Only 2 Kinds of People: The Uninsured & Those Falsely Believing They're "Insured" on Health "Care"

[Land Shark]

Almost nobody really has health CARE insurance in the USA. This is because insurance is tied to employment. But what happens to your employment if you get truly ill -- the very time when you need health care insurance the most?? You can't do your job any longer, and as a general rule it's not illegal to fire someone who can't do their job no matter how cruel that may be.

Losing your job do to a voluntary quit (unable to work) or a firing for lowered performance sets the clock ticking -- and you have only a few months to "live" in the world of private insurance. The "clock" is your "rights" under COBRA to extend the policy life several months past your terminated employment, or perhaps your "rights" under the Family Medical Leave Act -- but here again it's limited in time to a couple or a few months.

Thus, if you have a very serious long-term illness defined as anything that will last more than the few months of FMLA leave or COBRA "benefits" your insurance is going to go bye-bye.

Then, (and here's REAL "INSURANCE" of a sort) most insurance policies regarding health care have "stop loss" provisions that limit total lifetime benefits and/or total benefits that can be paid out for specific conditions or procedures. This will guarantee you get kicked off the private insurance policy you think you have if the requirement of employment is not met.

It is ILLEGAL to form health care insurance "groups" for the purposes of procuring health care insurance -- it is REQUIRED to be in connection with BONA FIDE employment. Since when is it ILLEGAL to form a co-operative and join together with others to get volume discounts? Since the health "care" insurance industry started to control our laws, that is....

DO you get the picture here? I know many of you do. This post is not intended to be directly responsive to the current health "care" bill's posture. Instead, I just wish everyone would spread the word -- the truth -- that those who FALSELY BELIEVE they have insurance are being pitted against those who KNOW they don't have health care insurance along with their supporters, with those falsely believing they have health care insurance motivated to PROTECT THEMSELVES and their "insurance" from a health "care" "reform" bill that supposedly threatens to bankrupt the system.

The subintelligitur -- the under-the-radar and thus unexamined assumption that sneaks into the health "care" discussion -- is the false notion that the average employed person truly has something that is FAIRLY called insurance. Sure, it's legally called insurance, but that doesn't mean it's true insurance. We all know that all except the most rare policies hit us up front with deductibles in 4 figures, co-pays, and exclusions, but many need a reminder that their "insurance" doesn't pay, either, at the other "end" of the policy -- true long-term illness. The existence of a partial "middle class" of mid-term illnesses that happen to be paid, in large part, helps keep up the illusion of insurance.

Again, the time we need insurance the most is when we're so sick we can't work, but if we're that sick, it's only a matter of a few months before the insurance lapses, even if one is ready, willing and able to pay the premiums.

How sad that some folks, fairly many folks, are motivated to protect their own non-existent -- in the true sense of the word insurance -- health care insurance situation from the desire of the uninsured to give real health care coverage to ALL.

There are Only 2 Kinds of People: (1) The Uninsured & (2) Those Falsely Believing They're "Insured" on Health "Care".

How Orwellian, in a nearly Ultimate sense of the term Orwellian, that all three words in "Health" "Care" "Insurance" require quotation marks around them due to their lack of truth.

P.S. Nothing in the above should be read as a response to the present health care bill in terms of pushing for its passage.

[snagglepuss]

1. K & R nt

[stray cat]

2. The GOP wants to eliminate employer subsidized insurance

[Land Shark]

4. GOP wants to eliminate employer-PAID (in part) insurance, but not requirement of employment... nt

[cilla4progress]

3. Does anyone seriously think

things could change dramatically in conference, i.e., public option back in?

[2 Much Tribulation]

9. In theory, yes, in practice, highly unlikely b/c Congress is corporate-controlled & rules disfavor

Here's the basic skinny on what can happen if a conference committee arguably exceeds the scope or intent of the House and Senate bills (given that a conference committee is only supposed to reconcile the two bills in a way acceptable to both houses and not create a new bill per se, but this standard is fairly debatable in many cases...)

Under the Honest Leadership and Open Government Act (S. 1 of the 110th Congress), (September 2007) any Senator may object via point of order against new subject matter inserted by the conference committee – specifically without objecting to the rest of the bill. However, a motion to waive the rule is possible, requiring 60 votes. See Senate Rule XXVIII

[cilla4progress]

15. I just wonder...

or "hope" is the better word, that this is part of Obama's strategy somehow. If so, it would make sense he is keeping mum about it. He's all about saving face for his opponents, which I respect idelogically, but is also correct as to political pragmatism. E.g., even someone like Nelson making the big fuss about abortion - how much of that is "show" for his conservative constituents?

I hope the fight for public option isn't over and SOMEHOW the greater numbers in the house can supercede the Senate "con-promise."

[Land Shark]

17. It's possible that this could be, or become, part of a strategy, BUT...

It would certainly inflame things, in particular driving the baggers nuts, and not without some justification since conference committee tide changes in legislation are not the gold standard for democracy-fairness by any stretch of the imagination. In this case, it would happen to align with the true will of the general public relatively well, though.

[cilla4progress]

18. EXACTLY (will of the people)

I mean, survey shows, overwhelming majority of people do NOT support the bill / mandates without public option! Why can't we have what we want?!

[Land Shark]

19. Yes we can do what we want - just be as clear as possible on what that is. nt

[Vidar]

5. K&R.

[inna]

6. I wish I could rec this post 100 times.

It makes a critical - but nearly always overlooked! - point.

:kick:

[Land Shark]

10. Thanks -- You can always PM your 100 best friends and suggest a Rec! ;) nt

[texanwitch]

7. I am lucky to have the VA to fall back on.

You are so correct.

:kick:

[Land Shark]

35. Yup, you have insurance from the only entity (for better or worse) qualified to provide it: Govt. nt

[cali]

8. I keep posting this link. this is my healthcare coverage

http://www.catamounthealth.org/catamount-health-information.html

[gtar100]

11. You are absolutely right. It's an industry in which the service it claims to provide

hardly exists in practice.

There are people who are willing to live off of other people's suffering. The health insurance industry attracts them in spades. Whatever ill befalls them, they will deserve and I won't be feeling sorry for them.

[Land Shark]

13. Insurance companies basically want a HAND OUT in response to their creation of suffering... nt

[BanzaiBonnie]

12. Is this something new in the Senate HCB?

Does it actually go to the point "It is ILLEGAL to form health care insurance "groups" for the purposes of procuring health care insurance "

[Land Shark]

14. It's not "new" in the bill, it's been existing law for some time now....

I don't specifically recall if it was state or federal but in the "progressive" state of Washington when I was looking at health insurance policies for myself and 2-3 other people, I saw these statements in several applications for group health insurance all to the effect that no group can be formed for the primary purpose of obtaining insurance. As I recall, at least one of the companies wanted the applicant to certify that via their signature, but as a law such certification was merely a "belt and suspenders" redundancy approach to "insuring" that no one got group health insurance outside a bona fide employment situation. Thus, you might say, if one is not sucking up to the right employer teat, one can't even get the fake insurance that's available for about half of us...

[havocmom]

16. K&R

Yup

[hfojvt]

20. interesting, but I don't think it is accurate

How many people really lose their jobs when they get sick. They COULD get fired, perhaps, but they usually do not. I have known a few co-workers who got cancer, and later died, and none of the three lost their jobs.

[Land Shark]

21. It is legally accurate: Keeping an ill person employed (when they can't work) is an employer FAVOR

...and not a legal right.

Your post is entirely unclear as to whether the employees who died in fact (a) showed up for work consistently like everyone else and (b) actually had no diminishment in performance. It's unlikely both of these would exist for someone that's terminal.

Sure, there will be examples of here and there of people keeping their jobs, but they often do not, and the core point made in the original post is that they've no RIGHT to keep their job if they're not performing it essentially at a 100% level. This is why the Americans with Disabilities Act was needed, to require employers to make even relatively minor accommodations -- but ALL to the effect and required end result of allowing the disabled employee to perform the SAME job as the non-disabled, and at the same level. There's no concession whereby an accommodated disabled person is legally entitled to 25% lower productivity across the board -- unless of course the employer voluntarily decides to tolerate that as an act of charity or grace or whatever... and even then it's still not a right.

If you still think I'm inaccurate, get an opinion from someone with more past years of experience in employment/business law as a lawyer and then we'll talk. Actually, I'd talk in any case, but I think the benefit of the doubt ought to go to someone who's worked for years professionally as a lawyer until you come forward with specific case law and statutory law establishing a right to employment while illness diminishes productivity, either from your own research or an experienced lawyer.

[hfojvt]

26. that it is legally accurate, does not make it factually accurate

you paint a picture of what COULD happen in some kind of worst case scenario, and I don't think it is accurate as to what actually does happen in REAL world scenarios. You want to say that we are all fooling ourselves, but many of us have seen sick co-workers not get fired even though they were too sick to work. Also, in between there, there are lots of times, or can be, when those of us with insurance take advantage of that fact. Like the guy I know who had a stroke. He must have been off work for a number of months and also run up some medical bills that his insurance likely covered. I myself was in the hospital for four days and also had knee surgery and was off work for two or three weeks. My insurance that I only imagined that I have paid several thousands of dollars in medical bills.

[Land Shark]

40. Most employers operate at the level of Minimum Legally Required, so it's also factually accurate

In fact (when a corporation is not simply a mom and pop business in fact operating like a sole proprietorship -- even if technically incorporated) for a corporation to do ANYTHING that doesn't further the bottom line is a violation of law called "waste" of corporate assets (something shareholders can sue the corporation and its managers for). Thus, even charitable contributions can and are justified (by corporations) solely in terms of the goodwill it purchases in the community that actually translates into a better bottom line, and conversely for corporations to "give til it hurts" can't and doesn't happen. It's literally illegal. (Even when the managers and shareholders are the same people, as in mom and pop corporations, it would be an act of largesse or charity and not a legal right to keep one's employment when so sick that one can't do the job the same any more).

Your basic case, in citing three unnamed anonymous and anecdotal stories from your experience, is that corporate employers go above and beyond the law (you implicitly admit I'm legally correct) and commonly further good outcomes for their terminally ill employees. This "above and beyond" the legal requirements of at will employment is not utterly unheard of, but it is so rare (and commendable) that it will get media star treatment - maybe even 60 Minutes - for its very rarity (and its humanity to boot).

I don't think it's "factually incorrect" to assert that the at will employment world is a tough world. Look at the "Dead Peasant Insurance" phenomenon for example, where Michael Moore showed memos from large corporate employers who had insured the lives of their rank and file employees and complained in writing that THEY WEREN'T DYING FAST ENOUGH. Is this compassion?

[suffragette]

22. It's like a really bad game of dominoes

You fall ill, which knocks out your employment, which takes down your income (and potentially home, etc), which takes away your eligibility, which leaves you sprawled on the floor at the moment of your greatest need.

Single Payer is the meaningful reform for all of this.

Hi from Seattle :hi:

[Land Shark]

23. ..Dominoes... in which the government is already holding 50% of the "bag"

With the remaining 50% being the uninsured.

Now, if only the government could also get all those billions in premium money currently being hoarded by insurance companies claiming to "protect" (but not by much) only the RELATIVELY healthy population (i.e. able to work) THEN we could have single payer for either a little more money than present, or for less money than presently -- because of elimination of the insurance company windfall.

Nice to hear a Hi from Seattle! :)

[suffragette]

25. And a switch in jobs from those finding loopholes to deny care to those

working with people to get them the care they need.

What a concept, eh?

[2 Much Tribulation]

34. Yes. What a concept! Who thought of that first? ;) nt

[suffragette]

44. Are you referring to supporters of Single Payer?

http://www.calnurses.org/research/
Medicare for All (Single Payer) Reform Would Be Major Stimulus for Economy with 2.6 Million New Jobs, $317 Billion in Business Revenue, $100 Billion in Wages. The number of jobs created by a single payer system, expanding and upgrading Medicare to cover everyone, parallels almost exactly the total job loss in 2008, according to the findings of a groundbreaking study released today.

[Greyhound]

24. Thank you for pointing this out. I hope it gets the exposure it deserves.

There are currently good outcomes in these scenarios, but as you point out, they are due to the largess of the employer and not legally required.

[Starry Messenger]

27. kick

[Odin2005]

28. Health Insurance is like a umbrella that dissolves in the rain.

[Land Shark]

30. "Like an umbrella that dissolves in the rain." Well put. Thanks. nt

[laughingliberal]

29. Right. Those who know they don't have it and those who will find out they don't have it at the worst

possible time.

[Land Shark]

31. Perhaps this is a rare moment when ignorance = bliss but ignorance certainly ain't safe

[Edweird]

32. That is EXACTLY what makes this bill a piece of shit.

Instead of being removed from the equation, they are given the keys to the kingdom. With the IRS to make sure you don't get outta line.

[Land Shark]

33. AND... it's what makes any reform that KEEPS corporate/private insurance a heap of dung as well. nt

[Bjorn Against]

36. K&R, thanks Land Shark

[Land Shark]

37. Sure, it's my pleasure to remind/expose this kind of situation. nt

[leftstreet]

38. K&R

[robinlynne]

39. This is so true. Instead of being about health care, the entire policy debate has been

only about insurance the entire time, with a few carrots thrown at us here and there (public option, medicare expansion which would keep the same insurance companies who have done all this to our people "honest"...)

[diva77]

41. On the brighter side, think of the money we save by not needing cardiologists

for the health insurance moguls:sarcasm:

[Land Shark]

42. Yes. Imagine that. nt

[2 Much Tribulation]

43. Kick for compare with today's story on skyrocketing health insurer's stock prices

See post by 2 Much Tribulation on greatest page...