My friend Ken Cohn recently posted about the troubles he is having with his health insurance provider (see Uncollaborative Insurance). I wanted to share his thoughts as I agree with them completely. Ken is paying an amazingly large amount of money for his health insurance as an individual yet his coverage is limited and the health insurance company refuses to look at his individual situation. I have found health insurance companies to be very unresponsive over the years. I have had frequent struggles over coverage were bureaucratic rules got in the way of common sense.
In one instance a family member required service from someone who knew the history of the patient. That was a critical nature of the service. However, the insurance company would not allow for coverage because the right doctor with the right experience was not one of their doctors. So they said we would have to go to a brand new doctor on their list because that was what the rules said. It would have been a waste of time to do this because the service required a prior base line understanding. The insurance company never seemed to understand this despite letters from our primary doctor. So we never got the service.
In another case I was placed into a potentially critical situation because my doctor did not want to perform an expensive diagnostic procedure that would have uncovered this condition before it advanced to the more critical condition. I could go on and on. We have one of the most expensive health care systems in the world but we do not get the value out of it. Part of the high cost goes to the large profits the insurance companies take out of the system, as well as the unnecessary bureaucracy. I understand the need to spread risk but the insurance companies have too much power over our health care. I do not know anyone who has good things to say about their health insurance provider when they need to talk with them. I wish Ken luck in his struggles.
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Posted by: Health Articles | April 24, 2009 at 01:33 PM