Published by WallStreetWeather.net
The Sun is our life force and represents our physical vitality. The zodiacal sign Virgo rules health matters. People born with the Sun and/or other planets in Virgo have a tendency to worry about their health and would want to insure they have access to every available resource at their disposal.
With his Sun in Virgo, Goldman Sachs (GS) Chairman and CEO Lloyd Blankfein’s credo must be you can never be too rich or have enough health insurance coverage. Blankfein’s health insurance is valued at $40,543 a year, which I would think should be enough to cover every possible exam, test and treatment for every ailment covered in the Merck Manual. And in what could only make a penny pinching Virgo absolutely drool with envy, Goldman pays for Blankfein’s health insurance even though he received $73.72 million compensation in 2007.*
Does it really cost $40,543 to get truly comprehensive health insurance in America? As The Wall Street Journal explains in “Going It Alone When Buying A Health Policy,” insured individuals are finding out the hard way that even a policy with lifetime coverage of $2 million does not mean your insurance company will pay your claim.
Tina Smith had that lifetime coverage benefit from Assurant. But what she didn’t know until after she ran up $86,000 in uncovered medical bills to treat her lymphoma was that buried within her policy was a $5,000 annual limit on what Assurant would pay for outpatient treatment (medical care when a patient hasn’t been admitted to a hospital).
Ms. Smith’s example is why looking at a policy’s premium and copay/deductible costs only comprises part of what you need to know when evaluating a health insurance policy. You also need to understand what the insurance policy’s annual out-of-pocket maximum (the total dollar amount you will spend in a year) is, as well as what the policy’s benefit limits and exclusions are. This information can only be found by thoroughly reading the policy’s “certificate of coverage” (also called the “evidence of coverage”).
If our “free market” health insurance system is so efficient and easy to understand, then why does the Journal advise consumers to “discuss policy provisions that you don’t understand with an agent or another expert”? After reviewing my own nearly 200 page certificate of coverage, I realize that our current private insurance policies are far too complex for anyone to truly understand what they’ve purchased.
A person might sincerely believe they have disclosed all of their medical history and potential health issues on an insurance application, but once a policyholder puts in a claim of any size or begins treatment for a costly disease, the insurance company will use your doctor as a weapon against you by trying to get the doctor to say that your ailment or teeny tiny spot detected on a diagnostic test could have been present before you became a policyholder. Regardless of how many years you’ve had your policy, the insurance company can deny your claim or rescind your policy altogether.
Because very few of us will ever have a policy that offers the level of coverage like Lloyd Blankfein’s, America needs a government option or better still open up the government run healthcare program known as Medicare to all ages so no one can be rejected for coverage, everyone will know exactly what coverage they have and how much it costs, with basic health coverage offering premiums that people of all income levels can afford.
If the government could pull out all the stops to wave its magic wand just before the stroke of midnight last September to prevent the Golden One’s riches from turning into rags, Congress should at least provide the American people with these basic rights, along with the peace of mind that unlike the “free market” world of private insurers will not deny treatment that is supposed to be included in their insurance policy.
*Blankfein’s 2008 compensation was $25.84 million.
Lloyd Craig Blankfein: September 20, 1954 time unknown Bronx, NY
Related Post: Full Moon Fever: WSJ Editorial on Healthcare “Mergers and Inquisitions”