Whistleblower reveals how insurers can game healthcare bill

[NorthCarolina]

By Brad Jacobson
Wednesday, January 20th, 2010

Though Senate bill cuts 'pre-existing conditions,' it still allows insurance companies to create 'pre-existing' categories to raise rates.

The Democrats' healthcare overhaul, billed as a monumental game-changer for Americans' health insurance coverage, provides numerous loopholes for health insurance companies which will allow them to raise rates to protect profit margins, a health insurance whistleblower says.

Wendell Potter, a twenty-year veteran of the insurance industry and former vice president of communications for Cigna, warns that current healthcare legislation does nothing to prevent the insurance industry from continuing its ongoing practice of increasingly shifting healthcare costs to consumers.

A form of bait-and-switch, such practices often set up individuals, families and small businesses for inadequate or unaffordable access and a continued looming threat of financial ruin. The overlooked element, Potter says, is that insurance companies will be able to claim they are reducing premiums by forcing more Americans to pay higher deductibles and offering less coverage.

“We talk a lot about affordability, and we talk about affordability of insurance premiums,” Potter told Raw Story in a nearly hour-long interview. “But when you talk about affordability, you need to talk about affordability of premiums plus out-of-pocket expenses.”

He said that there’s been a lot of discussion on how the Congressional Budget Office scored this legislation and what it says this legislation will cost the country in the long run, but little to no focus on how the legislation will directly impact individual Americans.

Potter pointed out, for example, that many plans -- even after consumers received proposed government subsidies to help pay for them -- would come with high deductibles that prohibit people from using their insurance or cause them the kind of financial hardships that healthcare reform was purported to prevent.

“What worries me,” he said, “is people who are forced to buy coverage and all they can afford to buy is a high deductible. And if they get really sick then they have to pay so much out of their own pockets that they’re going to be filing for bankruptcy and losing their homes.”

In the Senate bill, in particular, Potter noted, some people will be buying insurance that will only cover roughly 60 percent of their medical costs if they get sick.

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Link: http://rawstory.com/2010/01/whisteblower-reveals-health-insurers-game-insurance-bill/

[napi21]

1. I don't think there's any law or rule that could be created that

couldn't be gamed! It's like a game of Whack A Mole.

The other thing I querstion in that article, (and I usually have no problem with anything Potter says), is people having to declare bankruptcy. Isn't there a max out of pocket per year in the bill? I thought I heard there was.