Humana sent out a sales pitch from John Terry, Vice President, Sales. “You may be able to switch to a HumanaOne plan that could lower your monthly premiums.” Count the caveats in that? “May” and “Could” and “switch”… all presuming, of course, that you’re not only insured, but insurable. This pitch was aimed towards the self-employed amongst us, and calls those people “self-insured.” They even congratulate the self-insured on the ability to switch health insurance plans. (“Applications are subject to underwriting approval. Waiting periods, limitation, and exclusions may apply.”) Append extensive sales pitch and claims that you “may” be pleasantly surprised by their rates. (I may be the secret son of JFK too, but I’m not holding my breath on that either. — Ed.) Then, at the bottom, there is a list of conditions for which you “may be denied coverage, if you have been diagnosed with, or in the last five years* (varies by state) been treated for, any of the following conditions:
“AIDS/HIV, Anorexia or Bulimia, Cancer, Chronic Obstructive Pulmonary Disease (COPD), Crohn’s Disease, Depression, if hospitalization required, Diabetes, Emphysema, Fibromyalgia, Heart Attack Stroke or Angioplasty, Hepatitis or Liver Disease, Organ or Tissue Transplant…” It goes on to say that individuals who are severely obese, underweight or undergoing or awaiting the results of diagnostic tests, treatments, surgery, biopsies, or lab work may also be denied coverage. Ditto expectant mothers OR fathers, or children under 2 weeks of age.”
Let’s summarize: If you’re healthy as a horse and fit as a fiddle, they’ll take your money. If there are any risks of them actually having to give some of it back, then you’re persona non grata. What is it that they’re expecting to be paid for, then?
Certainly one can understand why they wouldn’t want to take on likelihood of huge bills. That said, someone who is diagnosed with Diabetes at 50 was quite welcome to spend money with them just a year before. The whole point of insurance is to spread the risks over a large number of people, so that the necessary care is affordable to everyone as they come to need it.
We will be glad to see the end of the pre-existing conditions clauses that are used to single out and exclude those who MIGHT otherwise have required that the insurance companies do what they were paid to do in the first place. It’s surprising that they haven’t tried to preclude people who go hiking or those with children who engage in interscholastic sports. While they’re at it, why not prohibit people from going to the beach? After all, there’s all that risk of skin cancer and shark attacks!
We all want to cut costs. And there are many ways that and places where costs can be cut. Their method is both unfair and cruel. Let’s hope that healthcare reform addresses many of these. Perhaps then we can stop worrying about those kinds of details and get back to the business of healing people.