Food is Good

Okay, so insurers must take everyone, right? But there is also an individual mandate to buy insurance. . . Insurers can either up premiums to cover the sickies OR simply make their money on the back end. By denying claims. And simply hope that people don’t have the patience/time/money to fight the denial.

This never happens, right? WRONG. I would love to see hard data on claim denial & time to reverse the denial (time being money, of course). Unfortunately, all I have is anecdotal info. One friend has had almost every submitted claim denied in the first go-around. Another friend actually works for a big insurance company and told the claim adjuster that “I will continue to call back during working hours until this is resolved, costing the company far more than simply paying out this claim.” And, of course, there are the doctors who aren’t paid by insurers because of the magic of computer systems where good data goes in and denials come out.

Yup. What incentive will there be for insurers to change if all they have for competition is status quo (clearly not working) and these co-ops? If the government is oh so bad at everything, why not give me the option to try it for myself?