A Penny For My Thoughts

Insurance: Coverage, Or Thievery?

By Paul Wein

Yesterday, I went to the doctor for a routine physical, and despite the fact that I gave the nurse my insurance card – the visit still cost me twenty dollars. And last month when I went to fill my heart prescription, the co-pay was sixty dollars. If a doctor’s visit and a prescription cost me close to one hundred dollars – then what do I have insurance for?

I am starting to notice, both by my own experiences and by working here at the TLC, that insurance companies are nothing but legal thieves that prey on hard working Americans simply because they can.

Let’s start with health insurance. The only people that can truly say they have good health insurance coverage are people who work for major corporations that have hundreds if not thousands of employees that need coverage. Just like the “group discount” theory when you buy tickets to a show, big corporations get huge discounts on health insurance by enrolling a large number of people at once to get a small rate – but what about individuals or people that work in “mom and pop” companies? They are the ones that the insurance companies prey on. Like defenseless baby seals swimming in shark infested waters, these customers get charged exorbitant amounts of money for the exact same health insurance that people in large companies have – but are forced to pay ridiculous amounts of money simply because they do not have the same amount of co-workers. And for those who need personal health insurance not related to a job – they would spend their money more wisely if they flushed it down the toilet. Take my mother for instance. She had to get her own personal insurance coverage – at a cost of almost three hundred and fifty dollars a month. And if that is not bad enough, there is also a one hundred dollar deductible, not to mention the high co-payments. I don’t think my mother could get sick enough to warrant spending three hundred and fifty dollars a month on doctors if she had no insurance at all. So where is the benefit in her coverage?

My personal favorite thing about health insurance is when they are happy to take your money – but then tell you that a certain procedure is not covered by your policy. This behavior was recently brought to national attention by the movie John Q – but I have my own personal experience with this ridiculous form of doing business. When I worked at the Marketeer in 1995, my friend and co-worker Mary Lou told me that her twenty-something year old son has developed tissue around his pectoral muscles that make him look like he had breasts. This condition is not a very common one, but one that some men do get. This condition has caused her son to not participate in sports or social circles, not date – and not make many friends. And despite the fact that this condition has prevented this man from leading a normal life – Oxford Insurance Company said that they would not cover an operation to correct the situation – because that is cosmetic surgery. Excuse me, but the man does not want a breast enlargement – but a reduction. Hearing this disgusting news, I contacted a State Senator I was friends with at the time and he wrote Oxford a very nasty letter. After they received the letter – they caved and decided to cover the surgery. While it made me very happy that I was able to help my friend’s son – I wondered about all of the other people that are suffering from a disorder that the insurance companies they rely on and pay dearly to will not cover.

Besides health insurance, another form of legal thievery is car insurance. This is my personal favorite way that insurance companies can cheat people, rip them off – and blatantly lie right to their face. Let’s say John Doe registers a car and needs insurance. And lets say that he gets a great deal on insurance from XYZ Company. So far so good, right – sure – until John Doe gets into an accident. Whether the accident was his fault or not, and whether or not he is injured – his rates automatically increase because of the accident. This way of doing business sickens me. I can understand if our Mr. Doe was caught driving drunk, or if he lent his car to a friend and they wrecked it. But if you are the victim of an accident that was entirely someone else’s fault – then why should your rates increase? And for taxicabs – its even worse. Right now, there is only one company writing and they can basically charge the taxi owners anything they want. And instead of working with the drivers to give them a fair price – they are using the power of being the only company to charge the drivers amounts that could possibly put some of them out of business – not that the company cares.

In defense of the insurance companies, I can understand that they have enormous expenses, and that insurance fraud costs them millions of dollars a year – and the fact that Lord knows how much money they have spent in paying out policies after the September 11th atrocity. But how about recognizing that you need hard working Americans as much as they need you. And without people to insure – you guys would be out of business.

So while insurance is lawfully necessary – I think that there needs to be some sort of national health coverage that is affordable to everyone – and agents that will help you – not steal from you.