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Sorry, kid, no individual insurance policy for you. Credit: Getty Images
"Yeeees," he said as he rubbed his hands together. "You can have your precious child-only health insurance policy back. And all it will cost you is ... higher premiums!"
From out of nowhere, there was sudden, loud and ominous blast of organ music. The man seemed to erupt in flames, and before the young mother could gather her wits, the mysterious stranger vanished as quickly as he had appeared. All that remained was a cloud of smoke that smelled faintly of brimstone.
To be fair and balanced, insurance companies are not the devil. Or even his minions. That's just an incredibly popular (and probably only partially true) legend.
Another is that the Obama administration made a Faustian bargain with insurance companies. That legend, however, is based on actual events.
Earlier this year, health insurance companies dropped child-only insurance policies because the kids just didn't bring in enough money. Administration officials feared sick children may go uncovered and untreated, so they struck a deal.
If companies agreed to restore child-only policies, in return, the administration would allow companies to jack up their premiums so they can turn a profit. That is, assuming individual state laws permit it.
But not all the companies are playing ball.
"Unfortunately, some insurers have decided to stop writing new business in the child-only insurance market, reneging on a previous commitment made in a March letter to 'make pre-existing condition exclusions a thing of the past,' " Secretary of Health and Human Services Kathleen Sebelius says in statement quoted by The New York Times.
Insurers argue they're not greedy devils, just economic realists. They won't have the resources to help anyone if they don't turn a profit. In other words, they can't help the sick unless the majority of the people paying premiums are healthy.
They told administration officials child-only policy are fiscal disasters waiting to happen because, under health care reforms, families can buy insurance for their children at the last minute. While that may make sense from a humanitarian standpoint, insurance executives argued it hampered their ability to do the greatest good for the greatest number of people.
All this may be moot in 2014.
Unless Republicans win enough seats in Congress next month to make good on their plans to scuttle health care reform, all Americans will be required to have health insurance by 2014. Insurance companies won't be able to turn either adults or children away because of pre-existing conditions.
The Times reports the Obama administration and insurance companies have been locking horns for months. Administration officials want companies to cover children with cancer, autism, heart defects and other conditions.
Yet, most parents are lucky if they can find insurance that covers braces.
In a letter quoted by The Times, Sebelius calls the continued reluctance of some insurance companies to offer child-only policies "extremely disappointing."











ReaderComments (Page 2 of 2)
10-18-2010 @ 10:12AM
Nick said...THIS COUNTRY NEEDS UNIVERSAL HEALTH CARE . GET INSURANCE COMPANIES THE HELL OUT OF HEALTH INSURANCE. IT WORKS IN ITALY CANADA SWEEDEN AND MANY MORE COUNTRIES...................AMEN INSURANCE COMPANIES CAN SELL FIRE AUTO ETC..................
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10-18-2010 @ 10:48AM
Bill said...America needs a basic, universal health care program for those who cannot afford insurance paid for by our taxes. Being the caring nation that we are, people should not have to lose their home because a member of the family has cancer. Our Postal Service can be used as a model. Polls show that 95% of Americans love the USPS. Although run by ididots, the USPS gives every American the opportunity to ship something to the bottom of the Grand Canyon at an affordable rate. If you want something better, you are always welcome to use Fedex or UPS. That's what goverment should provide. Basic government services.
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10-18-2010 @ 11:12AM
Tim Bryant said...I'm just glad none of this is our fault...
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10-18-2010 @ 11:11AM
empiresentry said...This administration has made it very clear that the goal is a one player system. This is just Phase 1 where services get cut, forcing people to go to gov systems: in this case CHIP which has been a failure for 20 yrs. Phase 2 is to charge high gov fees that force the companies to raise the rates. This reinforces gov argument that it is too expensive and also forces people and employers out of the choice. Phase 3 is where employers give you cash to buy yoru own insurance but none is available other than gov one player system. Within 2 yrs the system is gone and you will be on a medicare type program, waiting at the hospital and wondering what happened to your local doctor. A handful of you need to stop whinning since this is what you voted for.
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10-18-2010 @ 11:21AM
john said...Sorry all you Obama kool aid drinkers. Obama said he would get everyone covered. Now move to a new state with any sort of preexisting condition and see what your premiums are. You can't afford them. What did Obama think was going to happen. He knew exactly what would happen. Now we will all end up on the government insurance come 2014. The same insurance that will be made up of the politicians who said women should not have mammograms until age 50. Boy they went back on that one once women's groups protested. But that is what we have to look forward too. My premiums just went up 60% for no reason. When I called the BC/BS to find out why they had gone up I was actually told "Obamacare."
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10-18-2010 @ 11:22AM
empiresentry said...Investigate for yourselves the cost of the new Gov healthcare insurance. For each child, CHIP is extremely expensive. Look at the Obamacare New Jersey insurance for children or adults starting at $279 per month up to $725 with a $2000 deductible PER PERSON. Only two people have signed up for it.
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10-18-2010 @ 12:13PM
Johnoneone1999 said...Hey Chris..You don't have to provide proof...the GOP never provides truth-proof...and other idiots can't se the elephant in the living room.
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10-18-2010 @ 12:12PM
Johnoneone1999 said...Look as if the most vocal protests against the health care reformation comes from those who have made a very profit laden living off the sick, infirmed, and weak of this nation.
The public smiles they once offered hide the monsters they could become.
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10-18-2010 @ 4:56PM
BLJ said...The real elephant in the room, medical costs, have not been addressed. The health insurance industry is averging just over 4.5% net profit, while the health provider industry is at 16%. And it is a foregone conclusion that private industry runs more efficient than the public sector (see medicare, medicaid, post office, etc).
Before healthcare reform, 48 states had laws about unfair cancellations of policies, but to listen to all the media stories out of California (who is pretty much screwed up anyway) one would believe that was a national problem. In 48 states, there were laws with stated that you could only be terminated due to lack of payment or outright fraud.
With the government running healthcare, the worst is yet to come. Be careful what you ask for....
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10-18-2010 @ 1:08PM
Yon said...If you are healthy, why pay premiums for coverage you do not need? I does not make sense. If you are sick, you cannot get coverage fur what ails ya. It does make sense for the insurer. So forced coverage by law is the only way to make sure the insurance companies make a profit. Simple basic facism works. The result is forced coverage for auto, bike and skateboard... and now forced sickness insurance. It is really a tax taht government employees collect and the same government employees will decide whether you are worthy of reimbursement of medical expenses... except for eyeglasses, dental, podiatry, emergency surgery, veneral STDs, Aids, zits, ingrown toenails, etc...
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10-18-2010 @ 1:10PM
LILLIAN FIGUEROA said...An insurance company is not in the business to lose money. Most people only buy those policies after their child is already sick. If the costs of the treatment are so high that the insurance company loses money, pretty soon noone has insurance. Also, the insurance company has to pay stock holders. Most of the stockholders are pension plans and 401 k plans. Stockholders are you and me. Increasing taxes on small business owners means that they can't maintain their facilities, hire people, or pay benefits. Just because a small business makes over 250000. a year, doesn't mean the owner gets to keep that money. Most of it goes back into the business, one way or the other. When you expect a business to break even and be happy, what is the incentive to work the hours it takes to grow that business? Communism and Socialism have not worked anywhere else, why do you think it will work here? Have you ever seen that the biggest advocates of these programs, all of whom say we should all sacrifice for the greater good, never sacrifice themselves? Read Animal Farm. It still applies.
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10-18-2010 @ 1:27PM
hank said...In the interest of accuracy in reporting, how about actually listing the names of the companies, instead of just referring to "some" companies.
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10-18-2010 @ 1:41PM
Kathy said...My HMO refused to pay for my brain surgery.
I would be dead now...thank goodness my family
had the money to get me the surgery I needed.
I was a month from dying when the doctors opened
me up. We need insurance for everyone and NO HMO's.
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10-18-2010 @ 1:46PM
Lisa said...What about lowering the costs of medical care to a reasonable amount. 18 years ago one staple in my daughter's head (in lieu of a stitch) cost 200.00 we are talking the amount of time it takes to click a stapler~~ that is over and above all of the other charges for cleaning and looking at it. All in all a 45 min. hospital visit (without any medications) cost about 800.00. A little excessive in my opinion.
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10-18-2010 @ 2:37PM
Tanner said...The costs are high because people don't pay their bill. It gets built into the cost of care which gets passed on the the insurance comapnies who pass it on to us. In Ohio, Doc charged me $1400 for 15 mins visit for flu because I have insurance. Here they have different rates for people with insurance. My husband was $1600 to get fasting blood test. In Texas or Virginia, it would have cost us $85 to $120: the same for someone without insurance. Its cheaper for us to fly to Texas and see family doctor than see doc here in Ohio
10-18-2010 @ 2:31PM
ROY S. MALLMANN said...Just who do you out of touch with reality liberals, think is going to pay for these little children with autism or cancer or any other sad example you want to bring up. If only someone could wave a magic wand, life would be wonderful. These insurance companies are businesses and have every right to make a profit, that is a FAIR profit. Obamacare doesn't pay for anything, it steals from one group of taxpayers to pay for a group that doesn't pay. The next time your friend or neighbor submits a phony or exaggerated claim to an insurance company to get more than they should, then picture that poor little baby who is dying of cancer, because that money he gets is coming out of the big bad insurance company's profit. If you couldn't make a profit running an insurance company then why on earth would you do it. If you liberals would just realize that we taxpayers pay for everything! THERE IS NO SUCH THING AS A FREE LUNCH.
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10-18-2010 @ 3:27PM
Pat McIntyre said...A lot of people think Seniors have it made until they are on Social Security and find that Medicare pays 80% and they need to fork over the extra 20%. I had a friend who thought it was better to take care of the 20% until she fell ill with Asthma and her out of pocket was over $2500.00. She had to pay as much as she could monthly because her meds cost was so expensive. I was being taken by an off the wall Insurance Agent because I could no longer afford the one I had. My bank had to step in and solve the problem. Now I'm looking for another Insurance Co because I can't afford the 20% out of pocket. Then I have been told by all the Ins Co's that, "oh yes, next year for sure, the premiums will go up." I see where it will still put me in a bracket that is out of the range for me again. The insurance co's need to work with the people instead of against the people. The medicine that are prescribed for the people also need to come down in price. The Doctors. if the patient speaks up, will try to help in this field. When you are in my position, you find that these companies work hand in hand. Insurance companies, Doctors, pharmaceutical companies. The so called Health Care that is hanging over our heads is not good least to say. The Politicians are getting rich off us and we have allowed it to happen. WE need to wake up and see the light. Problem is we don't rally around like most do to be noticed. We haven't seen the worse yet.
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