5 ms·
Insurers deny expensive or cutting-edge treatments in the US all the time! You don't have to look hard to find sob story after sob story. And it makes sense.
by CydeWeys 8y ago
Insurers deny expensive or cutting-edge treatments in the US all the time! You don't have to look hard to find sob story after sob story.
And it makes sense. If a treatment is super-expensive and unlikely to be effective anyway, and that money could be put to better use to help more other people ... It's like how someone who smokes isn't going to get a lung transplant; there's too many others that need transplants and not enough lungs to go around, so give the lungs to the people who will benefit the most from them (generally, people who are young and otherwise healthy). There aren't infinite resources in this world, so in the cases where scarcity comes into play, they should be doled out in the way that creates the greatest good.
- mikeash 8y agoBefore Obamacare, insurance plans had lifetime limits. So even if you got a really expensive treatment approved, it would potentially push you over your lifetime limit and leave you with no coverage at all.
- danans 8y agoTo clarify, I think you mean lifetime limit for the insurance company, not you.
- mikeash 8y agoWhat do you mean? The limit was on your coverage. Once you exceeded that limit, you had no more coverage.
- danans 8y agoRight, a limit on how much the insurance company will pay to cover your healthcare expenses
- mikeash 8y agoI don’t understand the distinction you’re making.
- CydeWeys 8y agoThere was a somewhat common misconception that the limit was per person, not per policy. Although, the distinction wasn't very meaningful because you could be denied for pre-existing conditions, so if you had hit a lifetime limit on one policy, good luck being able to get another one anywhere else.
- danans 8y agoSome employers put a limit on how much you pay out of pocket, even below the maximum amount of pocket required by the ACA, almost, but not quite comparable to what you get in countries with socialized medicine or health insurance systems. They essentially assure that medical treatment can't bankrupt you. Obviously, most people in the US don't have access to such a generous plan, or the amount of medical expenses they can tolerate without going into bankruptcy is below the legal out of pocket maximum (6k/yr individual, 12k/yr family). Hence the GoFundMe pages to raise money for medical treatment.
- brewdad 8y agoYes. BUT the insurance companies knew that you had hit a lifetime limit with another company and would refuse to insure you. You couldn't jump from AETNA to BCBS to CIGNA and get a fresh million dollar limit.