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Insurance is a Sucker’s Bet

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Insurance is a topic to which I’ve devoted many a ponderous thought over the years, but nothing says insurance like a nine-hour stay in an emergency room. Mind you, I didn’t want to be there. Although the doctoring profession is a noble calling, and many MDs are fine people, including the ones I know, I have an aversion to sickness in general and hospitals in particular. Past experience leads me to believe it is better to suffer through on my own. However, it is nearly impossible to ignore chest pains accompanied by extreme sweating, shortness of breath and nausea. True, these symptoms could signal menopausal symptoms, panic attack or Elizabeth calling me home from above to keep her and Fred Sanford in fine company.

I called my doctor, who told me to go post-haste to the nearest emergency room. Since my mother dropped dead of a heart attack at the relatively young age of 58, I thought it prudent to take as few chances as I could. So in my nearly all-day sojourn lying flat on my back on the stretcher from hell and strapped into place by monitoring wires, I had plenty of time to consider my insurance. My husband was fretting how much my ER stay was going to cost. (We are basically uninsured, having a crummy policy with an uber-high deductible. It covers little and is meant to kick in only when catastrophe strikes.) I am a writer never without pen and moleskin, so I was able to sketch out my insurance theories while they jacked me full of drugs and took out half my blood.

First of all, it doesn’t matter what type of insurance or its intended use, insurance is a sucker’s bet. The only winners are those who issue the policies, and they, with their wheelbarrows full of cash, are laughing all the way to the bank.

The premise of insurance is simple: you buy a policy to cover the value of your car, your house or your life, and when God forbid, disaster strikes, you cash in. Glory be, it’s like hitting the MegaMillions.

But hold the presses. Maybe that’s how it was in the olden days when the insurance companies might have been honorable as well as flush. Insurance companies weren’t in the practice of investing in derivatives and junk bonds like they do now. Back then, if you made a claim, you’d have more than a snowball’s chance in hell of recovery. I know this, since I have filed claims that thirty years ago were speedily processed. These days, insurance companies look to nickel-and-dime their customers out of paying claims.

This relatively new phenomenon has only been around for the last ten years or so. When a tornado topples a tree on your roof and the insurance adjuster says the damages are $1,060 and you have a $1,000 deductible, you may as well hang it up and get rid of your insurance. You certainly won’t process the claim for $60. Or let’s say your piano gets dropped upside down during a move and the homeowners’ policy won’t pay and the movers’ policy won’t pay. When your health insurance says this drug isn’t covered or that treatment is disallowed, you bite the bullet and pay it yourself. When your employee cracks up a company car, it’s far easier (and safer, if you want to remain insured) to eat the cost of repair or replacement rather than file a claim. This has happened to our family on numerous occasions. I’m already looking forward to the day when I might try to collect on life insurance only to find the insurance company has located a convenient loophole and I’m out in the cold. Oops! I guess those thousands of dollars I paid in premiums went for naught.

But NO… You can’t just swear off the insurance habit. If you have a mortgage, you are required to have insurance. If you license and drive a car, you are required to have insurance. Now the government is saying if you are breathing air and live in the United States, you are required to have insurance.

You say, “No insurance? That’s insane talk!” Is it? What would happen if there were no insurance? People would have to calculate potential loss on their own and save for the proverbial rainy day — what a quaint, antiquated idea! Some do that now. Let’s say you own an ’89 Dodge Omni or live in one of those splendiferous $1,000 houses in Detroit. Surely if you chose to insure at all, you would choose the bare minimum and hope for the best.

As for health insurance, a family would have to gauge what their medical needs would be and save to that amount themselves. Of course, standard medical providers would have to be able to price out their services. Right now, if I see my doctor using my insurance with zero co-pay (I pay 100%) and ask for a total from the receptionist, she returns the question with a blank look. She has no idea, just as she was confused by our health savings plan. Minor things like billing have to be funneled through the big admin office where they can doctor (pun intended) what happens in the end.

It’s obvious the clinic charges more if you have insurance. On the day I went for my flu shot, people were walking in without insurance. I overheard a telling conversation between the receptionist and a patient. Flu shots for those with insurance, even the crappy policy I have, are $65. Flu shots for the uninsured are $25. I figure there is $40 worth of paperwork in between. I believe it's the same with regard to prescription drugs, although the wiggle room there is much larger and makes no sense. My prescription of non-coverable Zoloft at CVS costs $31 — at Sam's Club it's $7 and change.

People with employee-based health insurance have no idea what the real costs are. In Michigan, our teachers and union workers pay a bare minimum in premiums, with the state or car companies picking up the rest. One local school district has bitched because the premium is going up to $30. Thirty dollars a month? Try living my thin checkbook at $900 a month.

It takes a lot of self-control not to blow the money on a boat or a fancy purse or a Cadillac and instead bank that money for a reasonable expense, like medical bills, but it can be done. Plenty of doctors operate and make big money outside the realm of insurance. I’m thinking of plastic surgeons, eye surgeons, therapists and psychiatrists, dentists, etc. The savvy consumer will shop around as they would for a refrigerator or lawn service. I’ve had to pay for my own child’s testing services, speech therapy, orthodontists and glasses. (That’s right, no dental or eye care in our policy either.) It takes some diligence and responsibility, but it can be done.

The noticeable lack of insurance companies raising a hue and cry over the health care debate, and their future business, leads me to believe that they are in bed with the government on reform. This means only one thing:

We suckers are going to get royally screwed.

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About Joanne Huspek

I write. I read. I garden. I cook. I eat. And I love to talk about all of the above.
  • I sympathize with you, Joanne. You’ve read my issues with my health care and with my homeowners underwriters under my latest post. Had my wife not insisted on checking in with the homeowners insurance, I wouldn’t have lost three weeks time, waiting for them to come and inspect to find a reason to reject my request, that would have allowed me to finish the job that got interrupted by my illness – AND I wouldn’t be losing my coverage now.

    Back when I was young, my dad sold insurance. He was gone for several months for all intents and purposes. During that time, working his day job and selling at night, he came in #2 nationally in total new policies written that particular quarter. The first day of the next quarter, they handed him his “sales goal”. Because it was double what he’d already done, he decided that selling insurance wasn’t such a good way to make a living.

    I kept this in mind when I tried it. About all I got out of that experience was that unless you have debts to cover (so that you have something to leave to your heirs besides collection notices {went through this with mom-in-law’s estate, including a summons to appear in the Northern Illinois District Court to answer to her creditors}), there is no reason to have life insurance. Every other insurance I have is proving to be almost more trouble than it’s worth, but I’m required to have it as your post indicates.

    Once these blood suckers have taken us down to where we aspire to achieve the status of Zimbabwe, they will have to “adjust” their own priorities. They won’t be able to pull the same crap in whatever nation which foolishly allows them to buy in to live once they flee our shores to escape our wrath.

  • First things first, Joanne. How are you feeling? Was this episode of pain a mild heart attack (as if any heart attack is mild)?

    Finally, refuá shlemá – may you experience a full recovery from whatever it was that hospitalized you, however briefly.

    Now to the less important stuff…. I understand your attitude towards insurance. I used to sell it for a short time myself and saw what a scam it was. I preferred to sell financial planning packages myself – as I’m good at that. Or I was when the money in the States was more than a joke.

    My father didn’t believe in life insurance. And when he died, I got his tools and his boots. We all sure could have used a few thou. And it is hard to deny someone’s family the money when you buy the great big farm in the sky.

    I carry health insurance in Israel – it’s compulsory to buy the insurance and pay the premiums here. If I ever get to buy a house again here, I’ll have to carry life insurance payable to the bank so they do not lose their mortgage (no FANNIE MAE here). Otherwise, when I die, my kids get my (father’s) tools and my collection of “Wheat” pennies, and whatever clothing of mine that fits them. And my wife gets to file for a widow’s pension from Social Security (if it still exists).

    Ah life in the Promised Land is so fun! The blood suckers can’t suck me dry, though. You can’t get blood from a stone.

    Feel better!

  • Thanks, Ruvy, for your concern. Not heart failure, thank God, and I passed a stress test. It might be something more basic like a panic attack. My children will be crestfallen to learn that I might outlive them, or at least live long enough to spend all the money (what little there is).

    The entire system is screwed, but I’m not sure letting Congress pass legislation would fix anything. Look at the Post Office. What a mess.

  • Great article, Joanne.

  • Clavos

    Joanne, the sweetest revenge is to live long enough to be a burden to your children…

  • Look at the Post Office. What a mess.

    I’d rather not look at the Post Office in the States. My father-in-law was a postal carrier when he was working. He used to deliver the mail to “Dear Abby” and Charles Schultz, both of whom lived on his route in western St. Paul some three decades ago. He would come over on Sundays for coffee and cake and reminisce about the “stupidvisors” he had and how lots of junk mail never quite made it to their intended “customers”.

    You won’t tell the Postal Service on him will you?

    He apparently used to get lots of Christmas gifts from the folks on his route. There was once a time when the postman was not some anonymous flunky in a dumb looking uniform, and my father-in-law was lucky enough to be the last of a type, even getting a writeup in the local newspaper on his retirement.

    When I look at the Post Office here, doár yisraél, what I see is an organization that goes on strike every damned opportunity it gets, and a postal bank (an institution left over from British colonial days) that is unwilling to do anything other than the most basic deposit and withdrawal functions. I went there today to see if my son had gotten a stipend he is supposed to receive, and they said there was no money in the account. I asked if I could see a record of recent transactions that left the account so empty (there had been NIS 13 when I left a month ago or so) and the woman said, “I can’t do that. Call customer service, and ask them!” Bear in mind that these are all Hebrew speakers and I was doing my best to understand the rapid Hebrew she was tossing at me. So, I’ll wait until Sunday (Friday and Saturday are the weekend here) to call these wonderful people.

    As for health insurance and social safety nets, this is the social safety net you need, and for health insurance, this is a good model. The basic services are paid through the NII and you can add to the basic services by buying into the additional plans listed at the site.
    If you guys in the States had the money, all you would have to do is copy and paste.

    The trouble is, you guys can’t afford this anymore, a point that the “I-gotta-have-health-care-reform” crazies can’t seem to absorb. This has nothing to do with any ideological bullshit about “private enterprise” or “socialized medicine”. It has to do with the simple fact that your government is broke.

    A bum with $5 in his pocket can dream about $400 shoes in the window – but unless he is willing to steal the shoes, he hasn’t got the cash and has to get $3 sneakers at the United Way.

  • maskay

    Great article.

    My mother tells me how 45 years ago (when she was just starting out as a beauty shop owner) how her dentist had to raise prices once GM got dental insurance (we are from Bay City, MI) to pay for the added office people to process the claims. She didn’t think it was fair then that she had to pay more as someone who was uninsured.

    As an employee of one of the big three, I have to pay a few hundred towards my insurance (and it has a HUGE deductible also). But, I consider myself lucky. What I pay in a month is what we would pay per week if we were on my husband’s insurance.

  • i have had a lot of health problems in my life and i am darn glad that i have health insurance. pretty soon here with the new public heath care coming up i dont know what is going to happen in my case.

  • John Wilson

    The problem with all insurance is that you, a puny little consumer, are up against a gigantic international oligopoly whose bosses set prices as they please and are only as responsive to claims as they have to be.

    The reason is that a 70 year old federal law FORBIDS Federal regulation of all insurance leaving it up to the several states, who are disorganized and easily suborned.

    It’s a rigged game. You lose.