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2nd as I pointed out previously and as your article clearly indicates you can seek legal redress if your insurance company wrongs you. However if the government screws you over you are screwed and there is no way to redress the wrong done you.
Insurance companies are not immune to lawsuits. Insurance policies are legal contracts that can be enforced in court just as any other legal contracts can be
Sorry, but that is not the case. Do some research on ERISA.
When Obama suggests that his health insurance overhaul will keep private insurance companies "honest" beyond what the courts and state insurance commissions already do, he is simply lying and trying to frighten people into supporting his plan.
I think his main claim is that it will provide an affordable option for people who can't afford the employer plan or a private plan. And it will.
You're fooling yourself. Not only was that article full of examples, but I've lived it. I've lost someone I loved to it. And Google will be happy to find example after example. Unfortunately, your facts are simply wrong on that one. Wish you were right, quite frankly.
Again, research it yourself. Start with ERISA. You're assuming things are as they should be. That's not the case, and that's the problem.
It has nothing to offer me directly. I have very good insurance. But it has a lot to offer people who can't get insurance for one reason or another, and it has a lot to offer people who need treatment quickly and are given the run-around by their own insurance companies.
If it is not subsidized by tax payer dollars, it will just be another non profit insurance company like all the others we already have, and if it is subsidized, rather than offering us more choices, it will sell its policies below cost and drive all other health insurance companies out of business, giving us no choices rather than more choices.
Insurance companies are not non-profit. And the public plan is subsidized based on income. It provides an option for those who can't afford private insurance, and for those who are denied coverage based on pre-existing conditions.
Rather than the loose talk, empty promises and false accusations we are getting from Obama, Pelosi & Co...
Based on the mistaken beliefs expressed in your post, I think you need to do more research before you decide whether it's all loose talk and false accusations. I don't think you have a clue what people go through in our current system. That's not to be mean - you come across as a fairly logical person who is naturally assuming that the system works logically. It doesn't.
Excellus BlueCross BlueShield, headquartered in Rochester, New York, is part of a $4 billion family of companies that finances and delivers health care services across upstate New York and long-term care insurance nationwide. Collectively, the enterprise provides health insurance to more than 2 million people and employs more than 6,000 New Yorkers. The company's financial strength is reflected in its "A-minus" financial ratings from both A.M. Best and Standard & Poors. Excellus BCBS is New York State's largest nonprofit health plan.
Kaiser Permanente is an integrated managed care organization, based in Oakland, California, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney R. Garfield. Kaiser Permanente is a consortium of three distinct groups of entities: the Kaiser Foundation Health Plan, Inc. and its regional operating organizations, Kaiser Foundation Hospitals, and the Permanente Medical Groups. As of 2006, Kaiser Permanente operates in nine states and Washington, D.C., and is the largest managed care organization in the United States. Kaiser Permanente has 8.7 million health plan members,[4] 156,000 employees,[2] 13,729 physicians,[3] 37 medical centers, 400 medical offices, and $34.4 billion in annual operating revenues and $1.3 billion in net income.[1] The Health Plan and Hospitals operate under state and federal not-for-profit tax status, while the Medical Groups operate as for-profit partnerships or professional corporations in their respective regions.
If you have done research you should be able to respond with more substance than just saying I'm wrong. For example, exactly what item in ERISA are you claiming makes health insurance companies immune to lawsuits? Do you know or do you just want to believe it's true?
ERISA Section 514 preempts all state laws that relate to any employee benefit plan, with certain, enumerated exceptions. The most important exceptions i.e. state laws that survive despite the fact that they may relate to an employee benefit plan are state insurance, banking, or securities laws, generally applicable criminal laws, and domestic relations orders that meet ERISA's qualification requirements.
A major limitation is placed on the insurance exception, known as the "deemer clause", which essentially provides that state insurance law cannot operate on employer self-funded benefit plans. The Supreme Court has created another limitation on the insurance exception, in which even a law regulating insurance will be pre-empted if it purports to add a remedy to a participant or beneficiary in an employee benefit plan that ERISA did not explicitly provide.[1]
The result is that the only remedy available to a covered person who has been denied benefits or dropped from coverage altogether is to seek an order from a federal judge (no jury trial is permitted) directing the Plan (in actuality the insurance company that underwrites and administers it) to pay for "medically necessary" care. If a person dies before the case can be heard, however, the claim dies with him or her, since ERISA provides no remedy for injury or wrongful death caused by the withholding of care.
Even if benefits are improperly denied, the insurance company cannot be sued for any resulting injury or wrongful death. Many persons included among the some 47 million people presently without health care coverage in the United States are former ERISA "subscribers", insurance terminology for Plan beneficiaries. who have been denied benefits-usually on the ground that the prescribed care is not medically necessary or is "experimental"-or dropped from coverage, often because they have lost their jobs due to the very illness for which care was denied.
Many consumer and health care advocates have called for a "restoration of the freedom of contract enforcement," to the 75% of Americans insured under these work place group plans-in effect, a repeal of the ERISA pre-emption. Permitting these insured persons access to customary state remedies (98% of all civil disputes are resolved in state courts) would, they contend, result in a substantial reduction in arbitrary denial of care benefits, simultaneously alleviating a major burden on state Medicaid systems and clogged federal court dockets.
Employee Retirement Income Security Act - Wikipedia, the free encyclopedia
All health insurance plans, including Medicare and Medicaid, refuse claims if they do not meet the criteria for coverage, and a public plan would certainly do the same, just as all government run insurance plans in other countries do.
There are non profit health insurance companies in the US and there have been for decades. Blue Cross Blue Shield companies were all originally non profit and many still are, and Kaiser Permanente is non prop fit as are many others.
Again, if the public plan does not receive special subsidies, it would just be another non profit insurance company like the ones we've had for decades, and there is no reason to think it will have anymore to offer anyone than these other non profits do.
I already defined the narrow window. In order to sue the government you must be able to demostrate that the agency or agencies in question are violating their own rules.
Most law suits against the government today are in fact little more than requests that the government do its damn job in the manner plaintiff thinks it ought to be done based upon plaintiff's interpretation of the appropriate regulations.
They'd be seeing their doctor, as you suggest. Glad to hear you approve.
No, unfortunately, a lot of them can't. They can't afford it, or don't have insurance, or it isn't covered by insurance.
If you have done research you should be able to respond with more substance than just saying I'm wrong. For example, exactly what item in ERISA are you claiming makes health insurance companies immune to lawsuits? Do you know or do you just want to believe it's true?
Oh, I've done the research. But I see you opted against doing so yourself. Ok, here ya go, I'll give you the easy version.
ERISA Section 514 preempts all state laws that relate to any employee benefit plan, with certain, enumerated exceptions. The most important exceptions i.e. state laws that survive despite the fact that they may relate to an employee benefit plan are state insurance, banking, or securities laws, generally applicable criminal laws, and domestic relations orders that meet ERISA's qualification requirements.
A major limitation is placed on the insurance exception, known as the "deemer clause", which essentially provides that state insurance law cannot operate on employer self-funded benefit plans. The Supreme Court has created another limitation on the insurance exception, in which even a law regulating insurance will be pre-empted if it purports to add a remedy to a participant or beneficiary in an employee benefit plan that ERISA did not explicitly provide.[1]
The result is that the only remedy available to a covered person who has been denied benefits or dropped from coverage altogether is to seek an order from a federal judge (no jury trial is permitted) directing the Plan (in actuality the insurance company that underwrites and administers it) to pay for "medically necessary" care. If a person dies before the case can be heard, however, the claim dies with him or her, since ERISA provides no remedy for injury or wrongful death caused by the withholding of care.
Even if benefits are improperly denied, the insurance company cannot be sued for any resulting injury or wrongful death. Many persons included among the some 47 million people presently without health care coverage in the United States are former ERISA "subscribers", insurance terminology for Plan beneficiaries. who have been denied benefits-usually on the ground that the prescribed care is not medically necessary or is "experimental"-or dropped from coverage, often because they have lost their jobs due to the very illness for which care was denied.
Many consumer and health care advocates have called for a "restoration of the freedom of contract enforcement," to the 75% of Americans insured under these work place group plans-in effect, a repeal of the ERISA pre-emption. Permitting these insured persons access to customary state remedies (98% of all civil disputes are resolved in state courts) would, they contend, result in a substantial reduction in arbitrary denial of care benefits, simultaneously alleviating a major burden on state Medicaid systems and clogged federal court dockets.
Employee Retirement Income Security Act - Wikipedia, the free encyclopedia
Of course they do, but the government plan is not so free to reject individual claims in the manner we see with private insurance.
There are non profit health insurance companies in the US and there have been for decades. Blue Cross Blue Shield companies were all originally non profit and many still are, and Kaiser Permanente is non prop fit as are many others.
Lol. Yeah, that's beause by registering as a nonprofit, they don't have to pay certain taxes. I assure you, medical insurance companies are for profit.
Time for Blue Cross to act like a non-profit
You seem very idealistic about the noble insurers. Good luck selling that one. I'm afraid they're walking on two legs nowadays.
Again, if the public plan does not receive special subsidies, it would just be another non profit insurance company like the ones we've had for decades, and there is no reason to think it will have anymore to offer anyone than these other non profits do.
Nothing? Come back when you have a pre-existing condition and no way to get healthcare. Let me know if it has nothing to offer you then. Under no circumstances will this reform solve all problems, and it will certainly have its own issues. But it's better than the situation we're in at the moment, and far better than doing nothing at all. The only way you can deny that is to deny the abuses of the insurers, which appears to the route you're going. I'm hoping that's idealism and naivete due to never having seen it or had to deal with it.
Beyond that, I gave you ERISA to start with. Why didn't you look it up yourself? If you're so into your "rightness" that you can't even type "ERISA" into a search engine and attempt to learn, then what's the point of discussion?
Successful ERISA plaintiffs may be entitled to benefits improperly denied, along with pre-judgment interest and any consequential damages. Punitive damages and damages for mental anguish are not available under ERISA, though substantial statutory attorneys fees and costs are allowed in breach of fiduciary duty actions. As noted above, the Secretary of Labor can collect civil penalties under ERSIA. 29 USC Sec. 1132(g)(1).
The FTCA [Federal Tort Claims Act] provides a limited waiver of the federal government's sovereign immunity when its employees are negligent within the scope of their employment. Under the FTCA, the government can only be sued 'under circumstances where the United States, if a private person, would be liable to the claimant in accordance with the law of the place where the act or omission occurred.' 28 U.S.C. S 1346(b). Thus, the FTCA does not apply to conduct that is uniquely governmental, that is, incapable of performance by a private individual.
You are ridiculous !
And you're an idiot. Thanks for your contribution.
Maybe if you posted your views rather than just a link to someone else's you might get a more considered response.
Good find, don't expect the wingnuts on here to consider that irony, they need, actually require an enemy in order to feel alive. Death for them would be common sense.
So now that you have done some research, you understand that your original statement that insurance companies are immune to lawsuits was untrue.
So while you may find it emotionally unsatisfying that punitive damages and damages for emotional distress are not available to plaintiffs,
The FTCA [Federal Tort Claims Act] provides a limited waiver of the federal government's sovereign immunity when its employees are negligent within the scope of their employment. Under the FTCA, the government can only be sued 'under circumstances where the United States, if a private person, would be liable to the claimant in accordance with the law of the place where the act or omission occurred.' 28 U.S.C. S 1346(b). Thus, the FTCA does not apply to conduct that is uniquely governmental, that is, incapable of performance by a private individual.
The House plan will require all private insurance companies to insure people with pre existing conditions at standard rates, so this problem would be solved without a public plan.
Your understandings/misunderstandings of the issues involved seem to be guided by the sentimental bias that government is good and business is bad
