Imagine undergoing a cancer treatment and then being informed by your insurance company that had already approved the treatment that your claim has been denied. This is what just happened to Paul, a young man who passed away from cancer. His story was published in a series of newspaper articles, with each new article bringing an update of how his health insurance company was jerking him around. This man is a tragic depiction of the poor state of the health care structure in the United States. Paul was a human being, not just a number; he didn’t deserve to be treated so callously.
Upon his diagnosis Paul was informed that he needed several expensive treatments. When the treatment facility called for authorization, it was given since cancer treatments were a covered benefit under his policy. At his time of extreme vulnerability, the same insurance company that he faithfully paid premiums to denied him help instead of providing it when he needed it the most.
Not only did Paul have to struggle with a horrible disease that was claiming his life, he also had to put on boxing gloves and fight with an insurance company that refused to pay for treatments that it had already pre-approved. The company tried to say that his condition was pre-existing which was a ploy designed to impede the payment of his claim. When the media was notified and became involved, the insurance company decided to pay for treatment, but by that time it was too late.
It is really sad that an industrialized country has such a rundown health care system. The United States is listed as being one of the top ten richest countries, yet the health care system is so broken that people die because their insurance companies are employing the ‘delay until death’ tactic, also known as ‘bad faith insurance.’ The way it works is insurance companies make money when they don’t pay claims so they will do anything to delay or deny the claim knowing full well that if they hold the claim up long enough, the policyholder will die.
What is so appalling is that the very companies that we pay our hard earned money to and put our trust in to help us during our times of need actually have methods in place to abandon us and put our money in their profit accounts. Some companies go as far as to reward their employees for having low payout rates or high claims denials, and give incentives and gifts to employees that meet cancellation goals that are set by the company. If an insurance company decides that a person’s medical treatment is getting too expensive, they simply make a decision not to honor the contract that they entered into with the consumer without giving any thought to, or caring about the consequences.
Unfortunately there is an upward trend of insurance companies that approve treatments and medical procedures, and then deny the claim after the treatment or procedure has been performed. The policy holders are the victims while the insurance companies that use this scheme profit at their expense.
There are some really good insurance companies out there; the bad ones have cast a darkness that will be extremely difficult for our current health care system to overcome unless some kind of a major overhaul takes place that makes it impossible for insurers to discount human life in favor of money. The grass might not always be in better condition in the yards across the pond, but they do have the right idea in providing universal health care for their citizens where insurance companies aren’t deciding who lives and who dies.
© Copyright 2009 Patti McMann. All rights reserved