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The health insurance and managed care industries are strange bedfellows. Now learn what is meant by health insurance: it works better for health insurance companies than it does for patients, by and large.
They, the insurers "like to cite figures showing that 87 cents of every dollar in premiums is spent on medical claims. But a new Senate analysis suggests that for-profit insurance companies are spending much less than that, especially for policies sold to individuals and small businesses. Instead, as little as 66 cents of each dollar paid in premiums goes toward doctor and hospital bills, while the rest covers administrative expenses, marketing and company profits."
Ableson R. "Senate Pressing Insurers on the Amount of Premiums They Spend on Care." (about medical loss ratios)
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Holes in the safety net
A veritable rock under which an insurer may crawl
According to the Government Accountability Office, somewhere between 36 and 112 million adult persons, or 20-66% of the U.S. adult population, have "pre-existing conditions" —hypertension, mental health disorders and diabetes are the most common. Unfortunate for patients, but not necessarily in terms of their health; rather their friendly insurer may use such a diagnosis as an excuse to not cover the cost of care. Perhaps it's a rumor, but I've heard having a uterus is preexisting condition; so is having had cancer 10 or 20 years ago.
Shame on insurers for this deceitful practice. Clearly, we need rules of ethics and social responsibility that will prevent this greed and to keep our safety nets from having holes in them.
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