Friday, August 28, 2009

Deny the Claim

This health insurance company sent an e-mail to all their customers asking them to oppose health care reform.

I don't understand why so many people are passionately opposed to health care reform, but I suspect it has more to do with distrust of the government than with a deep affection for their insurance company. I can't believe the hassles and frustrations I encounter whenever I deal with my health insurance company are unique to me.

It would be kind of fitting if, now that they need us, we were to deny their claim.

This particular insurance company isn't my insurance company, and I didn't receive this e-mail. But if I did, I would have sent them this response:

Dear Health Insurance Provider,

It's come to our attention that you are facing a threat to your well-being that is costing you $1.4 million per day. After making regular payments to your lobbyists for years, we understand why you expect to be protected from these expenses and entitled to our help. But after reviewing your case, we've decided to deny your claim for one or more of the following reasons:

Pre-Existing Condition. Your last bout with government health care reform was 15 years ago, but according to our records, you've been battling government health care plans since Truman was President.

Treatment not covered by policy. According to the policy book, our job is to pay you increasingly large amounts of money every month, and, if we should get sick, to jump a lot of hurdles to get a portion of our costs recovered. It is not in our contract to petition our legislators on your behalf.

Procedure deemed medically unnecessary. All of our allies in Europe, Canada, and Australia have managed to survive just fine despite having their governments involved to varying degrees in their health insurance.

Treatment sought without prior authorization. We were never consulted when you spent our premiums to buy congressmen.

Improper claim filing (missing information, illegibility). How could you possibly expect us to stick to our side of the bargain if you didn't legibly print the ICD-9 code on the claim form?

If you feel we have denied your claim unjustly, you are welcome to file an appeal. If after a six month review, we determine you are entitled to our assistance, we will provide it grudgingly if you are still alive and not bankrupt.

2 comments:

Eric said...

Nice. :)

While I do think general distrust of the government is a big factor, I think a lot of the opposition comes from just plain-old misunderstanding what they're opposing. Hearing and reading many of the arguments makes this clear. As do polls like this:

http://www.fivethirtyeight.com/2009/08/poll-most-dont-know-what-public-option.html

To be fair, that poll also shows that many supporters don't really know what they're supporting either!

Whether this is the fault of insurance companies and Republicans actively sowing misinformation, or Obama and the Democrats not making the issue clear enough, or people just being intellectually lazy, is up for debate. Likely some combination of all three.

systemsgo said...

Good points. Your sister and niece have been participating in town hall meetings here in town on the subject.