THIS IS WHY YOU PAY PREMIUMS
4 July 2003
For a long time, I've thought that insurance is like playing the lottery. So many times
you pay and pay and pay and pay and then something comes up, you use your insurance, and
next month they cancel you.
I remember when I was working for an ob/gyn office years ago and a young woman came in
for a routine exam. She was a cash-paying patient. Not because she had no insurance. She
had insurance with one of the country's major insurers. But two years before a Pap smear
had showed some "irregularities." Now "irregularities" in a Pap smear
can mean a precursor of a precancerous condition, or a glitch in the laboratory or any of
a host of things in between.
Dutifully, the patient came in to be retested (S.O.P. with an irregular Pap smear) and
the second test came back clear. She was fine. No problem.
BUT because she had an irregular Pap smear, her insurance company put a
clause in her coverage when it came up for renewal....now everything was covered except
routine gynecological care.
Tell me--what is the thing that most 20-somethings need in health care? Oncology?
Podiatry? Cardiology? No. Of course not. Most 20-somethings are healthy young women who
only need to have an annual gyn exam. But because this woman had acted responsibly and had
taken care of her health, she lost the coverage she'd been paying for.
You see it happen over and over again. Pay thousands of dollars over the years in car
insurance. Keep a spotless driving record and then get a little ding one day and they
cancel your policy.
If you have to use your insurance policy for something, it behooves you to make sure
it's something big. Wait till you get inoperable cancer. Or AIDS. Or total your
car. Then you can get some of that "investment" back. But use it for a little
repeat Pap smear or a little fender bender that wasn't your fault and watch all of your payments go up in smoke.
Now granted, all insurance companies are not like this. I don't know percentages, but
probably more than half of them wouldn't cancel your policy for something minor. Thank
goodness Kaiser is among those who don't cancel your policy.
At least I don't think so.
Remember that little ride to the hospital that I got after my bike accident? They
loaded me up into the ambulance and my friend the paramedic and I chatted on the 10 minute
drive. I told him how it happened, he told me about his family, I took pictures of the
freeway through my toes, and then they dropped me at the emergency room.
I just got the bill: $900.
Kaiser says my co-payment is $50, which I am more than happy to pay.
But if they cancel my policy because of it, I'm gonna be pissed. I should at least have
split my head open for that.