The Health Of Our Care – me, naked but for my slingshot

I received a letter today from Aetna that starts out: Dear Valued Member…. At least I’m a valued member now. When Aetna sent me the letter last month announcing they were raising my premium more than 35%, I was not valued, I was just Julie Goodale.

This letter is notification that Aetna has terminated it’s contract with the hospitals where my doctors are. The termination is effective April 5 (and today’s date would be April 13, more than a week after the fact).

These are my cancer doctors, the doctors I’ve been with for nearly 9 years, the doctors who know me – my cancer, my treatments, my body, my life. These are the doctors who are largely responsible for me still being here, nearly 9 years later.

At least I’m not in active treatment. I know people around the country who’s insurers suddenly have dropped their doctors/hospitals. I know some who are in the middle of treatment and have had to switch to an unknown doctor, or drive more than an hour further for a covered doctor.

With my premium increase, I had been considering changing plans. But I worried about a new plan covering everything. I know too many people who check to make sure their insurance covers their cancer doctors, only to find out later that it doesn’t.

Now Aetna has made my decision for me – I’m looking for other insurance. The problem I’ve encountered so far is that I’m an individual and almost no one offers individual plans in New York. There seems to be a virtual monopoly. In response to my inquiries, I’ve gotten calls from brokers offering me plans that are not insurance, but rather contracted discount rates with certain doctors (but they can’t tell me what doctors are actually part of their network). And all the brokers, upon hearing that I want actual insurance and that I’m an individual, inform me they have nothing to offer. “New York is difficult, and you’re just one individual.”

I said in my original post of this series that this would not be an insurance-bashing festival. I’m trying. But Aetna is making it very difficult to keep this from degenerating into an Aetna-bashing fest.

From Aetna’s website: We believe we can help create a better health care system. This belief drives our daily decisions as one of the nation’s leading health care benefits companies. We help people achieve health and financial security by providing easy access to cost-effective, high-quality health care.

Aetna raised my (and many others’) premium over 35% a month ago. Aetna’s CEO, Ron Williams, says if people are seeing large increases, it’s because medical costs are going up that much. My records, from Aetna, do not indicate large increases from my doctors or hospitals. I don’t believe the billing rate for my cancer doctors has changed since I’ve been with them (and I’m thinking, since they worked so hard and were so successful in keeping me alive, if anyone deserves a raise, it’s them!). According to Aetna’s own SEC filings, downloaded from their website, Aetna’s medical costs have only gone up around 15%.

If this weren’t so infuriating, it would just be ironic because I am actually exactly who Mr. Williams and other insurance executives say they want as customers. They want customers who are young and healthy and pay their bills, not people who wait until they’re sick to sign up.

I was in my mid-20s when I signed up. I was healthy, took very good care of myself, didn’t run to the doctor for every little cold, and I always paid my bill. Alright, I believe once I was late paying because I was traveling. Aetna gave me a pass that time since it was such an aberration. (that was back before this new crop of executives signed on – I wonder if they would be so understanding now?) True, I was unlucky enough to get run down by a bad taxi driver and then got breast cancer. But the business of insurance is about risk, isn’t it? That’s why they want more young, healthy customers, to lower the overall risk. On paper, I was exactly who they wanted. Since my treatment, I continue to take very good care of myself – after all, I do believe in personal responsibility. And I have been blessedly NED (no evidence of disease).

At this point, I must question Mr. Williams’, Mr. Zubretsky’s (CFO), and Mr. Berolini’s (President) strategic business plan for Aetna. If, in fact, you are in the business of insurance, which is all about risk, don’t you want to encourage your ideal customer to join you? Don’t you want more of your ideal customers – the customers who are young, healthy, responsible people? How, precisely, do you plan to attract more of those customers when you treat those of us who were exactly what you wanted with such callous disregard? Is this the better health system? For whom?

Again, I ask the shareholders of Aetna, what is your plan? Surely, you do plan to short your Aetna stock, right? I mean, is this in any way a sustainable business plan? The decisions of the executives you pay so handsomely (some might call obscenely) are bankrupting your current customers or driving them away. And those decisions are driving away potential new customers as well. How is this a good business model? Please explain.

To anyone else out there, got any good insurance suggestions?

Julie

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One Response to The Health Of Our Care – me, naked but for my slingshot

  1. marry says:

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