Persuasion by Fear
Another thing they said on this talk show I was listening to today was about the upcoming Presidential election...
One of the guys said he was pretty sure that there would be some kind of major terrorist attack in October of this year.
While I don't know that there will actually be an attack, I'm guessing we'll at least have another one of these scares that gets dropped periodically by the government anytime they don't think Americans are scared enough to vote for Republican foreign policies. I think that it's not beyond the Republican party to take scare tactics to the extreme around October to frighten people into voting for McCain.
Do you think it's likely that we'll just happen to be attacked or threatened by terrorism just before the November election?
Insurance
This morning I was listening to a radio talk show called Lex & Terry. I've listened to these guys off and on for years, ever since they were still in Jacksonville (now they're in Dallas).
Well, one of them was complaining about his health insurance company. Apparently, he uses Humana for health insurance. Not too long ago, his wife went to the Mayo Clinic to have a mammogram. Now for women, this type of procedure is typical preventative care. After she went, they started getting letters from Humana saying that they were "reviewing" the procedure to see if they were going to pay for it. Humana continued their "review" so long that the clinic got tired of not being paid and sent this guy's family a bill for $500 or whatever the cost was. So now this guys is still fighting with Humana to get them to pay for something that under their contract they're obligated to pay for.
Now, I know for a fact that this type of thing isn't atypical. I know plenty of people who have experienced trouble getting their health insurer to pay claims. You can turn on the television, radio, or open a newspaper any day and find at least one individual or family who's having to fight with their insurer to get what they've already paid for through their premiums.
I'm not going to take this opportunity to rant about insurance premiums. We all know how much health insurance costs, and we all know it's way too expensive. What I'm going to rant about here is quality of service. Not only are Americans paying top dollar for health insurance, but in many cases, they just aren't getting what they paid for. Unfortunately insurance companies seem to have a policy of not paying claims instead of holding up their end of their agreement with their customers and covering medical expenses.
Don't you think that if we're paying such high premiums for medical insurance, the insurance companies should be required to do the job we're paying them to do, and do it with some efficiency? Well, I do.
This is one of those cases where I think corruption in the insurance industry demands government intervention. I think I know the answer, too. As usual, I think that the answer is making the companies be held accountable when they don't honor their agreements. Our government needs to set up steep penalties for excessive delays in payment of claims or outright refusal to pay claims, when it is found that the insurer should have paid.
Here's what I'd do. For starters, I'd mandate that an insurance company must pay any insurance claim or deny payment within 45 days of receipt of the invoice from the medical provider. If claims are not paid or denial is not issued within this 45 day period, the insurer would be required to pay damages to the medical provider of two times the amount of the original invoice, plus an additional $10,000 punitive fine to the government. If however, the insurer does deny payment of the claim, the insured would have the right to sue for payment of the claim. While the suit was going through, medical providers would be barred from turning the insured individual over to collections for the unpaid debt. If it turned out that the insurer denied the claim, but was supposed to pay it, the insurer would be required to pay the medical provider two times the amount of the original invoice, would be required to pay the insured $50,000 in damages, and would be required to pay punitive fines to the government of $100,000. As to what would be done with these fines paid to the government, these funds would be placed into a fund that would allow people attempting to sue their insurance companies to have money to pay the attorneys up front. Of course, if it turns out that the insurance company was right to deny the claim, the insured who filed the suit would have to reimburse this fund...
Now, as it goes anytime someone suggests raising fines or regulation of business, there's always the argument that all the companies will do is raise their rates to account for the extra fines they'll have to pay... Thtis is a great point, and it's why I decided on one more rule that would have to be enacted in order to make this work... Starting when these new rules went into effect, all insurance companies would be required to sumbit data to the government detailing what kind of premiums customers are paying for what kind of service. Based on this data, the government would need to create a number representing what premiums consumers were paying for insurance. This formula would be somewhat complicated, but I'm guessing that it could be done given some thought. Probably by assigning minimum levels of care to be provided by insurers, requiring that plans meet these minumums, and finding the average premium charged. Once the government had this number, they could track it, and based on that number and it's increase or decrease, the fines could be changed from their original amounts. For instance, let's say that after the first year of these new rules being in effect, Big Box Insurance Corporation decides to increase their premiums by 6%... Well, then that $10,000 fine for not paying or denying a claim within 45 days would be increased to a $10,600 fine. The $100,000 fine for denying a claim in error would be $106,000...
As I've said before, the only reason most people ever support government intervention in business is when businesses fail to act in an ethical manner. Based on what I've seen in my adult life, I'd say the health insurance industry definitely fits this description, and needs to be reined in.
Why We're Fat
So, this morning I was hungry and decided that since I had a few extra dollars, I'd stop in at my favorite guilty pleasure and get some breakfast. I arrived at McDonald's and there was a big sign on the window advertising two Sausage Egg and Cheese McMuffins for $2. "Good deal," I said to myself...
So, I went inside, and asked the girl at the counter, "I want a Sausage Egg and Cheese McMuffin. Can you just sell me one for $2?" She told me that if I just wanted one, it'd be $2.49. I had to order the two for $2 deal to get the special price. Pressing on, I tried to appeal to her sense of logic (I don't need to be reminded of what a misguided decision this was when dealing with a fast food employee). I said, "Listen, it saves the company money to just give me one sandwich for $2. You've got half of the food costs and the same revenue from the sale..."
Blank stare.
I decided to just go the easy route, "Why don't you ring me up for the two for $2 deal, and just put one in the bag?"
She looked around as if I'd just asked her to commit treason and replied, "I don't think we're allowed to do that."
Defeated, I just ordered the two sandwiches, took the second one out and set it on the counter, and left.
So, scholars: why is it cheaper to force someone to get two sandwiches than to give them one for the same price?
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