Has the insurance industry lost its collective mind?

According to my husband, who just watched SiCKO a few days ago, if we ever decided to move back home to the U.S., we’d be… well… fucked.

Ya see, my hubby?  He’s “underweight.”

Me?  I’m “obese.”

And my oldest daughter?  She’s autistic and epileptic. (Heck, she might even be overweight, too, but I actually don’t know how much she weighs!)

All three of us would be ineligible for insurance coverage.

ALL THREE OF US.

My hubby and I because of our weights, and my daughter because of the disabilities she was born with.

You know what really gets me about all of this?  I used to work in the insurance industry! 

I used to work for UniCare, from 1999-2003.  If I’m honest, I’d probably still be working there if we’d never moved to the other side of the freaking world.  I worked in this office.

I used to not want to tell people where I used to work.  I don’t know why – I guess it seemed like I was betraying something if I told people where I used to work and how insurance companies actually treat their clients’ claims and whatnot.

But with all of this shit that I’m hearing about how the insurance industry in the U.S. is going down the toilet, I thought it was time to speak up.

Apparently, not only would half of my family (I have three other daughters who would be accepted in a heartbeat for coverage) be ineligible for coverege, but they wouldn’t even tell me up front.

According to the hubby, in the movie SiCKO, there is a story about a woman who underwent major surgery while under insurance coverage.  She was told prior to the surgery that everything would be covered, and the claim was actually PAID by the insurer.  But then (insert suspenseful music here)… some claim investigator found out she’d had a yeast infection years before and didn’t disclose that information.  So her coverage was retroactively cancelled, they requested a refund from the doctor and hospital, and told said doctor and hospital that they should go after the patient for the money.

All because of a yeast infection.

Now, if you’re a woman, I ask you: do you know a single woman who has never in her life had a yeast infection?  I didn’t think so.  Would you think that not disclosing information about a yeast infection would get you booted off your insurance plan?  I didn’t think so, either.

The reason I’m speaking up about this now?  Because I know for a fact that when I was still working there, UniCare – and most other large insurance companies – wouldn’t have dreamed about doing something like that, because they would be taken to court and sued – and they’d lose.  I was “just” a “lowly” data entry technician (don’tcha love “professional” titles?), but I was one of those people who would literally talk to anybody about anything.  And I smoked – so I would meet people from all of our departments just by talking to the people around me outside.  And while, granted, I wasn’t in the office with them all the time, I know enough from my discussions with people about the ways claims were approved or denied to know that something like a yeast infection – back then, anyway – would have been laughable as a reason for denying a claim.  That’s not even touching cancelling someone’s coverage for one.

I don’t know what the hell has happened with the law in the last 4.5 years, but obviously some “genius” (yes, I’m being ironical) decided to pass some law that said that insurance companies could get away with this shit.  People have been fighting with insurance companies – and especially HMOs – for YEARS because of fraudulent practices.  And now they go backwards instead of forwards?

Is it just me, or has the entire fucking world lost its collective mind?  Not just the insurance industry, but the whole thingNew Zealand is denying entry to people just because they’re fat.  Here in the UK, you’re being denied treatment because you’re fat.  Women are afraid to go to the doctor when there’s something wrong, because we’re either hysterical, hypochondriacs, or we’re just too fat (even when we’re NOT).

It’s not just angering me, it’s downright scaring me.  What’s next?  Are we going to pass a law that says that if you’re not absolutely 100% “perfect,” you’re going to be put to sleep?  Yeah, I’m exaggerating here – but only a little. 

The fear?  It’s almost enough to make me go back on my promise to myself never to diet again.  Almost.  But you know what?  I am intelligent enough to realize that even if I DID diet again, there’s no guarantee that I would lose any weight.  As a matter of fact, I seem to be slowly shrinking now, without even trying.  But I’m feeling better than I have in years – because I’m eating well, I’m exercising, and I’m not berating myself about every single little thing.  If I were to go back and try dieting again, I would be depressed, anxious, and I can guaran-fucking-tee you that I would go right back to hating every single thing about myself.  The evil twin inside my head would rip off her gag and start telling me how ugly and worthless I am.

And I’m not willing to go back to THAT for anything.

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4 Responses

  1. *sigh*

    If the insurance companies were actually all in it to truly help folks out, then we wouldn’t have the issues we have now. But that, of course, is totally not the case. And it’s unfortunate.

    It’s equally unfortunate that the one thing that bands this world together is the universal hate of fat people.

  2. I have not seen Sicko, and really want to. All I can say is that as a health care provider, dealing with insurance companies nearly drove me crazy in private practice so that I now have a salaried job instead so I don’t have to deal with them directly and there is a whole department to advocate for our patients which I had to do myself in the past which was utterly exhausting and of course on my own time. Insurance is such a hugely aggravating subject, I can hardly stand thinking about it. Yes, I worry, too, as I get older, what kind of care is going to be available to me. And to my children. I hope for national health insurance, but as you say, they can still discriminate against arbitrary conditions, postpone your care until you’re dead etc.

  3. My mother wants my husband and I myself to get insurance. The premiums are $1500 a month with a $10k deductible – and that’s before taking into account weight and asthma.

    Needless to say, we haven’t bothered.

  4. I’m so sorry. That’s absolutely ridiculous! Shit, when I was working at UniCare, we were offered 3 options for insurance: the HMO, a PPO with a $500 deductible and a PPO with a $1000 deductible. The PPO with the $1000 deductible was actually the cheapest per month, and the HMO the most expensive. I chose to go with the HMO simply because then I wouldn’t have to worry about paying anything out-of-pocket if we ended up needing to go to the doctor or anything (the HMO paid for everything in FULL). I thought the $1000 deductible was absolutely astronomic! To know that they’ve upped the ante 10X? Unbe-fucking-lievable!

    Shit, with insurance like that it’s almost cheaper to NOT have insurance!

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