What really amazes me is how health insurance companies can get away with descriminating against sole proprietors and small business owners.  Why is it that if you work for yourself, you are unable to get group health insurance rates.  In New Jersey, about the only thing a sole proprietor can afford is a lousy HMO policy that basically pays nothing and makes your GP fill out a referral slip every time you have to blow you nose.  For a family of three, HMO rates run approximately $1200 per month for basic 80-20 converage and a $30 c0-pay.  Now, if that same person is an employee of a large company that does the same type of work, that person (or the companny for that matter) would be paying half as much.  The only difference between the two people is for whom the person work.  Work for yourself and pay through the nose or work for a large company and pay alot less.  Now, would someone please explain to me the rational of that? 

What’s even more ridiculous is the fact that the Health Insurance companies have given so much money to support the elections of “our” legislators are allowed to get away with this.  It’s no wonder why a National Health Care System has been talked about for a long time.  However, since legislators do not have to pay for any health insurance costs, it’s no skin off their nose to help their constituents stave off these escalating expenses.

It’s amazing how times have changed.  When I was a child, our family doctor actually made house calls.  Now, when you call the doctor’s office to make an appointment, you spend alot of time just trying to get someone to answer the phone.  The  primary reason for this is that your family doctor and their supporting staff no longer work for your benefit — they work for the health insurance companies - gratis.  

What makes this even more galling is the fact that the insurance companies keep raising insurance premiums while claiming that it costs them more and more to operate.  I don’t understand how they put forth such a ridiculous proposition when they dump most of their work on the primary care physicians.  Primary care physicians do not make any money filling out and processing “referrals”.  This is just a ploy by the insurance companies to use these “referals” as and excuse to not pay a claim.  If they actually provided the referals themselves, then they would not be able to deny the claim.  But hey, what do they care,  it costs money to pay the claim — heaven forbid they would have to do that.  Don’t let anyone fool you into thinking this current system is anything more than a fraudulent scam by insurance companies to pass off all their costs onto others while “claiming” higher costs. 

On reason the costs are higher than they should be is due to the amount of reprocessing that occurs with regard to insurance claims.  How many times have you spent hours on the phone with insurance company customer “service” (I use that term lightly)  representatives getting a claim reprocessed because the insurance company did not receive the “correct” information even though the procedure was pre-authorized and processed according to the instructions in the “referral”.  That is where the costs are frivously wasted — your premiums at work.