Davies Campus California Pacific Medical Centre, located in a heavily
gay district in Castro, San Francisco, had a problem in the year
2000. It simply could not cope with the number of HIV patients claiming
insurance health benefits that were not paid.
law was passed in California: the AB 2186, to require HIV patients
to seek specialist care in order to qualify for insurance benefits.
The problem was that medical practitioners did not have a specialty
for Aids in the same way for example, that heart disease is a specialty.
The result: HIV patients could not claim!
is one of the problems with health insurance: the apparent bias
against certain illnesses such as Aids, mental illness, cosmetic
implants, contact lenses and certain non-illnesses such as pregnancy.
And then there is retirement that simply cuts you off the plan.
insurance is also difficult for small business owners and individuals.
While premiums are fairly low for large groups, simply because of
the numbers equation, premiums for small groups are priced higher.
the US there are now laws such as the Mental Health Parity Act,
the Health Insurance Portability and Accountability Act, and the
Consolidated Omnibus Budget Reconciliation Act that came about as
a result of a consumer lobby.
legislation seeks to protect discrimination against certain individuals,
and guarantee their health insurance benefits in the long view for
healthy nation status.
interesting piece of legislation is the Womens Health and
Cancer Rights Act. In this law insurance companies cannot exclude
or refuse to pay for certain cosmetic procedures such as breast
reconstruction after a mastectomy.
in a health insurance policy refers to an illness the health plan
provider will not pay for eg HIV/Aids. There are other exclusions,
as well as broad-brush exclusions termed: a pre-existing disease.
pre-existing illness or disease is one that had manifested itself
before the employee applied for the health plan coverage.
US lobby that brought the Health Insurance Portability and Accountability
Act ensured that a pre-existing medical condition will not be subject
to an exclusion clause.
we are serious about first world nation status, it is an opportune
time to get involved in understanding what our health plans on the
local market will not pay for, and to initiate a lobby for international
insurance companies will not do this for its clients; this is something
the clients must do for themselves. Another interesting reform in
the US legislation is a move to make health insurance premiums a
term tax deductible refers to the ability to subtract the amount
of the annual insurance premium from the quantum of income that
is subject to tax; so you pay less tax.
such a move must follow legislation for consumer friendly claims
week: More tax deductions