General Discussion

Marr

(20,317 posts)

137. I have a friend who is an insurance lawyer, and the stories he tells would get your blood boiling.

Sun May 12, 2013, 12:16 PM

May 2013

He says it's all down to numbers. They refuse claims out of hand, whether they're covered by the policy or not, because the numbers show that a certain percentage of people will not contest it (probably because they're too sick or too broke). Very often, they roll over at the first hint of legal pushback, because they know very well that they're in the wrong and legally obligated to provide coverage.

Other claims are contested in court because they feel they can get out of providing coverage on some bizarre technicality.

It's all a matter of percentages and hitting the sweet spot for profit. It has nothing to do with providing health care at all.

Cannot edit, recommend, or reply in locked discussions

Edit history

Please sign in to view edit histories.

Recommendations

0 members have recommended this reply (displayed in chronological order):

166 replies

= new reply since forum marked as read

Highlight:

This message was self-deleted by its author [View all] devilgrrl May 2013 OP

What is your home state? MADem May 2013 #1

This message was self-deleted by its author devilgrrl May 2013 #5

Whatever you do, don't wait until the end of the fiscal year--they'll hit you twice if you are MADem May 2013 #17

Health insurance today is like "protection money" - you're not really protected. canoeist52 May 2013 #2

I'm not sure what you're asking RILib May 2013 #3

It's likely SoCalNative May 2013 #15

I was confused at first. BlueCheese May 2013 #24

Does it matter? In fact your very questions show the enormous problems with a Health Care sabrina 1 May 2013 #30

Good post. NCTraveler May 2013 #60

If countries like Great Britain can OwnedByCats May 2013 #100

Agreement all around here.... geckosfeet May 2013 #127

That's how I see it as well. JEB May 2013 #128

Thank you, JEB. I appreciate very much your good wishes. sabrina 1 May 2013 #156

What would it have cost you if you didn't have insurance? lamp_shade May 2013 #4

This message was self-deleted by its author devilgrrl May 2013 #7

It gets you a "discount." silverweb May 2013 #6

People who think PROpaganda makes SENSE like it, though. Occulus May 2013 #20

! OnyxCollie May 2013 #33

I get your response, but... I'm not laughing. Occulus May 2013 #34

What I thought was funny OnyxCollie May 2013 #48

I think both you and Occulus are quite clever dflprincess May 2013 #104

That's an excellent point, and I think many here have noticed the Marr May 2013 #135

The information may be presented PROfessionally, Art_from_Ark May 2013 #165

PROpaganda makes SENSE!!! I love it!!!! grahamhgreen May 2013 #39

+ a gazillion. nt Mojorabbit May 2013 #148

+ 1 brazillion Myrina May 2013 #43

I was clear as to why two posts later, in my next response Occulus May 2013 #45

A conglomerate of think tank hookers. grahamhgreen May 2013 #158

+1 HiPointDem May 2013 #8

Somebody's gotta make money somewhere... KansDem May 2013 #9

CA Dept. of Health Care Services may have some leads / info for you - pinto May 2013 #10

I had a failed surgery 20 years ago that at the time was covered by my parent's insurance. tridim May 2013 #11

You should check out Thailand taught_me_patience May 2013 #93

Surgery should be covered in 2014. Caps, not likely. Hoyt May 2013 #110

Call the hospital's Social Services Department alfie May 2013 #12

Probably not. I don't know of any such thing. MineralMan May 2013 #13

A dollar is too much to pay to get a working knee Occulus May 2013 #23

Actually, not. Ms. Toad May 2013 #76

Adjusted for inflation, not so Yo_Mama May 2013 #92

I see the results of the under and un-insured daily, hobbling. That's the result. freshwest May 2013 #28

You realize that to some people, $3000 is an astronomical Flatulo May 2013 #46

Of course. I do not have it. MineralMan May 2013 #47

Aren't you a font of compassion! rusty fender May 2013 #50

No. I'm a pragmatist. MineralMan May 2013 #51

Actually, that's a destructive and harmful psychological technique called "minimizing" Occulus May 2013 #66

I see. You have misread my reply, then. MineralMan May 2013 #67

No, I recognize it for what it is. Broadly speaking, it's termed "invalidation". Occulus May 2013 #68

You're wrong. But that is your opinion and you're entitled to it. MineralMan May 2013 #70

No, actually, I am not wrong. Occulus May 2013 #71

So then Newest Reality May 2013 #83

That's one of the points of the material, yes. Occulus May 2013 #84

That's a lot of fancy talk to explain a jag-off statement dropped in a thread. Hassin Bin Sober May 2013 #125

Thank you so much for putting this into words. canoeist52 May 2013 #140

Not too long ago he talked about having to borrow a couple hundred dollars to have... Hassin Bin Sober May 2013 #123

I understand you a lot better after reading this post. nt. NCTraveler May 2013 #62

$3K is a lot if you don't have it dflprincess May 2013 #99

Yes, it is a lot. I don't have that much on hand, either. MineralMan May 2013 #119

You don't know? Marr May 2013 #136

I don't know if there's a program where the OP is that MineralMan May 2013 #145

How bad is your knee? voteearlyvoteoften May 2013 #14

This message was self-deleted by its author devilgrrl May 2013 #31

Just something to look into... Melissa G May 2013 #49

This message was self-deleted by its author devilgrrl May 2013 #61

Make sure you get a talented doctor. Melissa G May 2013 #63

The procedure is actually kinda interesting. Puglover May 2013 #56

This message was self-deleted by its author devilgrrl May 2013 #59

Swear to God. Puglover May 2013 #90

What's the point in having surgery if you're the same without it? postulater May 2013 #16

Um, yeah, a competent clinic will not recommend surgery for knee arthritis. Warren Stupidity May 2013 #65

The point is for you to be required to keep propping up corporate thieves. Egalitarian Thug May 2013 #18

With long lists of blue links, because PROpaganda makes SENSE. Occulus May 2013 #25

Naw, Not ban. Just giving you more rope... BlueCaliDem May 2013 #80

Lack of insurance/insurance shenanigans were killing people before - haele May 2013 #27

We were already spending enough per American to have top flight health care for everyone Fumesucker May 2013 #29

I know - Before wasn't "better" and was untenable, but now is not good enough and more expensive. haele May 2013 #32

Do they use cannabis? They don't have to smoke it and it may help. Occulus May 2013 #36

Who would you rather have pay for it? It is your knee. cbdo2007 May 2013 #19

The insurance company to whom the OP is likely paying a hefty premium? Fumesucker May 2013 #21

The taxpayers buying weapons and vehicles the military SAYS it doesn't want or need? Occulus May 2013 #37

Why are you posting here? ForgoTheConsequence May 2013 #152

HAHAAHHAHAHA cbdo2007 May 2013 #159

The Culprit Is For Profit health Care colsohlibgal May 2013 #22

Profit for shareholders and sky-high salaries for executives Cal Carpenter May 2013 #26

Did you go to an emergency room? JDPriestly May 2013 #35

To make money for Wall St investors. It hurts the shareholder when you are treated like a person. raouldukelives May 2013 #38

No kidding. Every year I have to fork out more and more money smirkymonkey May 2013 #40

Medicare For All. Where is the FIX for Obamacare we were promised when it passed???? grahamhgreen May 2013 #41

First it has to be fully enacted. Another year and a half before that happens. Honeycombe8 May 2013 #87

A suggestion cyclezealot May 2013 #42

How's this for another thing to bitch about matt819 May 2013 #44

None, whatsoever. Cleita May 2013 #52

I lived without insurance for decades csziggy May 2013 #105

In 1991, I spent two weeks in a hospital, part of it in a coma. MineralMan May 2013 #53

I agree, doctors make far too much money.There are 1000s of drs in other countries that graham4anything May 2013 #54

This message was self-deleted by its author devilgrrl May 2013 #58

No it wasn't. Healthcare starts and ends with doctors. graham4anything May 2013 #124

What an odd position. Xithras May 2013 #64

1000s of doctors that are just as good at knee surgery? link? eom yawnmaster May 2013 #74

Uh, yeah, try again. (nt) Posteritatis May 2013 #81

What??? Are you living in your own world while ignoring what happens under a ... slipslidingaway May 2013 #96

It's not the doctors it's creeps like the CEO at UnitedHealth Group dflprincess May 2013 #101

Without a doctor there would be no insurance companies. Without a teacher, no doctor graham4anything May 2013 #122

"OR a doctor could accept something other than money for services(barter). " Puglover May 2013 #129

Doctors are rich. A doctor needs a car mechanic, needs a plumber, needs whatever graham4anything May 2013 #130

answer #2-I bet 1000s of the richest doctors would quit if there was a limit they could charge graham4anything May 2013 #131

BTW-a football team owner makes more than the quarterback who makes more than a defensive back graham4anything May 2013 #133

Doctors are not the problem generally OwnedByCats May 2013 #114

I had my knee scoped in the States. Puglover May 2013 #55

I see according to your profile info, that you live roughly truedelphi May 2013 #94

Yep. Puglover May 2013 #118

Actually i rather prefer that the RW A-holes truedelphi May 2013 #146

My Aunt and Uncle are both retired federal employees abelenkpe May 2013 #57

They don't get Medicare? nt Honeycombe8 May 2013 #88

I'll ask abelenkpe May 2013 #91

Should the doctor work 100% for free? If one wants free, then the doctor should be free graham4anything May 2013 #132

Who said anything about expecting doctors to work for free? abelenkpe May 2013 #138

starting last month, for 2013-14, thanks to President Obama, I have saved $19,200 in premiums graham4anything May 2013 #139

Can you do me a favor? abelenkpe May 2013 #143

The point? To keep insurance companies profitable. LWolf May 2013 #69

It seems. n/r Cleita May 2013 #108

Insurance companies should be eliminated and replaced by national health care--not insurance. Comrade Grumpy May 2013 #72

This message was self-deleted by its author BOG PERSON May 2013 #82

Making a small comment so I can get back to this truedelphi May 2013 #73

I suspect they are right. With insurance a bill I got was 3800, and I needed to pay 800 of that still_one May 2013 #85

$3000.00 is what percentage of the total? Did you have to pay that total, or just the $3K? bike man May 2013 #75

This message was self-deleted by its author devilgrrl May 2013 #77

I am old, and have noticed a trend. When I was a child a tooth filling cost $5. morningglory May 2013 #78

I noticed that, too. Dental ins. is a fairly recent thing. I held out for a long time. Honeycombe8 May 2013 #89

I had dental insurance from 1978 - 1989, and again from 1998 - 2000. Ms. Toad May 2013 #97

Maybe in your area it's been around. Dental ins. here (dallas) started in a big way... Honeycombe8 May 2013 #112

Around here there are dentists who accept insurance - Ms. Toad May 2013 #113

Oh, now you've reminded me. That's it! Not many Dentists would TAKE ins. Honeycombe8 May 2013 #116

My spouse is happy with her insurance dentist - Ms. Toad May 2013 #117

I'm talking about 1957. nt morningglory May 2013 #144

In that era any kind of medical insurance Ms. Toad May 2013 #147

This is how the insurance industry works. It is how they get us to pay more for less. n/t Egalitarian Thug May 2013 #121

I have a friend who is an insurance lawyer, and the stories he tells would get your blood boiling. Marr May 2013 #137

After the Big Insurers Profit Assurance plan starts operation, truedelphi May 2013 #79

During the holidays I had cataract surgery that I'm still paying for. Boomerproud May 2013 #86

Even with insurance many people file for bankruptcy ... slipslidingaway May 2013 #95

Most medical bankruptcies are filed by people who have (or had) insurance dflprincess May 2013 #102

Exactly and as you say this will not change with the ACA ... slipslidingaway May 2013 #106

I suspect most of those did not have a $6250 cap on out-of-pocket expenses. Hoyt May 2013 #120

A person with a chronic condition may hit that $6250 cap every year dflprincess May 2013 #149

I don't think you would want the out-of-pocket cap to increase. Hoyt May 2013 #150

The Affordable "Care" Act allows the cap to increase every year dflprincess May 2013 #160

Use an in - network provider and they can't charge you extra. Hoyt May 2013 #161

They can continue to charge copays dflprincess May 2013 #162

No they can't once you pay $6250. You will be much better off than before m Hoyt May 2013 #164

Any eligible expense you pay out of pocket Ms. Toad May 2013 #163

I don't know what options you had when you obtained insurance - Ms. Toad May 2013 #98

We had a choice of two policies from a fortune 100 company ... slipslidingaway May 2013 #109

Unfortunately, we know we will hit the max every year. Ms. Toad May 2013 #115

We now know we'll hit the annual max each year as well ... slipslidingaway May 2013 #153

Physically - holding steady. Ms. Toad May 2013 #154

Sounds like a net positive ... slipslidingaway May 2013 #155

Unless you absolutely cannot pay, it's worth it. JVS May 2013 #103

I hear you. Bonobo May 2013 #107

You've got to pay up to the deductible and 20% of the remaining treestar May 2013 #111

3k sounds like a co-pay for that surgery. geckosfeet May 2013 #126

The point is this: unscrupulous capitalists are ripping us off so that they can get as rich as Zorra May 2013 #134

I'm really surprised by some of the responses in this thread. Texasgal May 2013 #141

I'm not. ForgoTheConsequence May 2013 #151

1) pay off the insurers that are a part of the System (doesn't even have to be for campaign funds) MisterP May 2013 #142

Because, Prrrrofits Baby!!! kenny blankenship May 2013 #157

Insurance corps can't give up any premium monies on you. They may go bankrupt. lonestarnot May 2013 #166