SAN GABRIEL, Calif., May 23, 2007

The "Uninsurables"

CBS News Investigates The Tactics Used By Insurance Companies To Deny Health Coverage

  • Play CBS Video Video The Uninsured In America

    Insurers have become very picky in selecting which individuals they are willing to cover. Some companies have gone so far as to interview friends and neighbors of applicants. Armen Keteyian reports.

  • Video First Look: Insurance Expose

    Only On The Web: Armen Keteyian previews his investigative report for "The Evening News." It focuses on the many Americans who are healthy but cannot get individual health care benefits.

  • Video Denying Health Insurance

    Only On The Web: Jeffrey Miles, the former president of the California Association of Health Underwriters, talks about what insurance companies do to deny people health coverage.

  • Scott Svonkin, 41, calls himself the Photo

    Scott Svonkin, 41, calls himself the "new poster child for Americans living without health insuance." He's healthy, fit, and has been repeatedly denied coverage by insurance companies.  (CBS)

  • Blog Primary Source

    Armen Keteyian and his investigative team keep you informed daily on their blog.

  • E-MAIL US CBS News Investigates

    E-mail Armen Keteyian and the investigation team with your story ideas.

  • Interactive HealthWatch

    Explore health issues including AIDS, cancer and antibiotics.

(CBS)  With 46 million Americans living without health insurance, thousands of uninsured people who can't get insurance contact call centers every month.

Scott Svonkin, an active 41-year-old, never thought he'd be one of them.

"Pacificare rejected me because I'm an expectant father. Blue Shield rejected me because I got a spider bite. And then this one rejected me because of asthma," Svonkin said.

Svonkin has managed his asthma for more than 20 years with $150 a month in medication, making him one of the new "Uninsurables" — people who've been denied individual health insurance, but not for a serious illness, CBS News chief investigative correspondent Armen Keteyian reports.

"I'm the new poster child, or the poster man, for the uninsured in America," he said.

A two-month CBS News investigation exposes a system stacked against the individual. Unlike group plans provided by employers, individual insurers can pick and chose their customers, creating guidelines designed to deny coverage for the most common of health problems.

Acne, asthma, athlete's foot, allergies — and that's just the A's. How do you explain that?

"Our members very much want to get and keep customers," Susan Pisano, vice president of communications at the Association of Health Insurance Plans told Keteyian.

The argument from the other side is that they're cherry-picking the healthiest people, and people even with the most minor problems are being excluded?

"Conditions that seem minor to me and you entail a level of expense that is fairly substantial," Pisano said.

Last year one nationwide survey, the Commonwealth Fund, found that 89 percent, or 52 million, of those looking for individual health insurance didn't get it because it was too expensive or they were turned down.

"Insurers are getting double the profit that they make in the group market. Why is it so lucrative? Because they exclude anybody and everybody who has even a remote sense of risk associated with their health care," says Dr. Bryan Liang, who has studied the insurance industry for more than a decade.

One individual application asks: Have you ever had a headache? Have you ever had an infection? Have you ever had muscle pain?

"They want to know everything about you. Your credit history," for example, Liang said. "Your credit history is something that is very interesting to them, and they to know about it."

It's not just your credit history, but your driving record and the sports you play.

Insurers find all that information — and much more — in a massive, little-known data base called the MIB, or Medical Information Bureau. Insurers have even been known to question "friends and neighbors" about "morality and lifestyle" — using all of this information to decide who they will cover and who they won't.

"They can check your morals and your lifestyle?" asks Keteyian.

"Exactly," says Liang. "And they are going to judge you on this."

If you have any problem whatsoever, you are on the outside looking in — in the individual market.

"One of the things that you are saying essentially is the perception," said Pisano.

But it's a reality for millions of Americans as well.

"Maybe the perception and the reality are a little different," Pisano conceded.

Not for Svonkin. Ironically, he's a member of Los Angeles County's Insurance Commission.

"I never imagined it would be so hard to get health care," Svonkin said. "It's not a matter (that) I can't afford it. It's a matter that they won't give it to me at any price."

All of which has left the new face of the "Uninsurables" with nowhere to turn but a state-run program for high-risk people offering minimal coverage — for $528 a month.



For more information about finding insurance as an individual, see our FYI.


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Add a Comment See all 45 Comments
by babsmax May 23, 2007 7:46 PM PDT
This hits very close to home for me. My 23 yr. old daughter has multiple sclerosis and her 27 yr. old husband is in remission from Stage III Hodgkin's Lymphoma. They are not insured as of this year. The COBRA on my daughter expired March 31 and her husband was recently discharged from the Marines with no insurance. I don't know how they will ever have anything. What can they do and how will they ever get insurance??????
Reply to this comment
by mcvet May 23, 2007 7:50 PM PDT
This hits very close to home for me. My 23 yr. old daughter has multiple sclerosis and her 27 yr. old husband is in remission from Stage III Hodgkin's Lymphoma. They are not insured as of this year. The COBRA on my daughter expired March 31 and her husband was recently discharged from the Marines with no insurance. I don't know how they will ever have anything. What can they do and how will they ever get insurance??????
Posted by babsmax at 07:46 PM : May 23, 2007
+ report abuse

Yes but with the trashing of Unions Corporations have consistently dumped their Group Medical, pointing to Third World Labor as an excuse. The whole mess goes right back to "Free" Trade and the Rape of American by Multi-National's.
Reply to this comment
by chipcho May 23, 2007 9:50 PM PDT
My husband and I are both in the same position. We have been turned down for health insurance. The company who may be willing to allow us to pay for insurance requires a $5,000.00 deductable per person per year and 700.00 per month. If we have to be hospitalized 18,400.00 out of pocket would not be exensive, but if we are healthy and only need yearly exams and test we need decide which doctors and test are affordable. How sad health coverage has come to this. I fear if we ever need to use our insurance coverage, we could be dropped, and we would then be stuck without any coverage.
Reply to this comment
by rj760 May 23, 2007 10:18 PM PDT
I had a situation similar to this gentlemen.

I have come to the conclusion that there are only two realistic solutions:

1. Take a low-end job for long enough to get health coverage; then quit and go on COBRA for 18 months.

2. Do what I did and join a union, trade group, or organization that offers group insurance. I keep my real estate license current, not to sell property, but to buy group health insurance. I got a high-deductible HMO for $271/month, no questions asked. For a 52-year-old guy in marginal health, this is a steal.
Reply to this comment
by rj760 May 23, 2007 10:21 PM PDT
I had a situation similar to this gentlemen.

I have come to the conclusion that there are only two realistic solutions:

1. Take a low-end job for long enough to get health coverage; then quit and go on COBRA for 18 months.

2. Do what I did and join a union, trade group, or organization that offers group insurance. I keep my real estate license current, not to sell property, but to buy group health insurance. I got a high-deductible HMO for $271/month, no questions asked. For a 52-year-old guy in marginal health, this is a steal.
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by uhf62 May 23, 2007 10:45 PM PDT
In Canada there is government health care run by each of the provinces here and while it is not perfect by any means,rationing ia a big problem,
a serious shortage of doctors is another,
having to wait many long months to have surgery and numerous other things,there is one advantage that I wish my American friends had too,You are never stuck with a huge hospital bill to pay.
I dont pay one cent after a visit to see my family doctor.However you do still need to have private insurance bought at your own expense or through your job,in order to see a dentist or to
visit an eye doctor.The downside of course is that taxes are much much more higer here than in the US,however most people here are willing to pay the extra taxes to have health coverage.

Reply to this comment
by heresmy2cent May 24, 2007 6:21 AM PDT
All necessities in America are now a racket. Health care, gasoline, heating, etc. Prices are set with no concern about who can afford them. The gov't doesn't care and the crooks who run things in Washington, DC are in the pockets of big businesses.

America is going to h*e*l*l in a hand basket because of greed, corruption and indifference to others.

We are experiencing the modern day "fall of Rome"--American style.
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by mikeypres May 24, 2007 7:11 AM PDT
move to a Foriegn country and come back as an illegal and get your healthcare for free!
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by wiredwilly May 24, 2007 8:02 AM PDT
The President and the Congress are an embarassment. Any Nation that robs the sick and elderly in the name of Corporate profit is not worthy of the respect of its Citizens. Demand " the Deceiver" and Congress have to go without Medical Insurance, lower their pay to $16,000. a year, and see how THEY like it.
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by omega39-2009 May 24, 2007 8:32 AM PDT
Its abundantly clear why Bush has been squealing about getting all medical records digitized, the insurance companies can further cherry pick their clients and companies could lower their premiums by screening their potential employee health records.
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by funkiwiteboy May 24, 2007 8:59 AM PDT
Now wite Americans are feeling some of what (US) blacks have been putting up with since before reformation. You ain't quite what we was lookin for... thats what the recruiter said when I answered his questions honestly about my past as I was willing to join the service for the health benifits. Ha!! lucky me. Yea right...
LORD hep me forgive em!!
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by glb1969 May 24, 2007 10:01 AM PDT
I am so glad I live in MAss. Here we have laws preventing the consideration of any pre-existing condition as grounds for denial, it is also illegal to investigate or share any medical claims information between insurer's, credit history searches are also illegal, and with the new mandatory health care law in place soon no one will be able to be legally denied health insurance. If the country was not ruled by the largest moron in the history of the species, this would be the nationwide rule of law now. So come on down to MASS and enjoy some freedom.
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by nanaboz May 24, 2007 10:19 AM PDT
What I want to know is what is this guy Scott whining about?! He can get insurance through the high risk pool and I bet he can afford it! Or why doesn't his wife go get a job with ESI if he wants insurance so bad. Sometimes, you have to play by the rules. I tired of this "ME" society whether people thing everything is owed to them. I know the private market needs a MAJOR overhaul, but at least he (Scott) has options. If he lived in FL he would have none.
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by itwasntme000 May 24, 2007 10:25 AM PDT
I don't consider this the problem. Health insurance really dosen't cost as much as you people make it seem. Plus you know damm well right that most of the people uninsured say they cant afford it yet they blow tons of money in bars drinking, in casinos giving it to the indians, or how about on buying and smoking one pack of cigarettes a day if not more??? How many alacholoics and smokers do we have in this country(or both at the same time)??? yet you feel pity for them because they didn't get their priorities straight??? Or if we were in a universal health care system would it not bother you that the idiots that don't care about their bodies are draining the system??

The real problem with the costs is not the insurance companies tho(well maybe i don't know if the pharmicutical own them to) The problem is the BIG Pharmacutical companies. They charge extremely prices. A government control over them to try to make them non-profit would be awsome. or something i dont know what would work to lower prices.
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by jlwesley May 24, 2007 10:33 AM PDT
Where do you buy state sponsored for 528, I had to cancel my state high risk when it went to 1138.
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by arrowcatcher May 24, 2007 10:43 AM PDT
I'm self-employed but with the help of my creative insurance agent, I joined a union. I pay the dues and get a great Pacificare plan for just $721/month. Such a deal. It doubled in the last 4 years. Basically same situation as Mr. Svonkin. Just under $9K/year after taxes. Glad I can afford it. With a family, it would be $15K/year.

There's more than "cherry picking". I've gotten annual physicals - a mistake! - and any trivial finding the doctor notes has become a major illness on my record. One example of several is a 1995 creatnine test that went wrong at the lab and became "acute renal disease" forever. He redid the test, and it came back in the normal range as it always was and is, but that doesn't matter. My doctor is outraged and says he'll write letters, but we never bothered. There's clearly both cherry picking and gross exagerration going on in the qualification process.
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by torontorsh May 24, 2007 10:49 AM PDT
I live in Canada, and to keep it simple, I suggest that the U.S. needs to stop all this private *** and switch to a purely public owned hospital, government set doctor payments rate chart system. When I had a heart attack, a week later, after my angiogram, I had quintuple by-pass. When my son had osteogenic sarcoma, he was admitted the moment the tumor was discovered, had a biopsy in a week, had the surgery he needed after initial chemotherapy in less than a month, a year's worth of chemo, two subsequent lung resections, and survived. My cost was all lf $56! So the problem is that the American people have NOT demanded that their politicians stop supporting the AMA, the private hospitals, and the private insurance companies, and instead support the PEOPLE, and only the PEOPLE. If the 90% of Americans who are NOT part of the medical system did that, this nonsence would end!
Reply to this comment
by torontorsh May 24, 2007 11:09 AM PDT
I live in Canada, and to keep it simple, I suggest that the U.S. needs to stop all this private *** and switch to a purely public owned hospital, government set doctor payments rate chart system. When I had a heart attack, a week later, after my angiogram, I had quintuple by-pass. When my son had osteogenic sarcoma, he was admitted the moment the tumor was discovered, had a biopsy in a week, had the surgery he needed after initial chemotherapy in less than a month, a year's worth of chemo, two subsequent lung resections, and survived. My cost was all lf $56! So the problem is that the American people have NOT demanded that their politicians stop supporting the AMA, the private hospitals, and the private insurance companies, and instead support the PEOPLE, and only the PEOPLE. If the 90% of Americans who are NOT part of the medical system did that, this nonsence would end!
Reply to this comment
by toldyouso21 May 24, 2007 11:16 AM PDT
The real problem with the costs is not the insurance companies tho(well maybe i don't know if the pharmicutical own them to) The problem is the BIG Pharmacutical companies. They charge extremely prices. A government control over them to try to make them non-profit would be awsome. or something i dont know what would work to lower prices.
Posted by itwasntme000 at 10:25 AM : May 24, 2007

I normally do not call names but you are an ignorant person and do not have a clue of what you are talking about--the classic example of --"if it isn't happening directly to you--then it must not be true" Grow up. Of course what is said about the health insurance industry is true and it is unfair.

I happen to be in the unique position of having worked for a few insurance companies (Golden Rule, Conseco, etc) as well as worked for pharm co. The fact is, most of the high cost of drugs or equipment is NOT from the drug co but from the mark ups by the distributor and then the hospitals. A drug company may produce a drug for about 300K for a batch of 100K vials at a wholesale cost of 20.00 but by the time the customer gets it in the hospital that 20.00 batch of 20 pills (at an individual cost of 1.00 a pill will have become 6 to 20.00 PER PILL. Because everyone wants to make a profit. Insurance companies are complicit in this.
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by toldyouso21 May 24, 2007 11:24 AM PDT
Part 2. Many people do not realize that insurance companies cut deals with hospitals and surgeons that both must agree to uphold--this often includes the minimum amounts they can be charged as well as a ceiling. Hospitals must be assured of making a certain amount of money to accept or get in bed with a certain insurance group. This means they also have to agree that for certain services they will pay NO less than a certain price. It also means they will allow certain "extra or unnecessary tests to be performed for certain conditions. People think hospitals, insurance cos and pharm are there to help humans. They are not--they are ALL businesses, whose main and overriding goal is not life --but profit. To that end, they will diagnose conditions that do not exist, prescribe tests or drugs that they know are not really needed (like the overprescribing of acid reflx meds) and Pharm and Medical device companies reward them (discount on equipment and drugs or fringes for the hospital they associate with) Insurance companies are also in the same loop.

Be an informed consumer--before you say a situation is a lie or even go against it--LEARN about it--Americans are easily manipulated because most don't learn anything--they wait to be fed--so if they are fed bs--then that is all they spout and believe. Ask yourself why Ins companies charge more for an outpatient emerg. room visit in metro areas than they do if you stay overnight.
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by MizQue May 24, 2007 11:26 AM PDT
I have to pay my own insurance premiums of a little less than $200 a month for lousy coverage. After a few health problems this year, my premiums will most likely skyrocket to an unaffordable level next year, and I will be left without health care coverage. I have gone without the care of specialist because I am afraid I might lose what little coverage I have. I have a choice - go broke or risk dropping dead. Something is horribly wrong in this country when those are your only alternatives.

The insurance and pharmaceutical industry lobbyists have our elected representatives in their pockets. That's the main reason for this mess. No name brand drugs are covered under my policy, but I can buy name brand drugs or generic equivalents of some drugs that are not available as generics here from Canada for **half** the US price, but the government wants to outlaw this on the ridiculous grounds that imported drugs may not be safe. We are talking about Canada, not a third world country, and name brand drugs come from the same manufacturer as the drugs sold here.
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by jjp735i May 24, 2007 11:27 AM PDT
The bigger suprise is that this is the same type of story that is reported almost all the time, yet because the story reads a little different each time, people think it's new news.

People have neen complaining for years about not being able to get health care. Why not really start reporting on WHY they can't get help from Congress or the Insurance Companies. That is the real story. We already know we cannot afford private insurance. We already know the Insurance Companies are *** us. We do not need to read the same story day after day just because it holds a different spin on the story line.

Do some real reporting.

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by toldyouso21 May 24, 2007 11:28 AM PDT
Posted by rsh_rsh at 10:49 AM : May 24, 2007


You don't understand--America is very, very capitalistic--to the point of it being a religion. High insurance, high pharmaceutical prices--high hospital bills all mean more money--the government could not care less about the citizens, they are owned by big business and are in it for the profit also. As long as we allow businesses to run and influence government via lobbies, special interests and donations and PACs--we will have our current system and it will get worse and worse and worse. Social systems are for countries that actually put their people not personal profits first--we are not a social minded country and most Americans have been trained to reject any idea of shared cost or taking care of anyone in addition to themselves.
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by toldyouso21 May 24, 2007 11:34 AM PDT
If the 90% of Americans who are NOT part of the medical system did that, this nonsence would end!

Posted by rsh_rsh at 10:49 AM : May 24, 2007

If 90% of Americans were not part of the medical system they would either be dead or destitute. Just what do you imagine happens in this country if people cannot pay their hospital bills? They can lose everything and end up in bankruptcy. When hospitals learn they do not have insurance, they get the worst hospitals, bad service/care, horrible rooms. Accidents happen (though they also happen to people with insurance). They may wait hours and hours to be fed, medicated, SEEN---or worse yet, they may be sent back home uncared for --if the situation is not deemed acute and the hospital thinks it can get away with it. Often, people are transferred to the welfare hospitals, where the staff is overworked, the halls crowded and triage of gunwound victims, drug overdoses and preemie babies by children take precedence.

Telling Americans to stop paying for health insurance is like telling them to not pay taxes--they know they do those things to their own detriment--and since most will NOT join them--then only they would suffer for their actions.
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by jebby_one May 24, 2007 11:35 AM PDT
how they get by without anti-trust or fair pricing charges is beyond me. Oh wait I have heard the official explaination. Providers claim they charge veryone the same price, but they are willing to accept less from select buyers.

Joe Smuck ends up paying 3 times more for health care than someone with the right insurance card. Then when he files his tax return he/she gets screwed over by Uncle Sam. Employer provided health insurance escapes all taxes. Joe Smuck on the other hand has a high exclusion before he gets a tax break.

By failing to clamp down on unfair pricing and subsidizing employer paid insurance the government is forcing the public into zero deductible insurance. This is the most idiotic policy possible.

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by jebby_one May 24, 2007 11:41 AM PDT
If we paid for food the same way we are paying for health care services I suspect that 46 million Americans would go to bed hungry each night.

Imagine if you had to first buy food insurance to get reasonable access to food. And your food insurance company would thenm make deals favorable to them and decide what foods you could buy that would be covered by your food insurance. oh, and the only way that you could get reasonably priced food insurance is through your employer.



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by jn122736 May 24, 2007 11:43 AM PDT
Insurance came into being like marketing did, with one major difference. Insurance was a natural, community type agreement, to create a mutual fund to prevent the bankruptcy or financial destruction of any person and/or family in the event of unexpected illness/accident.

Marketing/bartering, in the beginning, was one person, having more of one thing than they need, trading some of it for something they haven%u2019t enough of.

Today, that is called %u201Csocialism%u201D. But then so are our police and fire departments, armed forces, county, state, and federal governments (not to mention the Supreme Court).

Social security is one of the most successful, government run programs in history. As a matter of fact, Bush and Reagan, between them, have %u201Cborrowed%u201D $2 trillion dollars from the social security surplus.

The only protection we ever HAD against over-pricing and control of commodities, or anything NECESSARY for survival, was/is anti-trust and anti-monopoly laws, which have been either gutted or ignored.
The favored way of defeating any person or thing is to label it/them. I.e.

Tie the word socialism to Russian communism and beat the hate drums until the word and reference become one in the minds of the people.

Other words have been debased to the point that they no longer have they original meaning in the minds of most.

Like, for instance, the word Gay once meant carefree/happy, and the word liberal once meant, preferring freedom.
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by itwasntme000 May 24, 2007 11:43 AM PDT
toldyouso21

did i say i was an expert??? no... my point was the huge insurance costs are directly related to huge prescription drug costs. how many elderly people do you know that take over 5 pills every day??? and isn't that baby boomer gen hitting old age??? Ok yea doc's need to actually be a real doc and know what and when a person needs for pills but still.
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by memerider May 24, 2007 12:16 PM PDT
Doctors have become pushers for big pharmaceuticals, in part because they've had to stop spending so much time researching and working with patients. We live in a world where we focus on one effect of each drug and ignore the others, labeling them "side effects." And we've been seduced by the magic pill idea. People believe medications will help them and trust doctors to have the answers. Neither is necessarily so, but the culture has been brainwashed by the AMA and big pharma. So now we have capitalists cherry-picking and ganging up against people instead of treating insurance as a mechanism for sharing the cost of losses. This is a disgrace.
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by memerider May 24, 2007 12:27 PM PDT
And I was converted from a fte to a contract position (common for more than 10 years), so I am without any benefits at all--I am an hourly worker who must file a 1099. I know many others in this predicament. I've been avoiding going to the doctor because I just can't afford it. No mammogram, no dentist, no pap smear. Nada. I have to eat, pay for shelter and transportation, and pay for medical bills for an entire family. Just food and gas have skyrocketed until I see no hope for the future. And I haven't a prayer of getting insurance. When did someone reframe public health as an insurance problem. If even one executive in one health insurance company or pharmaceutical company is only pulling a reasonable salary, I'd be very surprised. Those of us living on the edge are slipping off.
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by rainyday9 May 24, 2007 12:32 PM PDT
THIS should be one of the issues that helps us choose future leaders. Apparently, the ones we have now are helpless against the huge lobby force of the insurance/medical associations that run our country. It's disgraceful that they can check your credit and base an insurance policy on that. People who have no insurance, in most cases, find it difficult to have good credit. They have MEDICAL bills! Often, they have low-paying jobs that do not have insurance... that's why they NEED it. Again, we have the best medical care available in the world. We offer it to illegal aliens and third-world patients who need help... that's great. What about US???
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by toldyouso21 May 24, 2007 12:39 PM PDT
Posted by itwasntme000 at 11:43 AM : May 24, 2007

an even scarier question: how many nurses and care givers do I know taking over 5 pills a day? To your question I know of about 2500 to 3500 Seniors who take over 10 pills a day. This is because I also worked in the adverse reaction and complaint arenas in the Pharm business and have many friends and family working in the health care industry (incl nursing homes) Anyone with heart disease (most in their 40's and 50s) is easily on 4 meds.--1 or 2 for blood thinning, 1 for hbp, 1 or 2 diuretics---usually with this disease comes potential renal failure or complications and often type II diabetes--which means--insulin , testing strips, sharps, etc. If the diabetes is progressive and it usually is--then also pain meds, antibiotics, special socks, shoes, etc.
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by toldyouso21 May 24, 2007 12:41 PM PDT
For nurses--many are on depression meds as well as numerous medications for pain (autoimmune diseases and back problems are rife in nursing--hence the huge turn over and constant need for nurses) In fact, I know of quite a few nurses who work in ICUs for either babies or adults who are on as many as 19 medications daily including morphine--many have fibromyalgia--which is a catch phrase for "we don't know what is wrong with you and why you have all of these symptoms--but we better give it a medical sounding name so we can treat you"

I did not take issue with your remarks about pharm comp. but with your attitude that this stuff is not true--if anything, it is downplayed. The sad fact is, when it is bad enough for you to realize--you will be personally affected and then--those left will disbelieve you also. A terrible catch 22
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by weareone2 May 24, 2007 12:46 PM PDT
90,000 people die each year in the US because they don't have health insurance.
People who work harder than most, in low pay jobs, such as waitresses, may not be able to afford $25 or $30 for a visit to a low cost clinic.
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by itwasntme000 May 24, 2007 1:13 PM PDT
toldyouso21

While you are on the nurses topic... Why is it that they passed a law awhile back (or whatever it was) to make it so a truck driver can't drive for more then 8 hours straight without a 4 hour nap i think it is, yet a nurse after her lets say 8 hour day can be mandated to stay for another 4-8 hours if noone else will come in?? and nurses are the ones giving the meds to patients, taking care of them. When you are in your 15th hour at work I hardly think they are completely their....
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by mitch0927 May 24, 2007 1:32 PM PDT
WHat about the people that do have insurance and pay and pay and pay, but when it comes to actually using it, you find that what you need done is covered and you have to pay and pay some more. Case in point..I have paid over 20 thousand dollars in premiums through out the years and needed some work done, and found I had to pay full amount because of it not being covered. The 20 grand was for nothing.
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by sclaires May 24, 2007 3:34 PM PDT
I guess I am lucky in that I have group health insurance from when I retired and also Medicare. But, the problem is that it does not pay that much for dental work. Already this year I have paid out on credit cards $545 and $125 just to have two teeth pulled. Now I am going to have to pay out I don't know how much to get a partial fixed so I can wear it again. And glasses are also a problem. My vision can drop all of a sudden and then I need new glasses. And, of course, Medicare doesn't pay for glasses and neither does my insurance so that is anywhere from $200 or more out of my pocket. So that has to go on a credit card. Add all that and it comes out to a "young fortune". You either get teeth pulled or get sick from infection and get new glasses or not be able to drive. It is a "Catch 22" all the way around.
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by soundboy123 May 24, 2007 4:31 PM PDT
I live in California... have a Domestic Partner with type 2 Diabetes.

I know EXACTLY how this goes. Because he's self-employed, he was paying $650/month for health insurance.

the insurance company had a co-pay for his medication... they payed $.25 of the cost of the drugs he uses every month ($168).

twenty-five cents.

Recently, I changed jobs and my new employer offers Domestic Partner benefits... I now pay about $544/month for BOTH of us.

they tell us group insurance has a pool of HUGE amounts of money (paid in by people that hardly need to see a doctor) that allows them to cover people with existing conditions.

okay, so... how big a pool of money is the 'uninsurable'? If they're paying huge amounts every month for insurance, and there are thousands of people paying in... shouldn't the costs paid out be offset by the amount being paid in? why are they paying so much?

greed. Health insurance (in my view anyway) is just another form of Mob protection... especially to someone turned down because of Acne, Athlete's foot, etc.

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by catt42701 May 24, 2007 5:36 PM PDT
I laugh at the man that has paid a little over $1000 for his teeth. Mine will probably run up to $20,000 just because of having weak teeth to begin with and the fact I grind and clench, plus being exposed to radiation as a child. I am on SSI and my credit card is going to be loaded when it's done. I don't get much more than food and paying medical bills after a payment on my teeth. I also get the cheapest glasses frames they have where I go but my lenses cost ofer $250. He has it made.
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by dougbob3 May 24, 2007 7:16 PM PDT
As a doctor and a Canadian living in the land of the free, I see this insurance fiasco as a total underminding of the social fabric. In my humble opinion, there are at least two ways to take away both the control of the insurance companies of us patients and practitioners, and their inhumane, over-excessive profits. Either get a state controlled health insurance plan that we pay for, or just carry catastrophic insurance ,get a medical savings plan,and join a "concierge practice' to cover your primary care needs or pay as you go from your medical savings account. What this will do is reduce our costs, reduce insurance companies profits and take back control into our hands from these highway robbers. It's ridiculous for us to pay them, they use our money, take huge profits from our money, then tell us whom we can see, what we can get done, what medicine we can take, what they'll pay for, etc, using our money, and other people's expertise. It's a crazy situation!!!
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by louisbee May 24, 2007 7:23 PM PDT
lets here from individuals who have been damaged by agents of the policy racket---in my case the agent falsified info on my app and now my policy has been recinded after what was catagorized by as a near heart attack and expenses of near 100,000 dollars, NOW I AM BEING ACCUSED OF FRAUD!?!?!?!?!?!?! THEY AREN'T PAYING. MY CREDIT IS TOAST AND LIFE IS NOT EASY. IN ADDITION THE CREEP TOLD ME TO LIE DURING MY TELEPHONE INTERVIEW----I THINK THE LEGAL TERM IS DETRIMENTAL RELIANCE. HIS MOTIVATION, IN HIND SIGHT, WAS TO SELL A NEW POLICY AND COLLECT THE FIRST YEAR COMISSION INSTEAD OF THE RESIDUAL OF A SECOND YEAR RENEWAL. IN ADDITION THIS INDIVIDUAL COMPLETELY ABANDONED ME WHEN I WAS IN GREATEST NEED OF HIS ASSISTANCE THE ONLY TIME HE CONTACTED ME WAS TO WHINE ABOUT WHY I HAD FILED A COMPLAINT WITH THE TEXAS INSURANCE BOARD. I COULD USE SOME LEGAL ADVICE---IS ANYBODY OUT THERE?????
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by rudy654-2009 May 24, 2007 8:10 PM PDT
"Often, people are transferred to the welfare hospitals, where the staff is overworked, the halls crowded and triage of gunwound victims, drug overdoses and preemie babies by children take precedence."

That's the U.S. health care system!! The best that money can buy. Just be sure to have a lot of it!!
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by kaybird07 May 25, 2007 3:46 PM PDT
As an health agent I deal with several companies and rarely have I had trouble getting a claim paid for someone if the coverage was truly there. I have used Assurant as my main company for individual insurance and have yet to have a complaint about a claim not getting paid. I will say however that I make it very clear up front what the plan excludes, pre-existing condition clauses etc. so there is no confusion down the road.I feel sorry for the previous mailer who apparently hooked up with a bad agent. Lets be honest though--if an agent is telling you to lie on an application or a phone interview, you know he/she is not on the up & up and he should have went elsewhere.
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by trixie8476 May 25, 2007 8:51 PM PDT
People forget one critical thing...insurance companies are BUSINESSES. Why in the world would they want to insure anyone with an expensive health problem, or an older person who is likely to develop one?

This is exactly why government needs to be in charge of health insurance...insurance companies are not a charity...they are not there to HELP you...they are there to make $$$$!


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by toolmangler-2009 May 26, 2007 9:54 PM PDT
Posted by sclaires at 03:34 PM : May 24, 2007

Thats not fair!!! No way can I let you be sicker than me. I have had two heart attacks and Cirrhosis. I've got one eye, six teef,th thorry, an a veritable plethora of other ills, so there!!!! :p

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