The other day, the New York Times did a fine job of describing what happens when all you can afford, is bare bones junk insurance.
This tragic story of only-in-America healthcare, got me wondering whether anybody in the U.S. Senate has an Aetna limited benefit health insurance policy?
You want to talk about junk insurance. Look no further than what is known in the industry as mini med or limited benefit health insurance.
These junk policies on steroids are bad and wildly profitable for the insurance industry. The lengths insurers are going to scam them onto impoverished Americans, has none other than Charles Grassley asking questions. And for this guy to wake up, you know it's serious.
I recognize we're knee deep into the intricacies of policy, but I'm also knee deep into something known as 'what's fair'?
So I have a couple of questions for the political class.
If you see your senator or congressperson over the July 4th weekend yukking it up with average folks like you and me, would you ask them a couple of questions and report back to us?
Now, if you can capture these exchanges on videotape, that would be even better. We can show them to the world.
- When this new day in America finally arrives, will these "public servants", those we elect to do our business, pay the same for their taxpayer subsidized healthcare as we pay? Or even better, will the legislation give us the same 72% subsidy they receive? This is no snark, this is a serious question.
This is from the Federal Employee Health Benefit Manual. Do yourself a favor and read the entire brochure, it's something we can only dream about.
How much does it cost?
The premiums for your enrollment are shared by you and your Federal agency or retirement system. The government pays the lesser of: 72% of the average total premium of all plans weighted by the number of enrollees in each, or 75% of the premium for the specific plan you choose. If you are an employee, you automatically pay your share of the premium through a payroll deduction using pretax dollars, unless you elect not to participate in Premium Conversion. The charts in Appendix E provide cost information for all plans in the FEHBP.
- I'd also like to know, how many members of the United States Senate, especially those like Joe Lieberman, so vigorously opposed to giving the American people what they have, are Aetna customers? Are Lieberman, Landrieu, Feinstein, et al, holders of Aetna's bare bones, very profitable junk insurance on steroids known as limited benefit?
And I'd urge you to keep center in your mind as you're reading all this, that in the deeply amoral and corrupt world of Washington D.C., despite knowing the full extent of the lawless activity of the health insurance industry, the political class will do everything in its power to keep private, for-profit insurers at the center of our healthcare system.
Remember Wendell Potter, the former CIGNA executive, turned hero whistleblower? This is how he described limited benefit health policies during his recent senate appearance. This is a link to his full testimony, you should read the full transcript.
The big insurers have spent millions acquiring companies that specialize in what they call ―limited-benefit‖ plans. An example of such a plan is marketed by one of the big insurers under the name of Starbridge Select. Not only are the benefits extremely limited but the underwriting criteria established by the insurer essentially guarantee big profits. Pre-existing conditions are not covered during the first six months, and the employer must have an annual employee turnover rate of 70 percent or more, so most of the workers don’t even stay on the payroll long enough to use their benefits. The average age of employees must not be higher than 40, and no more than 65 percent of the workforce can be female. Employers don’t pay any of the premiums—the employees pay for everything. As Consumer Reports noted in May, many people who buy limited-benefit policies, which often provide little or no hospitalization, are misled by marketing materials and think they are buying more comprehensive care. In many cases it is not until they actually try to use the policies that they find out they will get little help from the insurer in paying the bills.
I must say, Potter's description of the corporate life at CIGNA, is the most breathtaking indictment by an insider of the Murder by Spreadsheet industry, I've yet seen.
Piss poor "journalism" from papers like the Boston Globe, with demented puff pieces about Karen Ignagni, the CEO of AHIP are also designed with only one purpose in mind, to maintain the status quo.
Let's return for a moment to limited benefit health policies.
Here in a 2007 Morgan Stanley Global Healthcare Conference Call, a Wall Street analyst asks Joseph Zubretsky its executive vice president and CFO, how Aetna might "profit" from a largely low income population which can afford to pay something for worthless, junk insurance.
Here's the skinny on the "skinnied out benefit packages".
Zubretsky responds by saying, "they [limited benefit policies] cost half as much as a 'good' policy".
Joseph M. Zubretsky, executive vice president and CFO of Aetna
UNIDENTIFIED AUDIENCE MEMBER: I'm sorry if this is actually just taking us one step back, but you were talking about these individuals and Generation-X people and these people that are not indigent but are uninsured. And you also commented that the U.S. growth in the medical system has benefited your company and a lot of companies. And I commend you for trying to create products that fit these people, but I guess I'm wondering is there something that could be done to get more at the root of why these populations are growing where they didn't really used to exist, and can something be done from the payer perspective to influence that and still profit off of that, because these people clearly have the money to pay for some degree of insurance.
JOE ZUBRETSKY:
Yes. It's a good question. I'm not sure I get -- there's kind of a public policy aspect to your question that I'm just not facile with enough to answer, but the interesting thing about these marketplaces is that the products you do design are different. When you're working for a big company in a group, you have a very robust package of benefits. It costs $300 per member per month. These packages we're designing are to get you through. They're limited -- I don't want to call them mini-med -- but they're more limited benefit, skinnied out benefit packages that can cost half as much as a [good] product or less than half. And it's basically to get you by, to fund basic expenses. Maybe there's no catastrophic risk covered. So they're not meant to be a permanent solution, because hopefully, unemployment isn't meant to be a permanent condition either. So we really do think that these segments are truly, truly underserved, and the products that we and others are designing to get at those segments serve as a link between coverage that you had when you were in the group and coverage that you will have when you go back to a group
http://www.insurancenewsnet.com/...
And I'll leave you with this doozy.
On Bill Bennett’s radio show, DeMint called blocking health care reform the top Republican priority, arguing that of all the items on President Obama’s legislative agenda, it would be the hardest to reverse. To support his point, he offered "government schools" — public education — as an example. "You can never, with another piece of legislation, change it," DeMint said:
DEMINT: I think the biggest issue is health care. I think if they succeed in a government take over of health care the situation may be irreversible. It will be like government schools. I mean you can never just, with another piece of legislation, change it.
Listen to Jim Demint (R-SC and AHIP) talk with Bill Bennett about healthcare.