Bullied by Our health insurance

The Story Behind the Killing of United Healthcare’s CEO
Unmasking our Health Insurance

Bullied by Our Health Insurance

When I was in 3rd grade, my folks bought a brand-new house, which was really good news. However, the presence of a large bully in the neighborhood was the bad news. Bad news that quickly had me flat on my back in front of our new home, with the bully beating the crap out of me when my father walked by. However, he simply looked down and said “You can’t win when you are on the bottom,” and kept walking. It was a lesson I have never forgotten and one that has sustained me throughout life. If you are unwilling to do what needs to be done to meet the challenges in life, you deserve what you get.

That’s not to say that there won’t be times when we need help. That’s only reasonable. However, we have absolutely no right to expect help to be there when we need it most. We have to look, first and foremost, to ourselves in dealing with the issues that life has in store for us.

Nowhere is that statement more-true than in getting the healthcare we will all need at some point in life. Because, as my father so aptly said, “You can’t win when you are on the bottom.” And, that is exactly where we will find ourselves if we don’t learn how to fight for the care and coverage we are owed from the bully we that call health insurance.

Fortunately, just as I was able to put my bully in his place all those years ago, there is a clear path to putting our health insurance bully in its place and winning the care and coverage we are actually OWED. Because the fraud inside the American Healthcare System is so big, the proof so absolute, and the absence of any reasonable defense so clear, that our health insurance company can literally be made to run from a fight, if we take the time to learn how to fight. Or as my bully found so many years ago, I had learned how to fight, and he needed to find someone else to pick on.

A great example of why your insurer can be made to run from a fight can be found in your state’s explanation of a critical provision in the Provider Contracts that all in-network providers (doctors and hospitals) are required to sign. It’s called the Hold Harmless Provision. And, it very clearly states that the provider may “NOT” bill a patient when coverage is denied. However, your State will readily explain that the provision ONLY applies in cases of insurer insolvency or bankruptcy. Knowing, full well, that the limitation of “INSOLVENCY or BANKRUPTCY” is never mentioned in the provision. Therefore, allowing insurers to apply the provision under CONTRACT LAW to block “ALL” payment when they deny the care we need. However, allowing providers to use the State’s interpretation to stick us for whatever our insurer fails to pay for the care we do get.

Two very different definitions with only one purpose, i.e., to deny us BOTH the care and the coverage we are owed. However, whatever you may think of our courts, they are NOT about to allow two very different interpretations for the same language. Particularly, when the only definition that CAN apply to us is Contract Law. Consequently, the insurance industry can’t afford to have the ever-so-clear meaning of the Hold Harmless Provision come before a court, because it would destroy the insurance industry’s business model. Or as my good friend and attorney Jerry puts, “It’s just cheaper to eat it,” i.e., to swallow the cost and avoid the fight.

Fortunately, the above is far from the only hole in our insurer’s boat when it comes to denying care or sticking us with a large healthcare bill. It’s simply offered as proof of just how weak your insurer’s position is, if you learn how to fight for what you are owed.

However, that never happens because we have been bullied to the point where we don’t have a clue of how fight the bullying tactics of our health insurance. And, while I can only guess at what was behind the killing of United Healthcare’s CEO and the public rage that followed it, I have to believe it’s the frustration of not knowing how to fight the bully we view as health insurance.

For a more complete explanation of what we are actually owed from health insurance and how to beat their bullying tactics, go to www.killAbill.com or order the book “The Big Lie in My Healthcare Bill” from Amazon Books.

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