Re:Health Insurance: was Pay the obese to lose weight

[Guest guest]

Dr. Ralph - the " best " quote I have right now is $150 a month - and that's

covering virtually nothing but sheer emergencies. I'm going to take it for the

very reasons you suggest - and still try like hell to stay out of the hands of

medicine <grin> No offense! My federation in PL also offers a small premium

annually accident coverage for platform mostly - and that's again, where I go

ahead and pay it once a year to cover this sort of thing. Not keen on losing my

home or anything - but I could have funded my retirement on this premium nicely

over the years... I feel badly for people with pre-existing conditions as you

relate below, they are getting hit harder and probably making even more

difficult choices. Something clearly has to give, as our salaries are not

rising to meet this continuing escalation!

The thing is, in the face of rising costs every year (and we're talking 10% and

more every year) you have a difficult time funding things that are now somewhat

" luxuries " - I let my NSCA CSCS go because it was literally too expensive to

renew now! (That being another cost that got somewhat higher than when I joined

at Mel's suggestion in 2000!)

The Phantom

aka Schaefer, CMT, competing powerlifter

Denver, Colorado, USA

--------- Re: Pay the obese to lose weight

> To: Supertraining

> Date: Saturday, December 20, 2008, 10:31 AM

> , I have no right to say anything,

> being what I am, but none the less,

>

> I'm looking at a United of Omaha Life Insurance Company

> applicantion as I

>

> type, and the upper limit for them for a person 5 ft 9

> inches is 277

> pounds. Point being that you may want to shop around.

> thanks,

>

> Doherty

>

> Cypress, Texas

I have to agree with . I just finished talking to one of my patients in the

ICU. In the past he was told he was uninsurable- History of heart disease,hbp,

CABG in 2000 (coronary bypass) overweight but not obese, construction worker

(owns his own business). He was a self-pay (no insurance) patient until

recently. He applied to Assurance Insurance company and has Health insurance

with a $5,000 deductible for $240.00 a month.

When he had his Heart attack he was uninsured and had to re-mortgage his house

to the tune of $100,000.

His wife is uninsurable, - Diabetes, Obesity but recently has been able to get

insurance through the State of Connecticut Charter Oak Insurance (must be a CT

resident) - she was no eligible for the same Insurance her husband was able to

get.

I have another patient who is uninsurable- 48 yo,- to look at him you would

think that he is the picture of health, slightly overweight by the scale but not

noticeable, but he has Hypertension , hypercholesterol and has had a Heart

attack (poor genes). His profession: self employed Health Insurance saleman. He

makes too much money to be eligible for the Ct. Charter Oak Insurance. He told

me he uninsurable at any price.

I could on and on with stories of individuals who are uninsured, through no

fault of their own and who are one major illness from bankruptcy.

As an individual it is very difficult to get insurance and sometimes impossible

at any price.

If you get into a group you will get your insurance no questions asked. If you

own a business you may be able to join the chamber of commerce in your town. In

my town the businesses who belong to the chamber of commerce are eligible for

group insurance rates (even if the only employee is the owner).

Health Insurances, as with any Insurance use actuarial tables to figure their

risk. In group insurance they spread the risk amongst the group betting that in

any given year only a few will get seriously sick. The larger the group the

lower the rates. However in group insurance they have to take all comers

irrespective of health risk.

As individual it is an all or nothing proposition. If you don't get sick they

have made a profit of $6,000 (or whatever your premium is). If you get seriously

ill they may risk as much as $100,000 or more (that is how much the Construction

company owner had to pay for his Heart attack and bypass).

You may not have a heart attack or stroke but what if you fall and break a leg

and need surgery to fix it? That could cost $6000 or more. If you rupture your

ACL, how much will that cost.

I am no defender of the Health Insurance industry. I have daily battles with

them trying getting them to pay my fees, justifying meds, CT scans MRI etc.

Prior authorization makes my blood boil.

On top of all of that I am lucky if they pay me 60 cents on the dollar.

Our country is in dire straits when it comes to health insurance. There are 40

million (the number is likely to go higher with all the unemployment) people out

there who through no fault of their have no insurance. Most of them are middle

class people who either own a small business or work for someone who owns a

small business and cannot afford to give his/her employee health insurance.

There are a lot of people who lead perfectly healthy lives, who do not abuse

drugs or alcohol, eat well, exercise, eat properly but suddenly show up with a

devastating disease that could cost them many thousands of dollars.

Like the school teacher in my practice who is ideal weight, went to the gym

faithfully ate well, did not smoke or abuse alcohol but developed nevertheless

Diabetes and later breast cancer. Luckily as a teacher she has good insurance.

By the way I disagree with those few righteous people on this forum who think

that they are the only ones who lead healthy lives and think that therefore they

are immune for illness.

I see every day patients who " live by the rules " but nevertheless require

medical care such as the teacher.

You may be one torn ACL or ruptured disk from serious medical problems.

I had a patient come to my office last week for a health evaluation. He wanted

to get back in shape.

Until 5 years ago he was a serious weight lifter and religiously worked out and

followed his nutrition faithfully.

He now is 50 lbs heavier and visibly obese (not by BMI). I asked him what

happened. His first answer was stress.

I asked him to elaborate. He told me that 5 years ago his wife divorced him and

took him to the cleaners. He no longer had time to workout, had to work

overtime, stopped going to the gym and gained 50lbs of fat.

He came to me because he wants to get healthy again and wanted to get an

evaluation of his health.

It is easy to sit there in an Ivory Tower and judge others. What is the saying

" there but for the grace of God go I " .

Excuse me for being so verbose but I have been wanting to post on this subject

for some time now.

I have more to say but not enough time to write it.

[Guest guest]

> Else, if it refuses to insure high risk

> species, it;s just a scam.

Refusal to insure a high risk is idiotic and should indeed be

prohibited, now we get into how much do we let them charge for

insurance for a high risk and do we want to regulate that. If the

answer is yes to the regulation question then I sure wouldn't want to

be in the insurance field.

Fair winds and happy bytes,

Dave Flory,

Flower Mound, TX, U.S.A.