Welcome to OpEdNews, Margie. As an investigative journalist, you've delved deeply into the issue of health care over the last few years. With legislative reform in the offing, your research takes on extra relevance. Let's talk about it. Can you get us started?
Hello, Joan. Good to be here. In fall 2007 and going forward, I was doing research on health insurance abuses--refusing coverage, denying claims, delaying settlement, the whole gamut that we are not becoming more familiar with. At the time, the issue was not being widely discussed in big media outlets; the Washington Post (the newspaper I subscribe to), for example, literally did not mention the issue of bad-faith insurance practices--for years. I interviewed a number of people including law professors, attorneys, a researcher at the Rand Corporation--which had produced a study on class-action lawsuits against insurers--and submitted questions to carrier spokespersons.
Here are some findings.
Regarding insurance bad faith, there are two areas of solid consensus uniting
industry critics, defenders and observers:
Second, whatever the extent of the problem, it can be ameliorated by good
administrative processes in the industry. Whether you're talking to
policyholder attorneys (plaintiff's attorneys), insurance company spokespersons
or industry observers, the consensus emerges that much of the problem lies in
claims. Skipping ahead to Chapter Two here--to my mind, that means that the
industry is well aware of where disputes are liable to arise. If the public at
large were equally well aware--claims handling needs some rigorous
standards--then we could have good national policy on claims handling.
This applies to health insurance itself, health coverage whether group or
individual, and to other kinds of insurance with an impact on health including
disability, long-term care, and medical benefits under automobile insurance.
I started digging into this issue when an editor then at a glossy health mag
asked me to write an article on it. But I had been thinking about it long
before. Here's a family memory with a satisfactory happy ending. I remember
that my parents had three insurance policies--that was what people did back
then, if possible, and ours was a union household--paying premiums on all three
for years, probably throughout my childhood. And when my father became ill and
had to be hospitalized, a rare occurrence, all three companies paid up. Rightly
so, of course; that's what the policies were for--coverage. You know, insurance.
That's why it used to be called "hospitalization." You paid your
premiums for years, and if you actually godforbid had to go to the hospital,
your insurance company wrote that check for the $150 per night or whatever
unthinkable amount.
Okay. So you've laid the groundwork. Why has this whole topic of health
insurance abuses not been widely covered over the years? What's your theory?
Good question. It's easier to explain why some things do get reported than why other things do not. Take the Vietnam War, for example. War deaths were reported "after enough public outrage at failures to report them made reportage respectable "and rightly so. But even after war deaths came to be nationally reported, U.S. highway deaths did not. In spite of the old "If it bleeds it leads approach in local television, few or no newspapers reported that as many Americans died in car wrecks, every year, as died in the entire war.
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Obviously the death of a celebrity will generate stories about the celeb, a natural disaster or catastrophic accident spawns headlines, etc. " ˜It's the airplane that doesn't land that makes the news.' But that in itself does not explain why insurance policies cancelled when people became ill " ˜rescissions' "or claims denied, or premiums going up faster than the rate of inflation, were not reported as outrages, or even as abuses for the most part. You'd think there would have been some pretty good stories, for any reporter with a real nose for news.
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