AMA trustee and physician in Temple, Texas. "The choices that patients have now are more difficult."

The AMA study cited a Justice Department benchmark in citing antitrust concerns, the Herfindahl-Hirschman Index, or HHI. A score above 1,000 shows "moderate" concentration. Those scoring above 1,800 yield a "high" concentration.


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newportdadde Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Apr-18-06 09:39 AM
Response to Original message
1. Much of the cost is stupid bullshit paper work - like asking me if I
was going to sue my wife.

My wife gave birth to twins two months ago, the second came rapidly and had some facial bruising. I get this claim letter in the mail asking me if a 3rd party was responsible for my son's injuries and if I intended to pursue legal action blah blah or if this was a workers comp claim and that I needed to fill out this paper work and send it back.

Think about that, an employee took the time to put together a packet of information about a freakin newborn... hmm did he get injured on the job? Will I sue his mother's vagina? Then that same person has to go through the trouble of reading what I wrote.

I got irritated and called em up and explained it to them but all I got was the 'standard procedure during facial 'trauma''.

Ow and don't you love the doctor bills they send out BEFORE FILLING WITH INSURANCE. Hey Newport you ow us 750 bucks! Two weeks later.. ow no make that 60 bucks. How about not wasting the freakin postage and time to send out this stuff unless its ready?

Waste waste waste.

Its Bullshit Admin fees that raise all of our damn costs.
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Acebass Donating Member (926 posts) Send PM | Profile | Ignore Tue Apr-18-06 09:48 AM
Response to Reply #1
2. I work in the healthcare industry...I know what you mean...
I canvassed for Citizens Action in the Summer of 92. We were lobbying then for a universal system of paperwork...the other lobby was too damn big...
A doctor spoke at one of our rallys, she said she needed to go back to college to get a legal degree to figure our half the damn paper work...

Working in the purchasing dept of a big hospital you see it all, the stories I could tell...

We Need A Change!...
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Democrat 4 Ever Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Apr-18-06 10:14 AM
Response to Reply #1
3. Two health insurance stories. I lost my health insurance coverage
Edited on Tue Apr-18-06 10:15 AM by Democrat 4 Ever
after exhausting my COBRA benefits after my divorce. Scrapped together a full 42% of my monthly income to pay that damn bill for a full 36 months after ex decided he wanted a newer model after 33 years of marriage. When COBRA ran out I was "offered" the chance of continuing the coverage for a measly 123% of my monthly income. Damn, had to pass on such a "great deal." :sarcasm:

Because of minor health problems I was turned down by every other company I applied to (find me one single 50ish person who hasn't had some kind of a health issue - no matter how small, or how long ago - it is a good reason for denial) so now I had the "opportunity" to apply for coverage under a state plan for the un-insurable. This plan only requires a small premium of 90% of my monthly income. Well, that won't work either. I have been self-employed for over 16 years and doing quite well but now I have to look for a job that offers health insurance. Been turned down by three different positions with small companies and I know for a fact one of them was because of health insurance underwriting - the owner told me, sorry as all get out, but what can you do? So now I'm flying solo, no insurance, no check-ups, no prescriptions, no hope for coverage unless the Dems can take back Congress and start addressing this problem for the 45 million of us.

Second story. Friend, owns a small business with her husband for 15+ years. Had a small business group health policy - just her and the husband as only employees and only individuals on group. Husband died in January. She is now trying to sell business (she is 60 and she and her husband had already planned on selling and moving to Colorado before he got sick). Well, she is now stuck because she is too young for Medicare but only gets continued coverage for 18 months - and only if the new owner agrees to keep the group in place for 18 months (which he doesn't want to do as he has coverage through his wife's employer).

IF she gets to exercise her continued coverage she will then have three and a half years with no coverage until she turns 65. She has been turned down for coverage from two different companies because a - she broke her ankle six years ago and has permanent pins in the joint - no problems since but Humana doesn't cover anyone with pins - period. The second company turned her down because her doctor recommended a sleep apnea test 8 years ago(!) and she declined (no problems with sleep apnea - husband "thought" she snored too much). She, too, can get coverage from a state sponsored program (with a huge monthly premium) but then she is locked into staying here in Kentucky because the coverage is not transferable.

Health care in America sucks. Period. The insurance companies have brought off Congress and the President and if we don't get this taken care of we are going to see the number of people without health insurance swell from a mere 45 million to a 100 million or more - and soon.

My friend and I are both tax paying, law abiding citizens. We are educated, contributing members of society yet somehow we are slipping through the cracks in the system and the repubs just don't give a damn as long as they keep getting those checks from the insurance lobbyists.

Sorry this is so long...but damn. Double damn.
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