Policy Holder Bill of Rights - Long (Health Care)

Discussion in 'Congress' started by Citizen421, Jun 7, 2009.

  1. Citizen421

    Citizen421 Rookie

    Jun 7, 2009
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    As a proud citizen of the United States of America, I can no longer be silent on what I feel is one of the biggest contributors to bankruptcy and low income in America. It’s health care.

    That being said, before we get to far into this, I want to be very clear on something. I am COMPLETELY against socialized medicine. Let me say that again, I do not feel it is the right move for our government to provide health insurance for every American. All it is going to do is increase our national debt and cause major bureaucratic headaches for hard working Americans. People that desperately need health care don’t deserve to have to be on the phone with health officials and have to argue whether or not their treatment qualifies for coverage. This will only put undeserved pressure and heartache into an already crazy situation.

    Therefore, I am proposing what I call the Policy Holder Bill of Rights. These are rights that I feel every American citizen deserves when it comes to getting the best health care in the world. This will not completely fix the problem, but I hope it will at least be a step in the right direction.

    The Policy Holder Bill of Rights

    All health insurance providers will be required to lay out all health conditions that are NOT COVERED to its policy holders.

    • All health insurance providers are required to lay out what is NOT COVERED in a policy. My hope is that by telling a policy holder what is not covered, it will be easier to decipher what IS covered.

    • All items that an insurance provider decides to NOT COVER, will be listed in the Not Covered section of the policy.

    If a particular health condition is not listed in the Not Covered section, it is presumed to be covered.

    • For example, if a health insurance provider does not list ‘Type 1 Diabetes’ in the Not Covered section, it is presumed that the health insurance provider WILL COVER ‘Type 1 Diabetes’.

    • Also, if for some reason a new disease pops up (such as the AIDS epidemic of the 90s), it will be presumed that the health insurance provider WILL COVER the new disease since it was not listed in the Not Covered section.

    • This also INCLUDES PRE-EXISTING CONDITIONS. A policy holder should not be punished for changing jobs or for being laid off through no fault of their own. Let’s face it, the day of staying on with one company for the majority of one’s working life is no longer here. People deserve to know that if a policy normally covers their condition, it will be covered… period. Also, this is supposed to be a free market system. A policy holder deserves the right to shop other health insurance carriers to make sure they are getting the best combination of rate and coverage available. Including pre-existing conditions will allow policy holders to do this.

    All insurance providers will be required to breakdown pricing.

    • All policies should be broken down in such a way that a policy holder can easily understand what the cost will be for a procedure. My suggestion is to break down pricing into three sections:

    • The Flat Rate section – this will be for procedures that are covered by a one time fee that is paid to the doctor’s office, lab, clinic, etc. These would include procedures like:

    • Office visits
    • Emergency room visits
    • X-Rays
    • Blood tests
    • Prenatal care

    • The Deductible section – this will list how much the deductible is for a particular policy and what the overall policy rate will be. Below is an example format:

    Deductible Section:

    Overall Policy Coverage: 6 Million per fiscal year
    Patient Deductible: $1,000

    • If a particular procedure is not listed in the Flat Rate section, it is presumed that the policy holder will have to pay the full price of the procedure up to the deductible amount, and the insurance carrier will pay the difference. The amount paid for by the insurance carrier will then be deducted from the Overall Policy Coverage amount. For example:

    • A policy holder has a $1,000 deductible and has an Overall Policy Coverage of $6 Million per fiscal year. The policy holder goes to a medical clinic and receives treatment not outlined in the Flat Rate section of the policy. This treatment has a cost of $5000. The policy holder would be responsible for $1000 of the treatment, and the insurance carrier would cover the other $4000. The insurance provider would then deduct the $4000 from the Overall Policy Coverage amount.

    • If a policy holder has a procedure covered by the Flat Rate section, the policy holder will pay the amount listed. If the cost of the procedure is greater than the cost of the amount paid, the insurance carrier will pay the difference. This amount DOES NOT go against the Overall Policy Coverage amount.

    • The PERSCRIPTIONS section – this will list all costs related to prescriptions.

    All health insurance providers will be required to cover policy holders out of state.

    • This should include traveling policy holders as well as policy holders that are moving. Again, we shouldn’t be punished for moving or for traveling. We should have access to the best policies available no matter where we are located.

    All health insurance providers will be required to send an electronic document (such as a PDF) to each policy holder.

    • The purpose of the PDF is to allow the policy holder to email the policy to their doctor and hopefully give the policy holder and doctor enough information to decide whether the policy is right for them.

    • If the policy holder does not have access to a computer, or would prefer a written version of the policy, the insurance carrier would be required to provide that to the policy holder.

    All health insurance providers will be required to give policy holders 30 days to decide whether the policy is right for them.

    • The purpose of the 30 day period is to hopefully give policy holders enough time to consult their doctor regarding the insurance policy.

    This is just a start of ideas that i think could help out with health insurance issues. In my opinion, we as Americans don't want a hand out. We just want to know that if we pay good money for health insurance, we should have a reasonable policy. In my opinion, the items listed above would go a long way to providing that.
    Last edited: Jun 7, 2009

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