|
|
The Insurance Companies Are Firing the Doctor’s Patients
In the small business insurance market, which includes not only health plans, but also commercial lines of coverage, the large insurers and their agencies are doing their best to mold the business practices of their small clients to their own advantage.
They now offer human resources outsourcing, for example, where for a fee they will act as the firm’s HR Department, advising them on hiring, firing, and payroll. They also offer risk management programs, which consist of training seminars and oversight over business practices that have the potential of incurring lawsuits from customers that the insurer would have to pay (Grocer, get that grape off the floor!).
In terms of group health insurance, insert the word employee before risk management, and you have a situation where the insurer may be implicitly or explicitly advising their small business insured’s to get rid of any employee who presents a high risk to the integrity of the health plan. This really means eliminating potentially expensive claims paid out by the insurer. The cancer survivor in this context is the loose grape on the floor of the grocery store.
Were these illegal practices to continue under the guise of insurance risk management, namely the ability of insurers to delete medically high risk employees from the insurance pool by encouraging employers to do their dirty work for them, the number of patients doctors could treat would progressively dwindle. As our population ages, more and more individuals will be stricken with cancer and other illnesses resulting in long term disabilities.
If the insurance companies succeed in their short term mission of purging our older citizens from the insurance pool, they will be in effect firing the doctors’ clientele. There will be few insured patients left who aren’t still young and relatively healthy. The latter do not make good doctor’s patients. The insurers may think that Medicare is the solution for our aging population. If cancer survivors like Adrian can just make it to 65, then she’ll be the government’s responsibility. Again, the insurance industry is looking to Uncle for the ultimate solution.
If they think Medicare is it, just ask our legislators what they think the long term future of that program is. If anything, the retirement age will be increased and benefits reduced in the not too distant future. Also, ask any doctor what he or she thinks about the current state of billing reimbursement under that plan. There are now many who will not even treat Medicare patients due to the slow and inadequate reimbursement rates.
Colorado and other states that allow their insurance carriers to run roughshod over their citizens must change their ways and re-institute fair underwriting practices. If one’s state government can’t protect its workers from predatory business practices, then we citizens must look to the federal government to remove that responsibility from the states. A system of national health care that is not tied to employment is the only answer, but the insurers are mistakenly convinced that their own survival would be threatened should that come to pass.
They will continue to flex their political and financial muscle to make sure they are the ones who dictate health care policy in this country, which will always be in their stockholders best interests. On this issue, our elected representatives have not supported our citizens’ best interests. They are the ones who elect those officials, pay taxes, pay their bills, and keep our country’s 500 top companies in good fortune.
PAUL HILL, A.B., Fellow, Life Management Institute
Director, Fair Employment for Cancer Patients & Survivors (FECAPS)
April 5, 2007
At this writing, a bill has been proposed in the Colorado State Legislature to re-impose community-based group health underwriting for small businesses, and prohibit selection by health status and claims experience. The Alliance of Independent Businesses is for it; the Metro Denver Chamber of Commerce is not. On April 24, 2007, the full Colorado Senate passed HB 1355. If it is signed by Governor Ritter, it will go a long way towards eliminating one of the causes of cancer discrimination in the workplace. See the Insurance Companies for details.
NEW: On June 1st, 2007, Governor Ritter signed HB 1355 into law. HB 1355, Colorado's New Small Group Health Insurance Law- text and analysis |
|