With all the swirling “data” thrown out to us it’s difficult to know what to believe since frequently the science is sucked out of statistics as they’re used by people promoting their own agenda.
But there is significance in the presentation of endless statistics on a particular subject and that’s that they express an “INTEREST IN” a particular subject matter that no doubt also indicates an INTEREST IN and a sign that some change in policy, procedure or law is coming regarding that subject matter.
Consumers should pay attention to where lots of statistics are coming from not only to help determine trends, but to help determine what’s NOT being addressed that should be addressed in order to better help consumers navigate the field of healthcare.
For instance, you won’t see health insurers sponsoring studies of what stress from medical bills does to people, or even what percentage of chronic stress and its related illnesses is traced to financial concerns about paying for healthcare or needed treatment.
Though the Employee Benefit Research Institute, one organization that considered the subject matter in 2003 still exists and creates surveys, if you look for a consideration of the COST OF HEALTHCARE AND HEALTH INSURANCE AS A DOMINATING CAUSE OF STRESS (which we already know is a major health issue) YOU’LL FIND THAT IT’S BEEN LARGELY IGNORED SINCE 2003.
Determining why the subject matter is ignored should be obvious, especially if you’re one of the millions of Americans who saw their health insurance costs increase/and-or their coverage decrease under Obamacare.
Similarly, you won’t see a lot of information on how many health insurance company decisions are appealed and how many of those appeals are denied or granted. It’s an important issue because under the PPACA, “Section 2719 of the Public Health Service Act, as added by section 1001(4) of this Act is amended as follows: SEC. 2719. APPEALS PROCESS,” individuals with health insurance have greater rights to appeal denials from health insurance companies,specifically in the form of external appeals once the internal appeals process is completed. You can look up this section for yourself.
First, under Obamacare, internal appeals must be provided for and insurance coverage must continue during that process. Additionally, EXTERNAL APPEALS, in most cases must be provided for. This means that though you’ll have to commit time and you will likely generate a lot of paperwork (keep a written record of EVERYTHING), in general, if your health insurer denies you coverage you should try to appeal decisions of denial from your insurer.
It should be noted that in addition to having to really search for anything about how many appeals are filed, it is equally difficult to find out how many appeals are granted.
Certainly, this information is not only useful to us as consumers, because who would want to use an insurance company that had an inordinate number of appeals being filed, especially if that number is accompanied by a large number of denials, but also because the government which has undertaken certifying qualified health plans, SHOULD BE interested in the performance of those plans it’s vouching for.
With all the analytics and studies and statistics thrown at us, consumers should ask the question, “How many health insurance company appeals are filed/granted (or denied) per year on a company-by-company basis?” The absence of available statistics indicates an absence of interest in an area that is very relevant to consumers.
