Op-Ed: Allegations surface over insurance companies bending rules Special

When it comes to the rules, insurance companies have it made in the shade. The companies have been given carte blanche to change their rules whenever they desire according to the opposition.

There are those in the United States who believe private insurance is the way to go when it comes to health care. Those individuals have not likely had to deal with pre-existing conditions or a cancer diagnosis. Individuals often find out the hard way that insurance companies can twist and bend the rules, allowing people to get sick or even die. There is no regulation in many states that make it mandatory for insurance companies to insure those with pre-existing conditions. One flight on a corporate jet will pay for five individuals yearly premiums according to the group Sick For Profit, an organization that recently put together a documentary about a woman named Jo Joshua Godfrey. As the Huffington Post reports Godfrey had cancer for more than two years while her insurance company allegedly told her she had bronchitis. Upon seeing her doctor, eNews Park Forest reports, he knew within 30 seconds she had cancer. "He told me, 'You have cancer,' and he said the reason [the insurance company] did not want to give you your records is they've known right way back for years that you have cancer and they're not going to treat you," Jo Joshua Godfrey told eNews Park Forest. Upon learning of this case, I contacted insurance company CIGNA with a request for comment. CIGNA spokesman Chris Curran told me via email: "Because of HIPPA regulations, we are unable to discuss the details of Ms. Godfrey’s case without her permission. However, we can say that when Ms. Godfrey was enrolled with CIGNA more than a decade ago, she received all of the benefits to which she was entitled under her benefit plan. There was no denial of coverage." At times it appears insurance companies have no problem misleading the American public about Medicare and Medicaid costing the taxpayers more in premiums. It is true that those government-funded insurance programs rack up high costs for hospitals. What is left out is the number of people having to use these services after being dropped from their private insurance companies. Those companies have used this information as a means of justifying adding even higher premiums to their clients. AHIP.org reports about the $90 billion being added on to insurance clients' premiums. What is interesting to note is that the report only shows one side of the picture; the side of the insurance company.

“This new study shows that cost-shifting is driving up the costs of health care for all consumers,” said Scott P. Serota, President and CEO of the Blue Cross and Blue Shield Association. “As our nation embarks on comprehensive healthcare reform—and we collectively strive to extend coverage to all, improve quality of care and keep healthcare affordable for future generations—cost-shifting is one of the areas where we should focus our attention.”

On the other side is a report from the Congressional Budget Office (CBO) that says private insurance payments may be a factor in driving up hospital costs. This report shows one very serious potential issue:

Without changes in policy, a substantial and growing number of nonelderly people (those younger than 65) are likely to be without health insurance. CBO estimates that the average number of nonelderly people who are uninsured will rise from at least 45 million in 2009 to about 54 million in 2019.

When it comes to Health Care Reform in the United States, citizens have to look at the background of the reports that they are being shown. Is that report written from the perspective of the insurance company or from a report that doesn't stand to profit one way or another from the final decision. Without serious changes to the insurance companies in the United States those facing life threatening conditions stand to lose the roll of the dice. It's a do-or-die situation for some with these medical conditions when the medical insurance field is left to make its own rules about who is covered and how much they can charge the public for that coverage.