Will The United States Ever Abolish Private Health Insurance?

There are two guiding theories about health and medicine. The first is the one we use in the United States: Convince most people to buy into private health insurance, which will pay the lion’s share of the costs in the event of a serious illness. The second is the one we don’t use (but many other developed countries do): Treat health like a human right, and use taxes to pay for medical treatment whenever someone becomes ill. 

You probably already know that Democrats like Bernie Sanders favor the latter system. They prefer a “Medicare for all” system that they say would eventually reduce the costs of medicine, which are consistently rising at an ever-increasing rate.

The problem is even simpler, though. The United States is a capitalist society. Most of us believe in protecting business in general, but especially those smaller businesses or those businesses just starting out. To change such a deeply-ingrained part of our society would require a reversal of Republican policy and a transformation of American belief. 

There are other obvious problems. We allow lobbying in politics. Private interests like big business are allowed to contribute to political groups and campaigns when their beliefs align. This makes those political groups feel indebted to the ones who gave them money (and even if it doesn’t make them feel that way, they still have to do it to keep constituents happy). Gutting our current healthcare system also means demolishing an entire industry — and a powerful one at that. No one could believe that private health insurance providers would simply lie down and take it if the voters decided true universal healthcare was in their best interests.

Sociology Professor Paul Starr at Princeton University said, “We’re talking about changing flows of money on just a huge scale. There’s no precedent in American history that compares to this.”

That’s why you shouldn’t expect private health insurance to be abolished anytime soon. Not unless something transformational happens within our society.

Did COVID-19 Change Business Insurance Policies?

Business insurance is normally purchased by a business owner in order to protect the business from specific losses. These might include natural disasters like earthquakes and floods. They might also include violence by an employee or customer. They might include protection for infestation. Any of these protections arise because the business loses profit when it is forced to close.

Many business owners discovered that COVID-19 was not among those protections. Most plans did not cover losses that arose when the businesses were forced to close. Owners could still rely on government subsidies, but these were slow to roll out and only helped mitigate losses rather than eliminate them.

Many business owners ended up in court, but judges routinely sided with insurers. The good news? On either side, most people won’t make the same mistake twice. Insurers are making it clear to those purchasing business insurance that the business will require protections against specific public health issues to avoid the same pitfalls that arose during the pandemic — and because the pandemic is ongoing, this insurance is limited. It’s harder to acquire health insurance when a person is already sick, for example.

Even so, several states have already introduced legislation that would force insurers to cover COVID-19 losses. This trend is similar to what occurred after 9/11 when insurers began offering business protections due to terrorism in response to public and private criticism. What will the federal government do? Right now, we’re not sure. But Democrats are in power, and they support people over business. They might not have time to get anything substantial done before 2022, though, when the power could vanish.

One aspect of business insurance that changed more than expected? Protecting business assets in the digital space versus the brick and mortar one. Many employees are still working from home even now, late into 2021. Many business owners have no intention of bringing them back — or are simply waiting for business insurance to make it worthwhile. Without a brick and mortar space to protect, policyholders have less incentive to purchase or upgrade a plan. In fact, they might have more incentive to throw it in the trash.

It’s worth mentioning that insurers have responded to these changes by employing new technology. These new methods include more streamlined customer data analytic tech, or integrating information across multiple platforms like mobile and website with a call center. This saves insurers money.

This is in line with what business owners are already doing. For example, policyholders already showed an interest in downsizing through automation — but the 2020 pandemic jumpstarted this transition. During the pandemic, business owners discovered new opportunities to sell goods and services to online consumers who weren’t already a part of the market.

Do you need to change or alter your business insurance? You should consult with a qualified lawyer first. Additional information is available on www.sederlaw.com.

This is an example of a news cycle during the height of the pandemic in 2020, when many were promoting the fear that insurers could be put out of business if courts sided with entrepreneurs:

What The Judges Are Saying About COVID In The Workplace

Everyone knew that a storm of sorts was coming. Many businesses — non-essential and otherwise — remained open during the coronavirus pandemic. This resulted in many people becoming sick because they were allowed to work. Not all employers took the necessary precautions to protect them. Could those businesses be held liable for employee damages? What does insurance have to say about it? What about Workers Comp?

You can see that the equations judges have to balance are complicated — and the law might not have all the answers. But we finally have some insight into how judges are ruling in cases like these. Suffice it to say, judges are ruling against businesses in COVID-19 lawsuits.

The University of Pennsylvania Law School tracked COVID legislation starting early. 

Many of the cases involved businesses that wanted insurance companies to cover COVID-19 losses because they had purchased “business interruption” policies. But the problem is simple: those policies rarely cover this kind of public health crisis. Business owners would have to voluntarily purchase a policy that does. Most don’t.

Judges ruled against business owners who built these lawsuits. The Penn data shows that there were thousands of such lawsuits over the past 12 months. In federal courts, insurers won lawsuits more than three-quarters of the time. Many more cases were “resolved” by the judge’s outright dismissal of the case.

Civil lawsuits are generally filed against the person or organization mostly responsible for financial damages. In this case, they should probably be filed against the United States government. The arguments would be obvious enough. The Trump administration failed to invoke many laws that would have increased production of PPE or attempted to standardize COVID restrictions from state to state. At the very least, he could have tried to limit travel. But in the name of business, that’s not what happened.

Unfortunately, those lawsuits would also fall flat — because the U.S. government would claim immunity.

Insurance Rates Poised To Skyrocket In 2021

New York-based insurance companies wish in hike premium rates on average of 11.7 percent for the 2021 year. Why? Because they say costs are growing due to the coronavirus outbreak. These projections were made public by the Department of Financial Services recently. Government authorities have yet to make a public comment to address growing concerns about already skyrocketing costs, especially since an increasing number of residents are uninsured after losing jobs.

One Manhattan-based insurer wants to increase rates a whopping 19 percent.

Shockingly, the rate hikes were called “reasonable and fair” by the New York Health Plan Association. According to the group, rate hikes would correspond to rising health care costs, most of which were do to COVID-19, a disease which has already resulted in 24,000 NY fatalities — nearly the number of deaths in a typical flu season, nation-wide. 

NYHPA President Eric Linzer said, “From the outset and throughout the continuing coronavirus crisis, New York’s health plans have made extraordinary efforts to meet the needs of consumers, businesses and our health care partners. This has included waiving copayments and cost sharing for COVID-19 testing, telehealth services and mental health services for essential workers, and providing cash advances and other support to hospitals, physician practices and others in the delivery system to address the financial uncertainty they’re facing.”

Nothing, as they say, comes free. The services recently offered without cost are the basis for most of the expected rate hikes in 2021. In 2019, eight companies with a public IPO made over $21 billion — which constituted a massive 31 percent increase in profit over the previous year. Basically, no one should believe that these companies actually need to increase their rates.

Do you believe you were taken advantage of by a health care company during the coronavirus crisis? Did you lose coverage at the most inopportune time? Insurance litigators want to hear your story — and we might want to build your case. You deserve compensation more than they do. Don’t forget it.

3 Common Tricks Used By Insurance Companies

Insurance companies should operate on incredibly tight margins.  If every client they represented used their insurance policies at the maximum values, the insurance industry would simply collapse.  With that in mind, insurance companies try to save money at every turn, utilizing intense mathematical gymnastics to figure out how they can pay you as little as possible when something happens to you.  While insurance companies will try to scare you into accepting their low-ball offers, you have to stand strong and understand what your true worth is.  At the end of the day, your insurance agent is not your friend.  Do not let them try to play around with you and your family’s livelihood.

Settlement Agreement Deadlines

One tactic many insurance companies employ is trying to force you to sign a settlement agreement while you are still undergoing medical treatment.  While it might sound like a good idea to get some money right away, you have to remember that insurance companies have years of experience with dealing with clients suffering the same injuries or damages as you.  They know how much money you are going to need.  By setting up an arbitrary deadline, they are trying to make you agree to a settlement that is beneficial to them.

Blaming Injuries On Pre-Existing Conditions

As we have established, the entire goal of insurance companies, like any other company, is to make money.  If you allow insurance companies to access your medical records (do not sign anything that authorizes this unless you are signing up for insurance that requires it), they will use that information against you.  For example, if you were in a car crash that left you with a concussion, the insurance company might use a previous injury or pre-existing condition to get out of paying you what you deserve.  They will say that you were aware of the risk, and they will charge you more in premiums.  Do NOT let them control you like this.

Disputing the Severity of Your Injuries

This is pretty cookie-cutter stuff.  Do give the insurance companies any reason to think you are in better shape than you actually are.  Do not lie about your injuries, but be realistic about them throughout the entire process.  If you tell the truth, and have your doctor to vouch for you, you will be fine.

If you have insurance for injuries and sustain a serious injury, do not let insurance companies bully you.  Understand your worth, and keep records of everything.  There is no reason why you should receive less compensation than you deserve.

Getting To Know Insurance Companies

One of the main themes of this blog will not just be to make you hate insurance companies but to suspend your belief of them when you talk with them.  Insurance companies could not possibly give out great deals to everyone, because then they would never make any money.  Sure, you need insurance, but there are types of insurance that are a huge waste of money (we will get into those later).  What you need to do is identify what you need for your insurance, and let your agents know your expectations heading in.  If you find yourself believing everything your agent tells you, please remember this video.  Just like with any other product, it is in your best interest to be an informed consumer when you make the decision to purchase insurance.  If you don’t do so, you will either wind up woefully underinsured or grossly over-paying.  Neither of those sound very good to us.