Sick Around America
The challenges that face employees are highlighted in a documentary Sick Around America directed by Jon Palfreman. Perhaps, the most conspicuous challenge is when the employee loses or leaves his/her job which results in health coverage loss. …
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Under the federal COBRA law, employees under comprehensive group coverage can only continue with the coverage provided they pay the premiums in full which is rather expensive leading to many employees not taking the option. Therefore, this leads to ‘job lock’. According to Buchmueller and Valletta (1996), this term defines reduced worker mobility that arises from the perceived risk of losing health coverage. This compromises especially individuals who have a medical condition, who, if they change jobs, may be denied coverage either for the existing condition or altogether under their new employers through application of the ‘preexisting condition’ clause.
Another challenge that is evident is that employees are forced into jobs contrary to their career choices, just to secure health coverage. To the employers, small businesses feel the heat of these plans. The documentary Sick Around America highlights the plights of a small business hit by a million dollar cost for the delivery of a premature baby by the employees that resulted in their insurers increasing the premiums by over 78%.
Consumer Directed Health Plan (CDHP) is operated by insurance companies who are not obliged to cover anyone. Indeed, they take steps to avoid those who are already sick through a practice called medical underwriting. This practice enables the private insurers to avoid the sick and select the healthy. This is done through rigorous forms that require a person to fill all his health history. This is compounded by the fact that the insurers have access to all the medical records ever developed about any person. As a result, any person with a history of serious conditions, such as diabetes and heart problems gets rejected. This was also applied to people with even common ailments. Failure to disclose anything material is regarded as fraud and the insurers employ this opportunity to recede retrospectively coverage of persons after they have become sick. Insurers take the opportunity of this window to frame questions that are ambiguous and that will, in some way, lead the unsuspicious applicant forgetful of some minor past details to give incorrect information, which would, in turn, allow the insurer to recede the contract. This practice was being abused. Indeed, the documentary points to the fact that some insurers actually paid bonuses to their employees who were in charge of rescission based on how many rescissions the carried out in a given year. Medical underwriting has been countered in some states through the guaranteed issues. In such states, the law requires everyone who seeks insurance to be insured. However, such guaranteed issues predisposed the subscribers to extremely high premiums given that it allowed them a leeway to subscribe after they got sick. In states such as Massachusetts that had the guarantee issues, everybody was mandated to buy a policy or else be fined. This was hard to implement given that due to the soaring cost of the premiums, many residents could not afford it, and it was, therefore, impossible to enforce it. The health care reform has introduced some far reaching provisions with regard to the above problems. For instance, to cure the problem that arises from medical underwriting, there are introduced programs that care for those who have been rejected due to health conditions or disability. Such programs include the Pre-existing Condition Insurance Plan (PCIP), while young adults below 26 years qualify for coverage under their parent’
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