NEW YORK, Aug. 17, 2007
Having Health Insurance Not Enough
Having Enough Coverage Key; 3 Out Of 10 People With Insurance Don't, Says Consumer Reports
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Play CBS Video Video Assuring The Underinsured Harry Smith speaks with Kim Kleman from Consumer Reports about how underinsured Americans can make sure their families get proper medical care.
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Kim Kleman and Harry Smith on The Early Show Friday. (CBS/The Early Show)
An exclusive nationwide survey by the magazine of working-age adults found three out of 10 Americans who have health insurance don't have adequate coverage. They are underinsured. And some 16 percent of those who responded said they don't have health insurance at all.
Consumer Reports Editor Kim Kleman discussed the situation on The Early Show Friday with co-anchor Harry Smith.
The underinsured said they can't afford health care, so, "They're not much better off than people without insurance at all," Kleman told Smith.
"Insurance companies," Kleman observed, "which are the middle men in this whole formula, cannot or will not reduce costs for medical care. And so, those costs are passed on to employers and consumers. Insurance companies are still making their comfortable profit. But employers and consumers have to make up the difference."
"Employers are trying to keep the same percentage of total premium," she continued. "They're trying to make sure they cover something. But because costs overall are increasing, employees … are having to pay more money, even though the share of what they're paying toward their premium is about the same. And, you know, benefits are getting skimpier. And co-pays and deductibles are increasing. So, this is a huge problem for a lot of people."
Kleman offered tips for getting the most out of your health coverage:
"It could bankrupt you," Smith pointed out.
"Absolutely," Kleman agreed.
To read the health insurance article in Consumer Reports, click here.
For more on health and fitness from Consumer Reports, click here.
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Add a Comment See all 20 Comments
- incog-nito
In fact when it comes to our healthcare we have no worries at all really. When we need to go to a doctor we just phone and make an appointment with our family doctor, and go. Or we can go to a walk in clinic without an appointment even. Everybody has a "healthcare" card with your number on it and if you go somewhere you haven''t been before like a specialist, you just show your card.
If we have to have surgery we just show up on the day of surgery. We don''t have to look into anything at all.
Okay, I am through bragging now!:)
Actually it stresses me out just thinking about what it must be like to live in your country and having to worry about that kind of stuff. - Reply to this comment
- incog-nito
"I did my homework and made sure all the doctors involved was in my plan."
Wow, I can''t even imagine what that would be like to have to worry about whether a doctor or anesthesiologist was part of my plan. We don''t have to look into that part at all because it doesn''t matter who we go to or have as an anesthesiologist, we are covered. - Reply to this comment
- erasmus6: I''ll tell you why Americans put up with this. It''s because they have swallowed since elementary school the propaganda that the "free market" is the solution to everything.
That somehow a corporation whose main goal is to line its pockets with their money, will somehow magically look out for their well-being. You can judge by some of the posts here that many, many people actually believe this. - Reply to this comment
- I live in Canada and my husband''s employer pays $80 a month for the two of us for our healthcare.
That is for basic healthcare which is doctors and specialist visits, tests, surgeries etc. It also includes extended medical and dental.
And there is no game playing on whether something is covered or not. If they say it is covered, it''s covered.
I don''t know why you people allow this to go on in your country. - Reply to this comment
- I had the exact incident as described in the article: I was in the hospital for surgery. I did my homework and made sure all the doctors involved was in my plan. I was out of surgery but had to go back a second round because of complications. This time another anesthesiologist, who was not in my plan, was involved because the original one had left.
Because of this, the insurance company would not pay for the second anesthesiologist, and I was stuck with his bill, even though it was an emergeny and I was unaware of the change. The point is, it''s not just the cost of healthcare, but the ARBITRARY way the insurers decide if they''re going to cover you or not. There are many people involved in your care at the hospital. How do YOU keep track of them all, while still sick?
The fact is, if you have insurance you NEVER really know if or to what extent you are covered if you need major medical care. This is how some middle class families go bankrupt and are financially ruined. This is plain WRONG and has got to change.
Why do people let FOR-PROFIT companies, whose goal is to make as much money as possible while reducing as much expense as possible, get to DECIDE their health and well-being? - Reply to this comment
- why should Americans have to worry about having enough insurance? If illegals can get fre treatment then we should all get free treatment.
Posted by killtheliars at 02:13 PM : Aug 17, 2007
Oh, so then you want all Americans to have health coverage, regardless of their ability to pay, right??? - Reply to this comment
- Why is insurance so expensive? Because medical treatments are expensive too. It''s a no brainer. In the 50s and 60s if you had cancer or diabities or whatever , the doctor would simply tell you to make out your will because you where going to die and nothing can be done about it. today we have very expensive procedures that can cure many ailments that were terminal 40-50 years ago. but these treatment cost a lot of money.
Another problem is the payrolls hospitals have to pay. adjusted for inflation a nurse makes way more than they used to back in the 50s. And then there are those medical specialties that didn''t even even exist 30 years ago like MRI techs and Ultra sound operators. all these people are making well over 30/hr and ultiamtly someone has to pay their wages and that someone is you. - Reply to this comment
- Health care in America is not the best system in the world. This is perhaps the worst rip off. The insurance companies are not middleman. Just look at the buildings they build, or look at the shares. It is a combination of several factions ripping off the American people. The insurance companies, the drug companies, the hospitals, and the trial lawyers. There are more than 30% of the Americans not insured and 20% are under insured. The uninsured is around 90 million people who are left to die whereas we are worried about the other countries. We try to help others and not Americans. We need to revamp the whole system to include every American citizen to be covered by healthcare plan.
- Reply to this comment
- Private health insurance in America is a fraud. Even if you have insurance, they can deny coverage for you nilly-willy, or choose to cover only a portion of your costs, sticking you with the rest which can be substantial. They can refuse to cover certain medication prescribed by your doctor. They can discontinue coverage for you at any time while you are undergoing treatment. They can deny coverage for you if you have a pre-existing condition.
The only real option most people have is employer-based insurance, which limits your options since your employer gets to decide how much coverage you get, and they obviously want to keep their cost low. Most employers would rather do away with this altogether. If you are in between jobs you have to pay exorbitant COBRA fees just when your income is reduced. If you want to retire early but buying outside insurance costs too much or they won''t cover you, no can do.
The current system is such a fraud only insurance companies and idiots support it. - Reply to this comment
- I actually have 2 medical insurance plans that I pay premiums for: United Healthcare (which is one of the biggest scams I''ve ever encountered on the planet) and Medicare.
So far this year I have had 9 claims submitted to United Healthcare (UHC) for a total of just over $10 thousand. They have processed these claims 17 times so far and still aren''t finished with them. Of this ten thousand bucks, UHC has paid a whopping $267!
I have had to call UHC''s customer service line 8 times, file a written appeal with their company and file a complaint with my state Insurance Commissioner over a $352 claim for a March emergency room visit that UHC has repeatedly agreed that they should pay in full but never has.
Further, this health insurance company rejected all facility charges associated with my last two hospitalizations. They claim the bills were not submitted in time. I can''t speak for one hospital but I actually visited the the other and watched as they submitted the claim for processing- the second time of three submissions!
I''ve had to give up my oxygen equipment because UHC wasn''t paying for it despite the fact I was told they would. Now I struggle day for day and desaturate at night and my body is deteriorating. I need a intrathecal pain pump but I know getting them to pay would be futile.
Why is our health care so expensive? Ask united Healthcare. - Reply to this comment
- The real issue is far deeper than insurance companies skimming 30% - 35% from the top of every insurance dollar. (I know. I worked for one of the biggest in the nation.) It is more than the rip-off prices of the drug companies who make heroin dealers in the street look like Santa Clause. It is a fundamental injustice of the distribution of the wealth created by the WORKING MEN AND WOMEN, the 90% of the population who have to split 40% of the value created by their labor. That is the cause. Some of the worst health care in the western world is only one of the results.
People of American need to wake up and stop being manipulated by the billionaires who are robbing them blind of their money. - Reply to this comment
- I have no health insurance, I haven''t been able to work for over a year cause of my failing
health conditions, July 31st 2007, I had a catastrophic emergency aneurysm in the right coronary
artery, and one hour after arriving in the Emergency Room I was in heart surgery and a triple bypass was
done, 10 days later i get a bill from the hospital for $58,958.60, sheesh thats enough to give
one a heart attack by itself, and I have started the process of filing for disability and was
told in the state of Arkansas, it could take up to 4 years to process it, so while I sit here
with no money and was lucky enough to come up with the $229.00 worth of medicines to maintain my
heart by borrowing it from a friend. I sit and wonder how I am going to be able to afford my
next medicnes I am going to need, four years is a long time to wait when you have no money and no
insurance and no job, and who is going to hire someone with the troubles I have??? Health
insurance in this country isn''t going to change fast enough to help me, but its something that
needs to be addressed... - Reply to this comment
- I have no health insurance, I haven''t been able to work for over a year cause of my failing
health conditions, July 31st 2007, I had a catastrophic emergency aneurysm in the right coronary
artery, and one hour after arriving in the Emergency Room I was in heart surgery and a triple bypass was
done, 10 days later i get a bill from the hospital for $58,958.60, sheesh thats enough to give
one a heart attack by itself, and I have started the process of filing for disability and was
told in the state of Arkansas, it could take up to 4 years to process it, so while I sit here
with no money and was lucky enough to come up with the $229.00 worth of medicines to maintain my
heart by borrowing it from a friend. I sit and wonder how I am going to be able to afford my
next medicnes I am going to need, four years is a long time to wait when you have no money and no
insurance and no job, and who is going to hire someone with the troubles I have??? Health
insurance in this country isn''t going to change fast enough to help me, but its something that
needs to be addressed... - Reply to this comment
- why should Americans have to worry about having enough insurance? If illegals can get fre treatment then we should all get free treatment.
- Reply to this comment
- Why worry about health care and medical treatment? We really need to take care of ourselves. Eat healthful foods, exercise, have a positive outlook on life, slow down, laugh. I''m in my seventies and take no medications, don''t trust doctors who, after all, are in business to keep you coming back. Drug companies do not find cures for disease because if they do they lose money. We need to take responsibility for our own health. No one else will.
- Reply to this comment
- don''t think for a minute that a good health insurance policy isn''t worth it. It can be difference literally between life and death on one hand and financial security and bankruptcy on the other. We have the best health care in the world with the right health insurance plan. I would pay health insurance over any other bill. I''d never go one day or one minute without it and I''d also never depend on an employer''s health insurance. I''d drive a clunker car before depending on the cheap crappy employer coverage.
- Reply to this comment
- one way to be able to take advantage of health care deduction is to schedule medical procedures and well visits in the same year. Like in Jan then again in Dec so it all falls in one year to be able to take advantage of 7.5% threshold for deduction.
- Reply to this comment
- Re: Kim Kleman''s answer to H. Smith''s question, "Who to blame for rising cost of health insurance?". Her answer: "Insurance companies". They are the middleman and refuse to lower prices. That is like blaming the supermarkets for rising costs of groceries. Why doesn''t anyone want to look into the real source of rising costs (More elderly requiring more drugs, more technology). Our government refuses to put a cap on pharmaceutal costs. Of course health insurance companies have to make a profit, otherwise they would be out of business. When HMOs were first created they did a great job of keeping premiums low. They did this by creating fee schedules which participating physicians and hospitals had to accept. Before this they could charge whatever they wanted. The whole idea behind the HMO was to keep premiums low so that employers could continue to offer this benefit to employees. Over the years the doctors and hospitals complained that their reimbursements from the ins. companies were too low for them to stay in business. Raising reimbursent rates rising cost of drugs have caused premiums to go up. This in turn causes employers to ask the employees to absorb some of the cost.
My point here is that Insurance companies are not the bad guy they are made to look like. This is a very popular misconception right now. It is a complex issue. Oh, and by the way Michael Moore doesn''t have a clue. - Reply to this comment
- I buy my insurance privately at a premium of $613 per month. I was recently referred to a neurologist for help with migraines, not knowing that the first appointment would be billed as a consultation, something my insurance doesn''t pay for. When the claim was rejected, I had to pay $540 to the provider. I appealed this and it was denied. I have 3 different deductibles that have to be met. I am limited in getting a new policy because of pre-existing conditions so I''m between a rock and a hard place and the insurer knows that so they continue to turn the screws. This is ridiculous -- I''m one of those people caught in the middle who makes too much for state help but I also don''t work for a company where I can get a group policy. Something needs to be done -- a country like this should be able to do better than this.
- Reply to this comment
- I agree that Health Ins isn''t enough. Many Americans are unaware of how ins. Co drive the "cost" of healthcare. I see things both as a consumer & as an ins billing specialist for a providers office. The cost of ins premiums and copays/deductibles, etc are rising at an alarming rate, but the amt that ins pay to Docs continue to decrease. Ins. Co''s change their "allowables" for Docs yearly. Fee schedules that Docs set are regulated by an RVU value system where the Doc must bill w/in Medicare''s (MC) fee guidelines and should make a certain % based on the codes RVU value. For 1 of our charges the RVU shows we should get pd in the mid/upper $40 range, & our MC fee (which should be the lowest amt we receive) is in the low $30''s. We are now paid less than a $1 more than what we should receive from MC by many big ins. cos. Docs are paid less every year, while the cost of living, the min wage pd to employees, the cost of ins, the cost of gas, etc. continue to rise. In many cases, we "write-off" over 50% of the billed charge due to our "contract" with the ins carrier. Last year my doc made almost $40,000 less than what he did 5 yrs ago, but he pays out more. Ins. isn''t raising costs to pay our office, as they pay us less every year. Our patients pay both premiums and most of their office visit, while the ins co. only pays a few dollars. When ins co''s only pay $0.48 on a claim d/t the patients copay and the amt of the "write-off" cover the rest of the charge - something is wrong!
- Reply to this comment
Best-selling author Mitch Albom on his first nonfiction work since "Tuesdays with Morrie."
