“Pretend” Benefits

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http://www.changetowin.org/connect/2007/07/pretend_benefits.html

Michael Moore’s movie “Sicko” made the point that it was not focusing on the uninsured, but on those “who have insurance.” It showed how working people “who have health care coverage” have, in fact, woefully inadequate insurance that can still leave them impoverished or dead in cases where a real national health care plan would not.

But a new trend to so-called “limited benefit” health plans indicates that the situation will get much worse than “Sicko” portrays it over the coming years if a true break with the profit-based health care system does not take place.

The following is becoming increasingly common. A worker is rushed to the hospital with a heart attack that prompts emergency surgery. After a four-day stay, the worker is released and presented with a bill for $48,000. He discovers that his insurance covers only $2,000 of the total; he owes the rest.

This scenario is playing out across the country as more workers are forced into “limited benefit” health plans that employers and insurance companies are pushing on low-wage nonunion workers in the service industries.

More than a million workers have already been shoved into these plans, including workers at Sears, Home Depot, McDonald’s, Wal-Mart, Target and Friendly’s. At Lowe’s, about 7,000 part-time employees are enrolled in limited benefit plans capped at $2,500 or $5,000 a year. Cigna estimates that the number of people covered under these plans is growing by 15 percent a year.

Cigna, Aetna and other insurance companies are promoting these plans to squeeze money out of workers at companies that have dumped their traditional health plans, raised the workers’ share of premiums so high that workers can’t afford to participate, or refused to cover all of their workers.

Under these “limited benefit” or “mini-med” plans, workers pay the entire premium cost, usually a premium of $50 to $100 a month. The catch is that these plans cap coverage at amounts as low as $1,000. They provide yet another vehicle for the insurance companies to get rich off the plight of the working poor. Many workers are unaware of the caps when they sign up for the plans.

With these plans, employers can pretend that they are providing health benefits, insurers can pretend that they are covering medical costs, and state legislatures can pretend that the number of uninsured Americans is falling. Cigna tells employers that the plans are “designed for part-time and hourly employees” and “will improve your company image” and “reduce turnover, absenteeism and fraudulent worker’s compensation claims.”

This trend toward pretend health benefits follows the same pattern that we have already seen with retirement benefits, where employers replace real pensions with pretend “pensions” - 401(k) accounts that shift all the risk to workers. Now employers have joined with the health insurers to create pretend health benefits - insurance policies paid for by workers with almost no benefits.

As long as profit-making insurance companies control the U.S. health care system, employers will find willing partners in their efforts to force costs onto workers. A national health care plan that puts quality affordable health care first and profits last is the only solution.

Greg Tarpinian is the Executive Director of Change to Win.

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