As I stated earlier, we live in the most prosperous country on Earth. Yet 13% of our fellow citizens hold no insurance coverage of any kind (including 10,000,000 children), and another 7% are underinsured. What this means, fundamentally, is that 72,000,000 of your friends, relatives, neighbors, perhaps even you, lack the ability to access basic preventive and emergency health services when needed.
Why?
Some can’t afford it. Some choose to not buy it. Some feel they’re invincible. Some believe that they’ll be taken care of just fine if something happens. And then there are people like Robin Beaton from Texas, who had health insurance from Blue Cross Blue Shield, yet, when she needed a double mastectomy, her policy was rescinded. It was rescinded because she had left out a “material fact” from her application. Namely that she had acne as a young adult, and had sought treatment from a dermatologist.
The process of rescission, put simply, is defined as the setting aside of a contract. It’s a legal maneuver used by insurance companies to cancel the policies of individuals who have “left out material information” from their insurance applications. The spirit of the law of states allowing the practice of rescission (it is allowed in 50 of 50 states of the union) is to allow insurance companies to protect themselves against being defrauded by people (like me) who have expensive conditions, yet fail to disclose this on their applications for insurance. Having worked in the industry, and being trustworthy, I don’t believe in hiding this
In practice, this process is used much more routinely to take policies out of force, for example as in the aforementioned case of Ms. Beaton. Double mastectomies are not cheap. In cases such as Ms. Beaton’s, files get “red-flagged,” for review of any preexisting condition that might allow the insurance company to merely tell the policyholder that their policy was never in force because of the lack of disclosure, so that the insurance company does not have to pay. Insurance companies will rescind the policy with the hope that the person whose claim is being denied doesn’t come back and appeal the denial – or worse, get their congressperson involved.
I know this both because of the Congressional record… and because I used to work for an insurance company and routinely typed letters rescinding policies and returning policy fees because policyholders “failed to disclose prior medical conditions”. It made me ill to have to type these letters denying claims for $5,000 or so dollars for life insurance because of the lack of some disclosure. Sometimes it was obvious that the client was at fault. Sometimes the company’s claim was dubious.
But I write this asking a simple question… in a case like this, who would you rather be dealing with? An insurance company whose primary responsibility is to the shareholders of the company to ensure the largest possible profit? Or would you rather trust the decision to a government bureaucrat?
I understand that government doesn’t generally fix things… but I’d rather someone who’s disinterested being in charge of approving my claim, and not someone looking out for their bottom line.
Contact your Representative and Senator and demand this reform. We need this if we’re ever to get on an equal footing with other industrialized nations.
