watch it: “Peggy Robertson's [sic] tells her story of insurance denial”
Another example of why the U.S.’s health insurance paradigm must die:
I’d like men to think very carefully about this: Imagine you were told you could get health insurance only if you were to have a vasectomy...
(via Feministing)
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comments
posted by LaSargenta (Wed Nov 04 09, 11:46AM)
...and to top it off that C-Sections are waaaaay more common in this country than any other, and our infant mortality is higher than most industrialized countries and I haven't heard very good things about our statistics on post-partum complications ... does this mean that US women are 'faulty' somehow? Hmmm?
Or, could it possibly mean that our whole medic-pharmaco-industrial complex is a mess and the people who set the 'needs' need to be gone after by a pack of citizens armed with flails persuing them in their corner offices up in the buidings and forcing them onto the streets?
posted by Kate (Wed Nov 04 09, 4:08PM)
So the company will insure the HUSBAND, who we assume is the father of her two children...but not her. Because apparently this woman got HERSELF pregnant.
Why not make the husband get a vasectomy? I mean, he's the one who knocked her up, which led to her eventually getting a C-section?
Or, I know, the insurance company could murder one of this couple's existing kids, since wiping out that child's lifelong medical care should counter-balance the costs of this woman potentially needing another c-section down the road if they decide to have another child.
Yeah that should work for the insurance company. And if for any reason this woman has complications with her health and costs the company more than they bargained for (after all, it's not like they are selling INSURANCE or anything), they can kill the other kid to make up for it.
Problem solved.
posted by CB (Wed Nov 04 09, 4:18PM)
Because making it physically impossible for him to impregnate a woman would not make it physically impossible for her to get pregnant.
Which is a very cynical thing of me to say, but that barely scratches the surface of the cynicism that is behind these decisions. Seriously, our health insurance industry is sociopathic, and we put these sociopaths in charge of our well-being. Because we're idiots.
posted by Accounting Ninja (Wed Nov 04 09, 8:13PM)
Yes'm! I faced a bit of this myself, though not as bad as her. At one point, I looked for independent health care. I am young and in perfect health. Well, a plan without maternity was reasonable (and by "reasonable" I mean it was still very expensive!). Buying an identical plan, only with maternity, was insanely more expensive. I don't want any more kids right now, but I might later...(maybe not though, lol). So I *guess* I could accept a no-maternity plan, but what if an accident happened? Well, I'd pretty much be fucked...twice. ;)
The REAL kicker was, if I got the no-maternity plan, they did not cover long term or alternative birth control! Basically, only pills were covered. I HATE pills and they mess me up. Horrid things. I'd much rather have an IUD. And hey, they work for 5-12 years, depending on the type! No expensive babies for years, Insurance Company! But no, it isn't covered.
No logic whatsoever. I ended up going uninsured for most of my 20s.
posted by CB (Wed Nov 04 09, 8:30PM)
Seems coldly logical to me. If they aren't covering your pregnancy, why should they care if you get pregnant? It's your problem! And if you can afford to have the kid then you'll have to pay for their insurance too. Why they provide even token support for birth control I don't know. Wouldn't be surprised if it's a regulation, and if not that then they have some chart that shows they get more money in extra premiums from saying they cover birth control than it costs to provide.
posted by MaryAnn (Wed Nov 04 09, 10:23PM)
Of course. Because if you're actually going to *use* the services insurance is supposed to cover, they're gonna make sure you pay through the nose for it. Which sort of defeats the entire point of insurance, which is to spread the risk and the cost around to everyone.
Which is the only reason I can think of, actually, for dental and vision coverage to be considered separate from medical coverage (as if your eyes and your teeth weren't part of your body): because almost everyone will take advantage of dental help at some point, even if it's just a cleaning or a filling, and almost everyone will need glasses eventually. With other medical insurance, it's possible that you'll skate by never breaking your leg or getting cancer, and the insurance companies win in that case. But they can't win when almost everyone will be getting reading glasses in their 40s.
posted by AJP (Thu Nov 05 09, 10:26AM)
Isn't this the sort of thing everyone has been saying they want insurers to take into account? I mean, it is preventive care and all, which is intended to reduce the cost of future care. . .
But seriously, the discussion here is exactly the reason insurance coverage is screwed up in the U.S. We don't treat it like insurance. Insurance is about spreading risk. Routine care is not a risk it is a certainty.
You hit the nail on the head as to why routine things like dental and vision vcoverage are seperate - because they aren't something that is cost effective to insure. Because they aren't risks.
Insurance works like this: the insurer takes a big pool of people of similar risk. It figures out the chance that one or more people will have an accident needing to be paid for. It divides that cost plus an amount to cover the insurer's administrative costs plus an amount of profit and charges everyone in the pool a share of that amount. Most people will not have an accident requiring coverage, and a few will. People buying insurance do so to avoid the possibility of having to pay out a big amount, and instead pay a smaller amount for coverage. The people who don't have an accident and get a pay out aren't cases in which the insurer "wins", they are what makes insurance work. The premiums they paid go to paying the big pay out for the people who did break their leg. The fact that not everyone breaks their leg is why paying insurance premiums is less than the cost of paying for the medical care yourself out of pocket.
Contrariswise, suppose the insurer decides to cover some sort of routine cost as well. The insurer has to assume everyone will take advantage of this and use the service. So they have to increase their premium by an amount at least equal to the cost of the service plus their administrative costs. This costs the insurees more than if they just paid for the care out of pocket. By definition coverage for routine matters is a bad deal for the insuree.
Now, in the U.S. we have gotten into the habit of expecting this, because we can pay for an employer provided plan with pre-tax dollars, which makes even this bad deal a little more attractive than paying out of pocket. But then people who pay for insurance on their own expect the same deal, and get screwed, because they are paying more for routine care than they would if they paid out of pocket. And the problem stems from thinking that health coverage for routine matters is somehow going to be a better deal than paying up front. Which is stupid, and a result of a fundamental misunderstanding of the nature of insurance.
Buying a plan with maternity coverage is more expensive, because it puts you in a different risk category. The category is "women who anticipate the possibility of getting pregnant, and therefore will need an expensive amount of care". Of course they will charge you more - they have to charge you pretty close to the amount the delivery plus hospital stay will cost, since the money for that visit has to come from somewhere. I'm always surprised when people are shocked by this.