He may have sounded cheeky to some, and perhaps downright egregious to others, but 17-year-old Canadian singer Justin Bieber’s comments to Rolling Stone magazine about the personal cost of health care in the United States packed a punch. The young maven even caught the attention of film critic Roger Ebert who, in contrast to other commentators, praised and validated Bieber’s claim.
For the sake of argument, if Justin had the necessary education and expertise to delve further into US medical care, he would find a system steeped in the discriminatory practice of medical insurance underwriting, with policy decisions being made primarily by those with a finance background, and the incentive to protect their company’s bottom line.
Medical underwriters are the nuts and bolts of the medical insurance business. The job of deciding type of coverage, how much you will pay for that coverage, and if they will even give you coverage, all falls on their shoulders.They are also responsible for the denouement of every policy holder who is disqualified from claiming medical expenses, and hence leaving patients with no further recourse. The amount of medical information they can find on any person who has ever had insurance or has been refused insurance is startling, and the ways they can use that information, if need be to deny a claim, is almost criminal. Canada and the US both use the same databases (information retrieval system) to access what is known as the blacklist in the insurance industry. Very few companies, if any, will insure anyone who is on that list. For further reading, underwriter’s guides can be found on the internet along with information about the blacklist.
What is very disturbing about these underwriters is that often they do not possess sufficient knowledge of medical or pharmaceutical language, nor do the government policy makers often know what they are talking about in terms of medical care, never mind Justin Bieber. A job search online of medical underwriter positions in the US reveals very few insurance companies requiring a medical background at all to underwrite medical insurance. Medical language can be tricky for some people. If it sounds like Greek, that’s because it is Greek, with some Latin thrown in for good measure. Thus it is easy to misinterpret certain terms. For example, abortion is an ablative term meaning anything taken from the womb, not necessarily a foetus. While the term Dilation and Curettage would be the proper name of this type of procedure, the usage of the word abortion in the medical community would suffice. However, someone reading that report who doesn’t understand what that term means in the context of the procedure, could devastate the policy holder, and add insult to injury if they were denied their coverage. Off-label prescriptions are another big issue because they mark the patient as having the illness they are meant to treat.
Fortunately for most Americans, under health care reform, insurance underwriters and their companies are not going to be allowed to turn down, or refuse to pay a claim, based on previous illness or even a reoccurring long term illness. This reform sounds like a huge improvement to an outsider; however insurance companies are worried about the risk and loss of assets with America’s health care reform. Hence the mandate, or pay the fine.
Higher insurance rates are inevitable, and shopping around for the best plan for any given family or individual without insurance, tortuous at best. Perhaps social networking can take it upon itself to act as a hub to match up people to plans.
It is important to note that no matter how favorably Justin Bieber may portray Canada’s health care system in comparison to the United States’ current health care reform, it is fair to say that no system in the world is without its own health care nightmares. That would also include Canada with its long wait lists.
Bieber is a young person simply looking in from the outside and cannot identify with what he sees after being raised in a country where, in his experience, care has never been denied.Powered by Sidelines