Friday, November 12, 2010

Too Healthy to Insure?????

I spoke to a friend this morning who is pulling her hair out. She is a woman who is mid 40's and never once had anything wrong with her. In fact...she comes from a family of 12 kids who have remained basically healthy their entire lives. But being in her 40's and going back to school in the medical profession and seeing that bad things (sickness, ER visits, and disease) often happen to good people....she decided she needed health insurance. Sounds easy...right? WRONG! The hoops this girl has jumped through just to get covered have been ridiculous and as of 9 a.m. this morning....she still was uncovered and mad as a hornet (which will not be good for those who have to come in contact with her today.)
So why all the struggle to get insurance? Good question. This woman is smack in the middle of her target weight range, exercises, takes care of herself, has never had more than a passing virus, has no family history of cancer or any other diseases and has no vices such as smoking or drugs. With this kind of history you would think the insurance industry would not only insure her but also put her face on all their advertising as the poster child for all that is good in the insurance industry. But alas....that is not the case. You the past she worked for a large company (who did insure her) and she did all the preventative things she was suppose to such as yearly pap smears and mammograms. And lucky her.....somewhere down the line she had a suspicious pap smear which on further investigation was nothing.....and a questionable mammogram which turned out to be a shadow in the film not on her breast. However.....these two tests now make her too high risk to insure. WTF!!! Pardon my french.....but are these guys crazy???? And she has not been turned down by just one insurance company....or even two, but she has been turned down by three.
In all three cases she has talked not only to the company itself but also to the underwriter. In no case do the individuals she speaks to seem to have read her files past the point where it says suspicious pap smear or questionable mammogram. Apparently their eyes are not capable of reading on and finding out what the conclusion of those tests were....because she has had to explain herself and her results over and over again...each time to a different individual.
My friend.....frustrated to her very core....finally asked the last insurance company she talked to a very honest question. She said..."I have absolutely nothing wrong with me and no family history to be concerned about. If "I" am too high risk to insure....then who the heck are you willing to insure?" Of course she got only mutterings and then silence to that question. And here she sits....still "uninsured!"
Okay people....I get the fact that insurance companies are running scared in light of the current administration and the proposed changes to health care and the insurance industry, but these changes have become necessary due in part to the very insurance companies who are now running scared. By these very actions...what message is being sent?
It appears to me that we are being told that having mammograms, pap smears and other possible life saving preventative tests may come back to bite us in the proverbial rear end  if at any time those tests come back questionable.....even if they turn out to be nothing. Is that going to cause people to be less vigilant about their health because at some point a shadow caused from developing a film may keep them from getting insurance? Are we really being punished because we go the extra mile to prevent life threatening disease by yearly testing? Do you know how many women I know (myself  included) who have had a pap smear come back questionable  or a mammogram come back suspicious both which require further testing.... only to find out that it was nothing? Does this make us ALL uninsurable if God forbid something happens and we lose our insurance and then at some point need to be reinsured? Apparently so!
So now my friend sits....without insurance because she is (I guess) too healthy to insure. What a ridiculous world we live in.

1 comment:

Donna B said...

THAT REALLY SUCKS!!! I just found out my HMO (Pacificare) has canceled its contract with Nevada. In order to keep my current doctor (which took me almost five years and five doctors later...) I must switch to the only option for an HMO, Nevada Health Plan...which has a TERRIBlE reputation. My other choices would cost twice what I WAS PAYING, plus, start a new search for a new doctor...Health Care in these United States is shameful!!!