I'm leaving the insurance industry for more stable pastures but I'll tell you this. Insurance is designed to "make one whole" after a catastrophic loss it is protecting against such as a fire, major medical necessity, accident, death.....etc. When mandates are issued to the companies the price goes up, so in a roundabout way the employer is forced to pay for the contraceptives through higher premiums and deductibles. That said I think ED treatment coverage is absolutely STUPID, it's a choice to partake in Viagra and it's competitors and there is no medical necessity for such, in fact people with heart conditions risk other insurance companies such as life insurers having to pay a death claim cause someone had a heart attack from misuse, or if they do happen to live the health insurance resources have to be utilized to treat their self induced heart attack so it can actually serve as a net negative from a health issue standpoing.
HMO or PPO? Big difference, in a PPO you have flexibility when there is no network provider available, in an HMO they will nail you during that situation.
but it was 1000$ dollars in ambulance fees alone??????? I live 6 mins from the hospital!terrible. One time in between jobs without helath insurance i was so sick, acute intestinal infection, that after throwing up for 2 days i lost consciousness after sleeping on the bathroom floor. My daughter called the ambulance, they gave me some basics meds and discharged me with in hours. the next day almost the same thing happened, I called myself this time, they tried to discharge me again and I told them im will not leave, they will have to get security to remove me. Also my family doctor was the head of their board, I let them know and I told them unless my doctor tells me in person or on the phone that its OK to go home nobody will make me leave. They addmitted me
Something has always bugged me. Pharmaceutical reps can take doctors out to eat, on golf vacations, and other monetary inducements to push their product legally but if a radio DJ or radio company takes anything besides a cd or promotional materials they can be fined heavily under payola laws. The worst thing that can happen if a DJ pushes crap is you buy a cd that blows, but a medicine pushed can kill or mess you up. Priorities anyone?
The market is good, the overall environment is not. While I think it's heartless to deny people ER visits in a legitimate emergency for inability to pay it comes down on payors, this can be fixed without a major industry overhaul by giving more lattitude for billing based on what can be recovered after treatment. As well the "single payor" model tends to stagnate, the private model tends to improve more quickly. So there are things we do well, and there are some things that need work, but I don't think anyone who is being honest would say heatlhcare is fine.
That was an issue years ago, there have been so many stupid moves in insurance and government in general that the ED one is largely forgotten. However even before I was an agent people were pissed about it, it's just that things have shifted to more important and more current issues, it's not that people don't have a problem with it but rather that it's not on the top of the list right now.
