Is The Health Insurance Industry In The US Broken?-5239

April 11th, 2011
Is The Health Insurance Industry In The US Broken?-5239

According to one rich family in New York, it appears so. Speaking with reporters from the New York Times one family member said: “Unlike many others, my family can afford medical care, with or without insurance.”

She added: “The truth is that individual health insurance is not easy to get.”

President Obama has tried to remedy the situation by passing legislation to force all American citizens by 2014 to have health insurance cover. Currently, there is a massive problem with millions being unable to get or afford suitable insurance cover. Further, many who are able to get it often find that it doesn’t cover sufficiently.

This last point is well known in the USA with many people who had previously been healthy suddenly find that no sooner than they contract a serious disorder such as cancer only for the insurance company not to pay out, or stop payments half way through any treatment.

Donna Dubinsky continued: “Since my husband had retired a few years earlier, we found ourselves without an employer and thus without health insurance. My husband, teenage daughter and I were all active and healthy, and I naïvely thought getting health insurance would be simple.

“Why did we even need insurance? First, we wanted to know that, if we had a medical catastrophe, we would not exhaust our savings.

“Second, uninsured patients are billed more than the rates that insurers negotiate with doctors and hospitals, and we wanted to pay those lower rates. The difference is significant: my recent M.R.I. cost $1,300 at the “retail” rate, while the rate negotiated by the insurance company was $700.”

Donna then received a letter, which essentially told her that she was denied health insurance.”It never occurred to me that we would be denied! Yes, we had listed a bunch of minor ailments, but nothing serious,” she said. “No cancer, no chronic diseases like asthma or diabetes; no hospital stays.”

She added: “Why were we denied? What were these pre-existing conditions that put us into high-risk categories?

“For me, it was a corn on my toe for which my podiatrist had recommended an in-office procedure. My daughter was denied because she takes regular medication for a common teenage issue. My husband was denied because his ophthalmologist had identified a slow-growing cataract.

“Basically, if there is any possible procedure in your future, insurers will deny you.”

The US health care system has been criticised by many both in the country itself and outside. In the UK, some are worried that if the NHS is privatised then the health care system here could go the same way as that in the USA.

As for Donna, she said: “I have no doubt that the system is broken and reform is absolutely essential. If we are not going to have universal coverage but are going to rely on employer plans, then we must offer individuals, self-employed people and small businesses a place to purchase insurance at a reasonable price.”

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