Having Health Insurance Not Enough

(CBS)  Many people who have health insurance may think they don't have to worry about paying for medical bills but, according to an article in the current issue of Consumer Reports, that's simply not true.

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:

Know what you have: "Make sure you take advantage of well-visits you might have or well-baby care. If you're shopping around for insurance, make sure the critical thing to make sure you have is some kind of hospitalization coverage. Because if you don't, that takes a huge bite out of what you would — what you would have to pay."

"It could bankrupt you," Smith pointed out.

"Absolutely," Kleman agreed.

Avoid surprises: "You might know, for example, that, if you know you need a procedure done, you're going to go to a hospital that's covered by your health plan. But you have to be extra vigilant and make sure every doctor or hospital person working on you is also covered by your plan. Because while your doctor or anesthesiologist might be covered, the radiologist might not be, and then that's money that you're paying out of pocket."

Check generic drug options first: "Generics are most often the best drug for a wide variety of ailments and conditions. We offer a free service for consumers, Best Buy Drugs, which is available on our Web site. You can check all the clinical studies for a variety of ailment and we tell you the best generic drugs that work."

Learn how to fight back: "The first thing to do concerning fighting back is ask your doctor for a discount. Don't go to the doctor's billing person. Go to the doctor, him or herself. If you're paying out of pocket, you can often get a discount for the procedure. And the second thing is if you feel you have been denied care, there is definitely a process you can go through with your insurer. Your state has a separate process. That's free on our Web site as well, To read the health insurance article in Consumer Reports, click here.

For more on health and fitness from Consumer Reports, click here.

[erasmus6]

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.

[erasmus6]

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.

[erasmus6]

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.

[rudy654-2009]

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???

[glidescube]

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.

[baroda1234]

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.

[cbsreader4]

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.

[leland61]

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.

[tom55ark]

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...

[tom55ark]

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...