First its coverage that insurance companies will find loopholes for, next it will be claims.

[Cleobulus]

And this is one of those situations with loopholes so big you can drive a train through them. First, yes insurance companies can no longer deny claims due to preexisting conditions. Great, all that means is that they will get more creative than just using that excuse. Does anyone remember the documentary "Sicko"? It covered, almost exclusively, people who HAD insurance and got screwed over by the insurance industry in one way or another.

The first people shown were a couple who lost their home, their savings, their livelyhood because of copays and deducts for multiple medical problems, and they had to move into what amounted to a closet in one of the kid's homes.

The movie featured a woman who drove to Canada(illegally) for affordable health care for her kids, she came down with cervical cancer and the insurance company refused to pay for treatment on the grounds that she was "too young" to have cervical cancer.

One woman had a brain tumor, the insurance company said it wasn't "life threatening" so refused to pay for it to be removed, she died of her non life threatening tumor.

One woman lost her child because Kaiser Permanente refused to pay for an out of network hospital to treat her.

Yet another woman had the insurance company refuse to pay for an MRI because she had symptoms of possibly a brain tumor in her head because it wasn't necessary, she was in Japan(visiting family) when she fainted and finally got the MRI there that proved she had the tumor. Her insurance company in the States still refused to pay for treatment, so she called a lawyer, and was finally able to get treatment after that.

Another woman lost her husband because the insurance company they were covered under refused to pay for his cancer treatments because it was "experimental".

The question isn't how to make sure people are "covered" by insurance companies, its to make sure these companies pay up when needed. The bill does allow for an internal appeals process, which will be a joke, and an external appeals process. The question is how long will the appeals process take, and what happens in the meantime? These companies make pretty cold calculations on this, they will deny a claim on the basis that the member they deny it too will NOT seek a lawyer, and hopefully will die before the claim can be payed.

[kenny blankenship]

1. You do not finesse these people. They finesse you.

And by "finesse" I mean fuck brutally. They are and have been way ahead of all so-called political "reformers." They bought us off at the top.

They will own and operate their supposed "regulators" too. They will direct the Executive agencies. They will direct the Congressional oversight committees.

[DebbieCDC]

2. That's why they were promised no public option and no Medicare for all

These fuckers can always find a way to deny paying for treatments. Without the public option or Medicare for all there's no competition and they are free to continue with this bullshit -- of course, using creative new names for "denial" like "not financially feasible at this stage of the disease".

[SocialistLez]

3. Before this thing passed

There was already talk that they can deny claims based on "lifestyle choices."

If you have a heart attack, they can say it's because of your diet, your weight, etc.

::sigh::

I already canceled my doctor's appointment for this week.
I don't want to leave a paper trail for the insurance company. I might end up going to a free clinic and writing down a false name.

[ChicagoSuz219]

4. Relax... all the kinks will be straightened out. n/t

[Cleobulus]

8. Those kinks can kill people, to put it bluntly, when will they be fixed? n/t

[ChicagoSuz219]

9. Well, according to an article I just read on HuffPost...

...the insurance companies have already caved.

[Cleobulus]

10. Not on the issues I raised.

And honestly I find it to be extremely naive that people think the insurance companies have caved so easily on this issue. Its PR, plain and simple, a few months from now we will probably get a trickle of reports from people that insurance companies refuse to cover because their kids have preexisting conditions, and the insurance companies have teams of lawyers who will sift through the bill and find other loopholes or omissions to exploit.

[ChicagoSuz219]

11. They're gonna have to play ball or get lost when the exchanges kick in.

This isn't rocket science. Once people have choices, they can choose the best deals for themselves. If a company doesn't play fair, they can take their business somewhere else.

[izquierdista]

5. "...she called a lawyer"

And there in lies the explanation of the health reform bill. More lawyers will be involved, on both sides, in the ongoing bickering negotiation of medical treatment.

Exactly what I would have expected from someone who was editor of the law review at his law school.

[Tx4obama]

6. Sebelius To Insurers: It's Over, You Lost, Stop Looking For Loopholes

Read more here:
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x8046759

[Cleobulus]

7. Nothing in that statement by Sebelius has any relation to what I'm talking about...

There is nothing in the HCR bill to stop insurance companies from denying claims for any reason whatsoever, except those related to preexisting conditions.