Total Drek

Or, the thoughts of several frustrated intellectuals on Sociology, Gaming, Science, Politics, Science Fiction, Religion, and whatever the hell else strikes their fancy. There is absolutely no reason why you should read this blog. None. Seriously. Go hit your back button. It's up in the upper left-hand corner of your browser... it says "Back." Don't say we didn't warn you.

Monday, December 31, 2007

"You got to know when to hold em, know when to fold em,"

Despite the fact that I am a sociologist- a notoriously left-wing occupation- I feel relatively positive about private industry and capitalism in general. My reason for this is not the lingering effects of my Republican upbringing or a false impression that capitalism is the best thing evar but, rather, because of a certain sense of pragmatism. I am fairly positive about capitalism for much the same reason that Winston Churchill is a fan of Democracy: Capitalism is the worst type of economics, except for all the other forms that have been tried. So, while I am by no means a booster of gigantic corporations, I am at least neutral about their possible virtues and vices.

The exception to this general rule, however, are insurance companies. I do not like insurance companies. Now, don't get me wrong: I have no problem with the concept of an insurance company. The idea is, itself, fairly sound and works more or less the same way a casino works. A casino makes a deal with its customers that, if they play certain games and a given set of events transpire, then the casino will pay the player a certain amount of money. If another set of events transpire, however, then the player will pay the casino a different amount of money. Since the likelihood of winning and losing is known to the casino they can guarantee that they make money more often than not. It's a fairly simple contract and not an unreasonable one, though I confess I have no interest in casino gambling myself. Fundamentally, insurance companies make the same contract with their users and, as such, are more or less casinos. Their players clients agree to pay a fixed amount of money on a predetermined schedule and the casino insurance company agrees that, if a certain set of events come to pass, they will pay the player client a certain amount of money. Again, since the probabilities of certain types of payouts are well understood, the insurance company should be able to structure their game such that, aggregated over many players, they will win more than they lose.

Now, I have benefitted from insurance companies in the past. During my recent medical issues I was spared considerable expense because I had health insurance and, so, am grateful to them. At the same time, however, I fear that all too often my smooth experience with them is the exception rather than the norm. My parents, for example, who live in central Florida recently had their home insurance cancelled because they live in Florida. No, seriously, it was cancelled because many insurance companies are trying to reduce their vulnerability in states that may be slammed by hurricanes.* This would make sense except that my parents live in Central Florida- so far from the ocean that for a hurricane to cause the sort of catastrophic damage seen in New Orleans with Hurricane Katrina, the state would effectively have to sink.** So, it's a little like refusing to let someone play in a poker game because you once lost big to someone else who had a similar sounding name.

Yet, this isn't my biggest reason for disliking insurance companies. No, my biggest reason is that sometimes the bastards cheat. Case in point, the company that provides insurance for grad students (which my wife and I rely on) recently changed here at Drek State University and we have been, in a nutshell, fucked with our pants on. We were screwed in two unique ways, actually. The first is that while we have supposedly gained prescription drug coverage, that coverage requires that we spend a godawful amount of money on medications ourselves before the insurance kicks in. Not so bad except that, given our state of relative poverty, it was possible before this to get price breaks from the pharmaceutical companies. Not anymore, though, because now we have drug coverage. Yay! The second, however, is that the company recently sent my wife a notice that her asthma treatment may not be covered because it is a pre-existing condition. To this I can only reply: bullshit.

You see, we did not choose a new insurance company- our employer did. As such, when the new company comes in it is required by law to assume the liability carried by the old company. In other words, there's no such thing as a pre-existing condition for current employees. Yet, here we are with the paperwork ruling her asthma as such. Here we are with substantial charges that are being bounced back to us and here we are with a most-likely protracted paperwork fight on our hands. I feel confident that we'll win this thing but, in the meantime, it's stressful and expensive. And I'm forced to wonder if this is accidental. I would like to believe that their computer system just has a glitch in it but, really, this glitch stands to benefit the insurance company financially. If just 10% of all those on campus who get hit with this "glitch" fail to demand their rightful coverage, then the company has just saved an awful lot of money. I get suspicious when "glitches" work that way. And what happens when insurance companies pull stunts like this with less-educated workers who don't know how to figure out their rights and push for them?

And that is what pisses me off. See, if you want to gamble, that's fine. I don't have a problem with that. This pre-existing condition crap, however, is a little like opening a casino, taking people's money, and then refusing to pay when they "win." That's not being a businessman, that's cheating, and I dislike cheats immensely.

As Kenny Rogers says, you've gotta know when to hold 'em and when to fold 'em, but that doesn't mean you can just grab the pot and make a break for it whenever the hell you feel like it.


* Indeed, I often think that Florida should be referred to as the "Death from the Sky state" given the prevalence of lightning strikes, tornadoes and hurricanes.

** Not impossible, I know, but more likely as a result from a large impact than from a hurricane.

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2 Comments:

Blogger forHealth said...

I have experience similar difficulty. I have been covered by group or private health insurance for the last 10 years. I was under the impression that as long as I maintained some kind of coverage I couldn't be denied for a pre-existing condition due to HIPPA. Truth is that the rules change when moving from a group policy to a private policy and I was outright denied a preferred policy. Insurance laws and rules seem to favor the insurance providers 100% of the time and screw the customers.

Monday, December 31, 2007 4:14:00 PM  
Blogger TDEC said...

Health insurance is the only paperwork I know that beats US Immigration for being unnecessarily complex, slow, cumbersome and life-changing. To inflict such a thing on a healthy person choosing to undergo the process is bad enough; to inflict it on a sick one trying to make ends meet seems outright immoral. Both systems are designed to weed out those without the determination or resources to keep going; and while a case can be made for it in immigration, it is incredibly offensive when it is a private company toying with someone health.

Wednesday, January 02, 2008 7:42:00 AM  

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