The insurance company is basically saying, you should still choose the in-network provider even if you are unconscious or don't have a choice or we'll fuck you financially. I've had this happen to me, appealed, and after many months, actually won. In my case I was unconscious and the ambulance and hospital were out of network. I was lucky the hospital was willing to wait over a year and not send it to collections. It was hell. Why the fuck isn't there a law against this kind of shit? Do we expect people who are unconscious or having a heart attack to say, "oh no, take me to an in-network provider so I don't go bankrupt?" Fucking absurd the healthcare in this country and the lack of proper regulation. How long are we going to allow these insurance companies to get rich while people die and go bankrupt?
> The insurance company is basically saying, you should still choose the in-network provider even if you are unconscious or don't have a choice or we'll fuck you financially.
Actually, they are saying if you choose to cut premium costs by selecting a narrow provider network, well, there's a reason why the premium costs are low.
> Why the fuck isn't there a law against this kind of shit?
Because Republicans actively oppose any attempt at health security, and Democrats keep ignoring the majority support for single-payer that polls have shown for close to 30 years in favor of Rube Goldberg solutions that keep private insurers and this type of network-based limitation as central features, despite the fact that hey have less public support and are thus more subject to being politically sabotaged before passage (Clinton) and after (Obama).
Though there's signs of potential for that to change on the Democratic side in the near future...
Your first point is simply not true. There is no plan that covers every ER and every hospital. Even on the top plans, there are in-network and out of network providers. So once again, we're back to making decisions while incapacitated or unconscious. No matter how carefully you chose your plan and how much you pay, you're still fucked. Not to mention that almost everyone is stuck with the plans their employers choose. Even the platinum level ACA plans, however, are like this. That's what I'm talking about above, BTW, as well as equivalent plans provided by corporations. It's simply impossible to get a plan that covers everything and therefore prevents you from going bankrupt in all situations.
My first point is what the insurance company is saying. It's absolutely true that they are saying that. (It's also a true claim; your argument that all provider networks are limited such that the risk of similar problems exists at some level in all insurance plans is perhaps pedantically true, but not necessarily relevant—e.g., it may be that the only reason the care from the profile provider in this particular case was out of network was that the district's individually negotiated narrow network plan excluded providers that would have been included in standard plans this insurer offered in the area.)
> Not to mention that almost everyone is stuck with the plans their employers choose.
That's factually false; only 49% of Americans are covered by insurance provided by an employer (either their own or as a dependent) health insurance, and not all of them have no other practical option than that plan, so, no “almost everyone” is not stuck with their employer's plan choices.
But, in any case, the employer's plan choice is exactly what the insurance company is highlighting as the issue in this case.
> Why the fuck isn't there a law against this kind of shit?
There's a pretty clear answer to this question almost every single time it's asked... the people who benefit are wealthy and the people hurt are poor. The latter structurally lack the ability to fight it or lobby their congresspeople to change the law to help them. Until a mass movement steps forward to say "no, we will not tolerate this", nothing can possibly change. We have no recourse but each other and collective action.
Based on voting demographics, the poorest are the ones who are voting for politicians who hate the government and are opposed to any kind of subsidized healthcare.
How true is that? Poor people just don't vote, period. They're overworked, politicians don't listen to them, and in many states there are institutional barriers to casting a ballot even if one wanted to.
And it's not necessarily true among those who do vote either:
It's an old article and I don't doubt that 2016 has messed with the numbers, but the narrative of poor rednecks screwing themselves over every election is largely unfounded and smacks of classism.
Mostly because they believe and have been encouraged to believe that any protections/benefits would go to people who "don't deserve it" (also known as: whichever racial/ethnic demographic those voters have been raised to hate the most). They're very much in favor of discriminatory special-treatment programs that help them and only them, but very much against broad safety nets because they've been told such programs would only benefit the bad other people.
There's a lot to unpack here. First, neither party has the trust of the working class, whatever the rhetoric. Second, the candidate that talked about fixing the system, including healthcare, won -- that he was actually talking about breaking it further gets lost in the discourse around both candidates. There's a longer discussion to be had about how to build trust and what can be done about broken political systems, but it's not the parties that can act on that at this moment.
It will take something like the union/wildcat teachers' strikes, that forced Republican majorities with unified control of state governments to raise wages and increase funding, to do anything about healthcare or the many other structural challenges we face as a nation.
I should have written one health insurance company instead of one organization. Obviously it doesn't make sense to compare a health insurance company that has to abide by 50 different state insurance regulators to the US government.
Then they shouldn't be allowed to conduct business. Of course I expect them to cover all emergencies period. How they do that, I don't really care. If it were up to me, I'd ban these monstrous leeches from society altogether and only allow them to offer supplemental plans. They clearly can't do their own job so they should be replaced by a program like Medicare or Medicaid that can do the job. Would you accept a car insurance policy that only covers some accidents? That's beyond ridiculous.
