I am currently employed by a Fortune 500 company. While not an executive, I'm reasonably embedded in the pecking order rather than being part of the support staff. Translation - I have "Cadillac Health Insurance" and I am pretty sure this will be the case for a while. Maybe I should call it "Trek Health Insurance" because Cadillac isn't so secure.
Anyway, just one more anecdote as to why choice, which will be one facet of a public option, helps even those of us with the goods.
My company is large enough that from an actuarial standpoint it makes sense to self-insure, and allow a "big Connecticut based health insurance company" to run the program. I got a letter from them about a month ago.
"THIS IS A COPY, NO NEED TO RESPOND"
Amusingly, it then inficates that I was asked to provide additional information before they could process a claim. The provider was listed as "Miscellaneous Provider". Great. No explanation of benefits in my big stack could identify the provider. It was obvious that it had something to do with my wife's post-partum checkups, but with our wonderful health care system the way it is, one trip to the doctor can end up in 3 different bills coming from 3 different providers, especially if you do something so crazy as "give a blood sample". Now you have to pay the hospital, the doctor, and the pathology lab.
Understanding that "NO NEED TO RESPOND" meant "NO NEED TO RESPOND UNLESS YOU WANT US TO PAY YOUR CLAIM", I put my wife on the case. She determined, after phone calls to the hospital and the insurance company, that the bill (we did have the amount) was for the pathology group. They told her that the insurance had "Already been processed" and that "No payment was made by them because you are still funding your deductible. We wrote of 32.50 as a courtesy, please pay the bill".
My wife has a BA from the University of Illinois and an MA from Northwestern. This puts her in the top couple of percent in the US in terms of education but she was still beaten. Fortunately I stayed at Illinois for my MS so I am smarter than that. OK, it had nothing to do with my education, I've just been through this ringer before. I knew my insurance pays at 90% until the deductible is used, and even if it didn't - WE HAD A BABY IN FEBRUARY - how could we have any "deductible" left. Basically, the billing people threw her back into the court. Now, if you have "Cadillac Health Insurance", chances are you might have a mortgage or two you might want to refinance, or might be buying a house, or whatever, and a 50 point dip in your FICO score is going to be worth a hell of a lot more than 90 bucks. The hospital doesn't care - either the insurance pays or we'll pay. A quick glance at the bill shows the referring physician, and the person in billing knows, if that's our doctor, we have bigger fish to fry than this bill.
Well, I wasn't going to take that balogna. I called up billing, she read the same line, I pointed out the incoherency in that position, and read her the memo from insurance. "The provider must provide the name degree/title of the individual provider". She said "We do that as a matter of policy. Always." "Really, I said? Then why I am staring at this letter!??"
That's when I dropped the "O-bomb". "Obama has a lot of people in DC trying to fix this crap, and the insurance companies have a lot of money in DC, trying to keep it the same. Big Insurance Co made a typo, and they have no real incentive to not make those mistakes, because if they fail to process a claim and it's there fault, people like my wife won't understand and she'll just write a check, and they mane money. Or I might get tired of trying to fix it and I'll write a check, because my credit score is more important than the money. But I fight it because there are people out there for whom 90 dollars means their family can pay the rent, and if this was cancer instead of a routine blood test it wouldn't be 90 dollars, it would be bankrupting someone who doesn't have the wherewithall to fight the typo. That's how they make money. I don't blame you, and I want the doctor to get paid, but I need your help because they put the ball in your court, not mine - I can't do anything about it, because I don't have the information they need."
Well, apparently I found a Democrat in Fresno California because she perked up and said "They make money no matter what. Let's get this figured out".
Damn straight brother! Fight the power.
Fast forward. I get a phone call frmo the billing person. She says that "The insurance company has no record of Jill being in her system".
ROTFLMAO!!!
Step 1: Deny
Step 2: Typo
Step 3: Typo, part deux
Step 4: ???
Step 5: PROFIT
How can I be getting a mailed copy that they need the name/degree/title of the provider if we aren't in the system at all!?? Not to mention they have paid $20,000 or so in bills for her this year already. I fax the ID card to billing - and await "Typo, part trois". What's amusing is that, as I stated before - MY COMPANY SELF INSURES. The $90 at stake is not even "Big Insurance Company's" money.
It feels like typos and screwups are embedded into the system, so that people who don't review the bills, or aren't willing to negotiate the maze to get their benefits, just pay the bill. I can guarantee if they fight me off one more time I'll be sending a check to defend my FICO score and once that happens, I'll probably let it fall under the rug.
What does this have to do with a public option? Competition! The thugs keep talking about the concept of "The Government screwing everything up" - I ask how could it be any more screwed up than it already is! At least a Government run option would not have an inherent incentive to screw the customer over for the sake of profits. Aside from the inability for most to switch to an insurance company that has better customer service or treats the customer more fairly, as it stands they confuse and obfuscate so much that the customer frequently cannot even tell they are being rooked.
I mean, if they can't tell they were rooked for 8 years by George Bush, how hard could it be for an insurance company to rook them over for $90???
I might be willing to "STAND IN LINE" a bit longer to see my doctor in a completely socialized medicine system, if it meant not traversing the levels of paperwork I have dealt with in the past 8 months. Refusal to insure my son because someone was hard of hearing and spelled his name "Lian", the number of times I have had to resubmit insurance claims because our insurance company changed, etc... If you really want a laugher, talk to my friend whose daughter was denied claims because they didn't have her date of birth in the system. You see, she was born on Feb 29, and their computer couldn't handle that....
/rant