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It's been a long time since I last posted here at Daily Kos but I recently saw my former health insurance company advertising on FB, so I wrote them a quick message.  Some clerk there told me I should email her and she would try to help with the issues I had with their company.  She got more than she bargained for; she got the truth!  I wanted to share.

Dear __:

I Facebook messaged you and was surprised to hear any reply from your company.  I did not expect a reply; I basically wrote because I found it hideous to even see your name, and I wanted to express my disgust with your company to you.  

We had BCN for many years as a group insurance.  Then we had to switch to individual, just like many did due to the poor economy.  As an individually covered family, you treated us with every ounce of greed and maleficence you could get away with!  For years, my husband and I had to put up with illegal, fraudulent behavior on your part, and the constant barrage of creditors hounding us because your company didn't pay what you were contractually obligated to pay.

Your company illegally cashed our checks and didn't credit them properly.  We had creditors attacking us because you wouldn't pay for the doctor's visits.  You prevented me from getting my regular health care checkups, mammograms, and Pap smears, and when it was known I needed more appointments with other specialists that was when you rescinded.  You pulled both of our daughters off  our insurance with 30 days notice right during Christmas time when most companies can't even be reached between Christmas and New Years!   You  actually gave doctors the wrong billing address and we got stuck with creditors coming after our daughter.    Then to top it off, you didn't pay her bills because whatever coding issues you had between the physician and your office.

Basically, the behavior of BCN was illegal.  It was fraudulent.  It was a disgrace.  It was shameful.  You got away with it and it was business as usual for your company to rescind and potentially cause death.  There is a reason insurance companies are known as 'murder by spreadsheet.'

I have no idea why you asked me to reply here because unless you are willing to pay for every medical bill we've incurred since you illegally rescinded the insurance, you can never make up for the medical, mental, and financial problems you caused.    You can never make up for the lack of ethics on your company's part either.

Sincerely,

~Silence is Complicity  

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Comment Preferences

  •  Insurance, as it is currently practiced in many (21+ / 0-)

    quarters, is legalized theft.

    I resent that. I demand snark, and overly so -- Markos Moulitsas.

    by commonmass on Wed Jun 05, 2013 at 05:54:19 AM PDT

  •  could you (16+ / 0-)

    also send a copy of your letter to your local papers, your reps, etc.?  

    I experienced similar problems, and my son is now.  Obamacare will not resolve this.  Nothing but single payer will.

    Justice For Will Will spent his brief, courageous life fighting for the rights we all take for granted. Please share his story to support the fight!

    by KibbutzAmiad on Wed Jun 05, 2013 at 06:03:08 AM PDT

  •  Very nice rant!!! I'm about to find out what (2+ / 0-)

    type if issues I'll have with my medical insurance....

  •  Your doctors sicced debt collectors on you? (4+ / 0-)
    Recommended by:
    Vatexia, SuWho, greengemini, chimene
    We had creditors attacking us because you wouldn't pay for the doctor's visits.
    Ugh, that doesn't sound very ethical (or even nice).  But I guess that's what the medical profession has become these days now that many to most doctors regard themselves as business people rather than health care providers.
    •  Yes. They have a sign on the window... (4+ / 0-)

      The sign says, "you are responsible for payment..."  That's pretty standard practice.  What all of them do is bundle the debt of all their patients and sell it to creditors.  The creditors get a percentage of what they get us to pay and the physicians who have 'written it off' take less than they would than if they got paid it all outright.  Thus it's a win-win for the creditor and the physician to hound you until you pay.

    •  Besides, it's not that I wouldn't pay, it's that (8+ / 0-)

      the INSURANCE COMPANY WOULDN"T PAY.  I paid my co-pay!

    •  OMG. Did you really think doctors wouldn't do (4+ / 0-)

      that?  You have no idea how many people have their doctors' bills in collection right now.  The biggest single reason for bankruptcy filings is medical bills.  

      Believe me, it's considered not just ethical, but necessary.  And since doctors' offices have to have several additional, expensive employees just to handle the insurance claims, I can understand that.  Much of which could be eliminated with single payor.

      "If you trust you are not critical; if you are critical you do not trust" by our own Dauphin

      by gustynpip on Wed Jun 05, 2013 at 06:54:34 AM PDT

      [ Parent ]

      •  Hospitals sure, but an individual doctor? (0+ / 0-)

        I just haven't experienced that myself, in my circle of acquaintances, so I'm just monumentally naive about this itwould seem.

        •  Private doctors have to survive too. However (0+ / 0-)

          the insurance companies are the ones who are playing fast and loose.  The patients go in with good faith expecting the insurance company to pay for their portion but often the insurance companies dick around with coding, mailing addresses, miscrediting payments or charging the wrong amount, and they do this because most people give in and pay to get the creditors off their back while the insurance company has enough lawyers and accountants to steal for good.

    •  How doctors get paid (5+ / 0-)

      It used to be that a patient would go to the doctor, the doctor would treat the patient, and the patient would pay the doctor for the treatment.

      Very few medical transactions occur that way today.  Most involve a large medical business and a large insurance business.  There are still doctors who work by themselves and only see patients who themselves pay for the treatment.  Many doctors prefer this arrangement, and are trying to unencumber themselves of the medical and insurance bureaucracies, if they can.

      Let's say the doctor is part of a large medical practice.  The large medical practice takes insurance.  The doctor typically makes a yearly salary from the medical practice that stays the same regardless of how many patients are seen, what treatments are given, or the health outcome for the patients.  There may be a year-end bonus or a profit-sharing scheme to augment the salary.

      The medical practice sets prices for treatments.  Let's pretend the practice prices a yearly physical exam at $100, and screening blood tests at $50.

      Let's say a rich person without insurance comes to the practice and wants a physical exam and blood work.  The practice charges the man $150, and he pays it.  Everyone is happy.  But, most patients coming to the practice are not rich, so this is a rare event.

      Let's say a person with insurance comes to the practice and wants a yearly physical exam and blood tests.  The practice charges the patient $20 copay for the physical exam, and another $20 copay for the blood work.  The insurance company pays $60 to the practice for physical exams and $25 for screening blood tests.  So the practice makes in total $125 for work that they price at $150.  The practice is willing to accept the lower payments from the insurance company because the insurance company pays for a whole lot of other patients and the insurance company helps drive new business to the practice in the form of new patients.  It's a business arrangement: we'll lower our prices for you, and you send us lots of business.  This represents the majority of medical visists and payments.

      Let's say a poor person with medicaid come to the office wanting a physical exam and blood tests.  Medicaid pays $45 for the physical exam, and $10 for blood tests.  With the copays, the medical practice might get $100 for work it prices at $150.  The medical practice takes a loss.  Some practices accept the loss as part of doing business (some money is better than none) and being a good neighbor, but many medical practices now refuse to see patients with medicaid because it is not profitable for them to do so.  

      Let's say a poor person without insurance comes to the medical practice and wants a physical exam and blood tests.  The work is done and the practice bills the patient $150 for that work.  But this patient has no money and nothing gets paid to the medical practice.  The medical practice can try and sue the patient, but this is expensive for the practice and takes a long time, and if the patient truely has no money, all the practice gets is a court order but no money.  Or the practice can try and negotiate with the patient to get whatever money they can.  Or the practice can sell the bad debt to a collection agency and gets pennies on the dollar.  Or the  practice can simply swallow the loss.  In any case, the practice loses big.  So the medical practice tries whenever possibe to avoid seeing patients like that.  So this also represents a minority of medical transactions, but in a bad economy a growing problem for medical businesses.

      Notice that the price of a treatment changes depending on whether or not an insurance company is involved.  Notice that the medical business wants more rich people without insurance and no poor people without insurance.  Sadly, there are not enough rich people without insurance to keep all the medical businesses profitable.  Hence, even though the medical practices don't like the reduced payments and paperwork hassles they get from the insurance companies, they are dependent on the insurance companies.  

      Most doctors, if they could, would choose not to have the insurance companies involved in their business.  Few doctors want to take action against patients who have not paid, but the business side of the medical practice has no such qualms: their job is to keep their books balanced, not guard the health of their customers.

      "The fool doth think he is wise: the wise man knows himself to be a fool" - W. Shakespeare

      by Hugh Jim Bissell on Wed Jun 05, 2013 at 07:46:46 AM PDT

      [ Parent ]

      •  umm yeah the price changes (3+ / 0-)

        as has been diaried on this site multiple times, the price charged a private payer for serious work is often many times what is accepted from insurers.

        •  As expected (2+ / 0-)

          The medical practice is behaving like other businesses.

          They want to get as much money as they can, but do not want their prices to be so high as to scare away customers.  And they have to be in rough parity with the prices of other local docs.

          The insurance company is like a preferred customer, so they get a price break.  The medical practice can lower their prices, but it eats into their profits so they would rather not lower prices.  If they lower their prices too much, there is no profit and they operate at a loss.

          This is similar to the pricing for other consumer goods.  The difference between buying a toaster and buying medical care is that deciding whether or not to buy a toaster rarely has long-term consequences for health and well-being.

          For many practices, medicaid patients are a loss.  The practice must carefully balance the number of medicaid patients vs. the number of insured or self-pay patients or the business loses money and eventually dies.  That is why it is often so hard for people with medicaid to find a doctor to treat them.

          There is certainly (in my opinion) an ethical dilemna in how patients who can't pay are treated.  The medical practice deserves to recover the expense they incur in treating a patient, but it seems unethical to me that the poorest patient gets the highest price - the highest price that the medical practice never gets from their insured patients, and the highest price the medical practice has already shown it does not need to stay in business.

          "The fool doth think he is wise: the wise man knows himself to be a fool" - W. Shakespeare

          by Hugh Jim Bissell on Wed Jun 05, 2013 at 10:48:08 AM PDT

          [ Parent ]

          •  medical practices are caught up in a severely (2+ / 0-)

            dysfunctional system.  They have to make up what they lose on bad debt by screwing who they can, since they can't make it up out of insurance payments.  The real answer, of course, is single payer.  

            Insurers are hardly entitled to lower prices by patient economics since there are no economies of scale involved in treating the insurer's patients.  There in fact are diseconomies dealing with insurers since extra staff have to be hired to squeeze payment out of them.  They merely get lower prices because of negotiating power.

            •  I agree (3+ / 0-)

              I agree entirely.  In my opinion, the needs of a for-profit enterprise are incompatible with the health needs of an individual, a family, or a nation.  In a society dedicated to making money, the need to show a profit will ALWAYS trump issues of health and wellness.

              If the needs of health and wellness are paramount, for-profit insurance businesses should not be involved.  There must therefore be a way to provide medical care without regard for making profits - i.e. public funding of healthcare.

              But because we here in America hold profits more important than people, we have a medical system that prefectly reflects our values.

              "The fool doth think he is wise: the wise man knows himself to be a fool" - W. Shakespeare

              by Hugh Jim Bissell on Wed Jun 05, 2013 at 11:24:09 AM PDT

              [ Parent ]

      •  If you go to a teaching/research hospital ER (1+ / 0-)
        Recommended by:
        Roadbed Guy

        then you can work out a financial arrangement with them, but if you go to a private company, they are blood suckers.

        •  Different kinds of enterprises (2+ / 0-)

          Yes, there are different kinds of medical practices.

          There are some privately-owned medical practices that exist to make money.  They are very aggressive about making money: they advertise to get patients, compete aggressively with other practices, and aggressively chase after every penny.

          Then there are hospitals.  Some hospitals are publicly owned and receive substantial amounts of public money - from the city, state or feds.  They are required to do a lot of unprofitable stuff: treat indigent patients, guard the public health, train future doctors, do research, etc.  Many of these institutions are in dire financial straits and many have closed altogether.

          Some hospitals are privately-owned but function as charities - like the numerous catholic hospitals.  They take on as their mission the work of providing healthcare to the unprofitably poor.  They get their money from charitable donations and getting what little money they can their poor clientele.

          Then there are public/private partnerships - the model favored by republicans: the privatization of public functions.    These hospital exist to make profits for share-holders.  In return for taking on some of the necessary but unprofitable medical work, they get some public money.  Their ability to be profitable depends in part on doing "upper crust" medicine (i.e. liver transplants for wealthy foreigners, elective double-mastectomies for movie stars, elective gastric bypasses for hefty politicians, etc), and skimping whereever possible on all that unprofitable stuff (training, research, etc).

          And then there are the hospitals that exist solely to make profits.

          What kind of arrangement you can make for payments depends in part on what kind of institution you are dealing with.  

          "The fool doth think he is wise: the wise man knows himself to be a fool" - W. Shakespeare

          by Hugh Jim Bissell on Wed Jun 05, 2013 at 11:14:04 AM PDT

          [ Parent ]

      •  But they really don't want to tell you how much it (1+ / 0-)
        Recommended by:
        Roadbed Guy

        is going to cost.

        I've gone round and round with specialists about this, and gotten switched round and round the office until they find someone who can tell me....how much an office visit costs.

        When you come to find how essential the comfort of a well-kept home is to the bodily strength and good conditions, to a sound mind and spirit, and useful days, you will reverence the good housekeeper as I do above artist or poet, beauty or genius.

        by Alexandra Lynch on Wed Jun 05, 2013 at 12:48:50 PM PDT

        [ Parent ]

        •  Doctors rarely know (0+ / 0-)

          Doctors themselves rarely know how much a treatment is going to cost.  Partly that is because treating 2 different patients with the same problem might involve 2 different procedures, partly because of the bureaucracie sinvolved, and partly out of ignorance.

          Let's say you are going to have a mammogram.  Your GP who orders the mammogram charges a fee to prescribe the test.  The hospital or x-ray clinic will charge for the use of the x-ray equipement.  Tne radiologist who examines the x-rays also charges a fee.  You GP who orders the mammogram may have no idea what these other entities charge for their services.

          And of course, what you pay out of pocket depends on whether you have insurance or not, and the terms of that insurance.

          "The fool doth think he is wise: the wise man knows himself to be a fool" - W. Shakespeare

          by Hugh Jim Bissell on Thu Jun 06, 2013 at 07:06:43 AM PDT

          [ Parent ]

  •  Insurance. Huuhh! (1+ / 0-)
    Recommended by:
    Silence is Complicity

    What is it good for?  ABSOLUTELY NOTHING!

    Of all the preposterous assumptions of humanity over humanity, nothing exceeds most of the criticisms made on the habits of the poor by the well-housed, well-warmed, and well-fed. --Herman Melville

    by ZedMont on Wed Jun 05, 2013 at 06:56:54 AM PDT

  •  They're evil. (1+ / 0-)
    Recommended by:
    Silence is Complicity

    But mainly commenting because our user names go together nicely!

  •  Blue Care Network? (3+ / 0-)

    Is that the name of it?

    The Julianna Michigan Show on Itunes and Podbean.

    by libnewsie on Wed Jun 05, 2013 at 08:28:03 AM PDT

  •  One of the main reasons I retired in ASEAN was due (2+ / 0-)

    to the high cost of health care in the USA (double the other industrialized countries). When you add the dysfunctional insurance industry to this high cost bear trap, bailing out made good sense. Same for the cheap dental care out here. With sufficiently low prices, there is no need for insurance because there is no reason to spread the risk because the financial risk is so low.

    Yeah, if I get cancer or have a massive heart attack, my life turns to dirt and I will die, rather than leaving my widow and children broke. Well, not all lives have happy endings, but I will gladly take this risk, rather than be bled for life savings.

    I voted with my feet. Good Bye and Good Luck America!!

    by shann on Wed Jun 05, 2013 at 09:14:34 AM PDT

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