Saturday, March 24, 2012

"Over Usage" of Medical Insurance?

I just popped over to one of my favorit blogs, the link is in my right side menu, Our Place Called Home. Her families medical insurance premiums have doubled every year for the past five years. Yes, they have adopted several children with medical needs, but once the insurance is purchased, how can they raise it due to medical conditions that come up? Medical insurance, I thought, if for when we are sick and need medical care. Why then, after we get sick and use it, does the rate go up? What in the world are we buying it for in the first place? Now, this family is afraid their insurance company will drop them. Can they really do that?

I am perfectly healthy. I have had insurance for five years. In that time, I've had 2 pap tests, 2 dermatology visits, the second because the first one's doctor froze off a pimple instead of a "pre-cancerous" spot, and I had one throat culture. My premium is now at $225 per month, just for me. I pay for Jie Jie, too. It has gone up every year since I turned 40. In Dec. 2009, I ignorantly down-graded my policy, because, as a new home owner, I couldn't afford the rate increase that was starting Jan. 2010. Now I wish I'd never done that, but it's too late now. I have a large deductible and out-of-pocket maximum. Drugs are not covered and neither is durable medical equipment, though the equipment is after I meet the deductible.

I could quit Kaiser and qualify for a great free county program, but I can't because in order to adopt, one must show proof of insurance. If Kaiser could adjust their system to be able to bill the county (they can bill the state, but not the county) then I could get this free program. The first thing the social worker told me when I originally inquired about this program was that I should move to Sweden. The second bit of advice was to ditch Kaiser, which, or course, isn't an option!

How did the United States get so broken? Why can illegal immigrants get federal grants to attend our universities? Why does my school district feed any child under 18 breakfast and/or lunch during the summer regardless of their parents' income? Why do I have to pay for that? Why do students on federal or state food aid have to take the milk and food even if all they do is throw it away? Why is it illegal for them to give another person that food or milk? The janitor at my aunt's school in from Germany. He said hundreds of unopened milk cartons get thrown away EVERY DAY!

Our children come to us from China malnourished and we all know how we feel about that. How do you feel about children in the United States of America throwing away milk in clean unopened cartons that you are buying for them with the money you pay in taxes? Why can't those cartons be saved for the next day or donated or given to others?

I know I've ranted and ranted lately. I know I need to let it go, but I'm afraid to do it. You see, if we all let it go, it will never be fixed. Who is going to fix these enormous problems? Who is going to stand up for what is right?


Karen said...

I don't think it's going to get "fixed". Adopting from overseas is considered a luxury when there are so many foster kids in the US. The opposite of that coin is the argument of, "why bring kids here who need medical help, when there are already families and kids here who can't get the same kind of treatment?" I don't agree with that statement, obviously...but that is the other argument at hand.
Insurance companies are not here to help the underdog...they cloak themselves as such..but they are not. They are here to be able to pay their doctors, nurses, hospitals (or in the case of fire, house, car insurance) they are here to pay their agents GOOD MONEY. Then second on their list is to make a huge profit so they can pay for their commercials, pay their CEOs and presidents, third on their list is to pay off their share holders, and last...and least on their list is to pay for your needs. Bottom line...that's the way it works and that's the way it always has worked. You can have car insurance for 30 years, and never have an accident, but once you have that accident .....premiums double.....triple in some cases if it's "your fault". Loyalty goes out the window then. and even though they won't admit it, adopting a child from overseas KNOWING they have medical conditions is similar to having a car accident and it being YOUR FAULT.
Again..I don't buy into this crap, it's just what it is. And bottom line, profit is first and foremost, regardless of being a nonprofit insurance or hospital.
IMO that's also why they have not found a cure for cancer yet...took a lot of money to build a medical establishment for the care they give. If they find a cure, those machines would be outdated and would lose the companies lots of money. That's a bit out there, but I believe it to be true.

Anonymous said...

I agree with Karen. I adopted twice internationally from Russia and had to sign documents that the children would never rely on any kind of public assistance. If I couldn't provide for them we had to have a proven back up plan...this was Russia's requirement. If I can afford to do this twice knowing the risks then how can I expect someone else to foot the bill? Trust me, I work in health care and the kids on public assistance fare much better than those with private insurance. I don't get annoyed at my insurance company...I get annoyed that our government has somlittle oversight on the system.