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

[Guest guest]

>

> Subject: 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.

Ralph Giarnella MD

Southington Ct USA

[Guest guest]

Ralph,

I believe the state should ensure that there are no non-insurable ppl

by enforcing legislation on medical insurance companies to prevent

such cases.

If a sick man is not insurable, then the whole system is flawed and

only used to make more money to some insurance companies, and not to

serve the ultimate purpose, saving the life of a human. Federal

legislation should ensure that a company should not be allowed to play

on insurance market unless it offer medical insurances to all

citizens, regardless of risk. Else, if it refuses to insure high risk

species, it;s just a scam.

Also, I would like to thank you in this message for the many wise

posts you made during the years on this list, more often than not it

was a true pleasure to read your posts.

Dan Partelly

Oradea, ROmania

>

> 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.

>