The Insurance Scam

I understand arguments on both sides of national health care, but when you see a lot of the instances of insurance companies abusing their own systems, it’s not hard to see why people are fed up with the current system and are pushing for the government to do something about it.

Check out this post on The Daily Kos. If you don’t feel like surfing, the gist of it is Blue Shield told him they’d pay a claim, then spent seven months assuring him they’d pay, and in the end refused to pay anyway. And to put a little more force into the nutshot, Blue Shield told the anesthesiologist behind the claim that they paid the patient (Kos) and the anesthesiologist needed to collect from him. Kos, of course, never received a check.

It’s a travesty what companies decide to pay and not pay. The guy’s paying $800/month in premiums, and Blue Shield is fighting him over $632. I think it’s just as bad for the doctors; the anesthesiologist is short that money and is getting the same runaround from Blue Shield, and the insurance company bean counters come up with their own pricing for procedures. Not to mention the times insurance suits make decisions on whether a patient should or should not have a procedure based not on the patient’s health but on the cost of the procedure.

The problem I’m dealing with now is an increase in premiums. Our group is fairly small, and we’ve had some major problems hit our staff in the past two years. As a result, our insurance premiums are going up 62%. The insurance agent says that’s the worst news he’s had to deliver in his several decades in the business.

I crunched the numbers on my pay stub and learned I’ll be coughing up another $100. That was bad enough, but as I showed my wife the figures it dawned on me I get two of those stubs a month, so I’m actually looking at an increase of $200/month.

That’s almost my car payment. It also means I may take a pay cut on my net paycheck compared to last year; my raise this summer came to around $60 a paycheck. The insurance agent is shopping around for other options, but I’m not getting my hopes up.

If the increase goes through, this will be the second time I’ve had this happen. My employer the first time didn’t much care, and he refused to talk about alternatives. Hopefully things will go better this time.

About Mike Oliveri

Mike Oliveri is a writer, martial artist, cigar aficionado, motorcyclist, and family man, but not necessarily in that order. He is currently hard at work on the werewolf noir series The Pack for Evileye Books.

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