Why does Senator Baucus think of US citizens as beggars for health care, even when they (over)pay for it?
Here is a quote, the one that gives away his true opinion of his abandoned constituents and the rest of us poor saps--directly from his proposal for health insurance reform:
"Ombudsman. In 2010, states would be required to establish an ombudsman office to act as a consumer advocate for those with private coverage in the individual and small group markets. Policyholders whose health insurers have rejected claims and who have exhausted internal appeals would be able to access the ombudsman office for assistance."
Why should insurers serve as a government agency? Why should citizens, consumers, wait until they have 'exhausted internal appeals' before being allowed to seek any rederess from their government? If health insurance is a business, why should its customers be forced to beg for service?
There is no industry currently active in the US marketplace quite as adroit at pushing their customers around as health insurers. They lose your claim, lose your prescription (for medical devices such as prosthethics),. lose the payment order and (conveniently) omit payment to the dental provider (who decides to 'make do' with your copayment which was 50% of the fee, anyway).
Health insurers deny you without admitting as much. They routinely 'forget' to send out formal, official denial letters, because that particular missive gives the customer the right to petition the state for assistance with health insurance in California.
Can you see the process Mr. Baucus outlines in action? Moving with the speed of molasses (of course, while the sick or injured person waits for treatment) insurer rejects claims, takes inordinate amounts of time between rejections to elongate the agony and further delay the ability of the customer/consumer/patient to seek redress from a government office that may/may not be staffed, and may/may not possess any real authority to redress problems.
This is the problem with HIPAA; it looks good on paper, but the electronic transactions in it have been used to perfect the finer arts of insurer rescission based on old conditions where it was supposed to support portability of health plans. As it's currently misused, HIPAA supports purging of sick people from employer rolls instead of protection of their privacy.
And what's this 'internal appeals' requirement? Why should the insured be forced to participate in whatever internal appeal process might be created by the insurer? Who defines that process, determines when it is too long or requires too much hard work on the part of the customer? We've seen Mr. Potter's testimony and read countless agonizing stories of health insurance gone wrong. We know that 'internal appeals' means 'find ways to delay or deny' in order to improve the bottom line.
No, I'm afraid this proposal is far too cozy for the insurers. It leaves everything as-is, with business as usual for those currently profiteering on the misery of those trying to use the benefits they pay for. This isn't reform; it is extension of the taxpayer trough for the insurance companies to continue feeding.