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You are here: Home / Healthcare / The Leopards Claim Another Party Member…

The Leopards Claim Another Party Member…

by Tom Levenson|  June 8, 202110:05 pm| 99 Comments

This post is in: Healthcare, Open Threads, Vouchercare, World's Best Healthcare (If You Can Afford It)

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There was this story in the Boston Globe a few days ago about a woman who switched from an Obamacare compliant plan to a “healthcare sharing ministry”–aka a Jesus be-draped sham plan:

Hargreaves, 58, of Chatham, a self-employed real estate agent, said the religious aspect of the plan was not the primary reason she chose it. She was shopping for savings.

Hargreaves said she had purchased traditional health insurance through a broker since 2015, but began discussing alternatives a couple years later when her premiums rose significantly. At the time, brokers were free to sell sharing ministry plans, and Hargreaves signed on to one such plan in March 2019 and switched to OneShare at the beginning of 2020.

So, not a religious move, but an economic one, which is fine; health insurance can be damn expensive in the Hub of the Universe, and lots of people try to save whatever they can.

But you can guess what came next.

For a while it worked, cutting her monthly premium by hundreds of dollars.

Then, in March, she had double hip-replacement surgery to relieve acute pain, followed by a four-day stay in the hospital and extensive physical therapy.

The surgery was successful, but Hargreaves’s “insurer” refused to cover any of the costs, saying her surgery was the result of a preexisting condition. She was saddled with nearly $75,000 in medical bills.

The Leopards Claim Another Party Member... 1

There are a couple of morals to draw from this utterly predictable tale. First is that “religious” business will be as vicious as any secular one in defense of the bottom line. Assuming otherwise is a mark’s move.

Another is that there is no such thing as a free lunch. If you buy “insurance” that says right on the box it isn’t insurance, well…

At the bottom of its website homepage, OneShare says it is not an insurer. In an e-mail, a spokeswoman for the nonprofit told me it’s different from a traditional insurer because it does not assume the risk of medical expenses incurred by its members, does not promise to pay expenses, and makes no guarantee of coverage.

Instead, it collects monthly “contributions” — the equivalent of premiums paid to insurers — from members and coordinates the payment of eligible medical expenses among members according to its own established rules.

This is why I do have some sympathy for Hargreaves. She is a minnow, swimming with sharks:

Still, the nonprofit shares some of the look and feel of an insurer with its offerings of various coverage packages with names like “Catastrophic,” “Classic,” and “Complete,“ each with a schedule of per-visit payments (looking a lot like copayments) and different in- or out-of-network rates. (Hargreaves has the “Complete” plan, which is the most comprehensive.)

And the operation does try to put plenty of lipstick on their pig:

Health care sharing ministry members have “a common set of ethical or religious beliefs and share medical expenses in accordance with those beliefs,” according to the exemption in the ACA. Many of them are aligned with Christian ideals or principles.

The OneShare website displays biblical quotations, including one about carrying “each other’s burdens.”

Maybe they’ll carry your groceries across the street, especially if your hips aren’t doing well…but there are clearly limits to “Christian” charity in this instance.

So, yeah: these not-insurance insurance scams are just that…fine if you don’t need them, a possibly fatal, certainly expensive shit show if you do. The good news in Massachusetts is that since 2020, these “plans” can’t be sold in the state by brokers or agents. You really have to work at it to get one now.

But that still leaves Hargreaves on the hook, and, as noted while I do have some sympathy for her circumstances–hell, a lot from one angle; $75,000 is a potentially life-wrecking sum to have to pony up–there are limits, and this detail in the story tests them:

Hargreaves assumed coverage would be routinely approved. Her ailment was degenerative, attributable to aging, not a preexisting condition, she said.

Hargreaves said she did not hear back from OneShare on her request for preapproval of coverage until the day before her surgery on March 4. She said she was shocked by the denial.

Hargreaves said the surgery went forward nonetheless, in the belief that coverage would be granted on appeal.

But it wasn’t. In its denial, OneShare focused on her 2019 checkup, when her primary care physician wrote that Hargreaves had “osteoarthritis in both hips,” based on Hargreaves’s own description of pain and reduced mobility.

It’s the “I’ll win on appeal” assumption that gets me. I can think of ways to describe the thoughts and emotional perspective that might lead one to bet on that assumption, but perhaps that should be an exercise for the commentariat.

And last, this line is the one that we all could have anticipated:

“If I knew [OneShare] was this difficult and restrictive, I would have stayed clear of it,” she said.

Well…

The Leopards Claim Another Party Member...

This thread: open is it. Is it? It is.

Image: Jean-Baptiste Oudry, Étude de léopard, c. 1732

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Reader Interactions

99Comments

  1. 1.

    Jim, Foolish Literalist

    June 8, 2021 at 10:11 pm

    Nobody knew healthcare could be so complicated.

  2. 2.

    RaflW

    June 8, 2021 at 10:12 pm

    There was a time in this country when at least a decent number of people understood that most regulations existed because someone previously had been scammed, harmed, or otherwise victimized by folks lacking scruples.

    But along came the Cato Institutes of this world, and the Saint Ronnie of Hollywood types, and many other hucksters. And we didn’t really have a regulation against hucksterism parading as politics.*

    Alas, here we are. Will the pendulum swing out of learned experience? Or will we continue to swirl the drain? I’m not very sanguine, but I’m not ready to give up.

    *Pesky Constitution plays some role. But so does a bizarro ‘money is speech’ ruling by other hucksters masquerading as Justices.

  3. 3.

    guachi

    June 8, 2021 at 10:17 pm

    Someone clearly doesn’t read her Daily Mayhew.

  4. 4.

    Chetan Murthy

    June 8, 2021 at 10:17 pm

    The reign of TFG has destroyed so many things, including many people’s ability to feel even one iota of compassion for Face-Eating Leopard Party voters.  I’m glad (for his sake) that Tom still has that ability.

  5. 5.

    John Revolta

    June 8, 2021 at 10:25 pm

    Wouldn’t a lot of insurance companies pitch a bitch though, if you signed up with them and then went in for double hip-replacement surgery two months later?

  6. 6.

    Chetan Murthy

    June 8, 2021 at 10:31 pm

    @John Revolta: before Obamacare, yes.  But (IIUC) for ACA-compliant policies, no.  That’s what “pre-existing condition protections” means.  They cannot deny coverage for care for a pre-existing condition.

  7. 7.

    debbie

    June 8, 2021 at 10:31 pm

    It’s the 1990s all over again.

  8. 8.

    Gin & Tonic

    June 8, 2021 at 10:34 pm

    Frankly, $75k for two hips seems like a bargain.

  9. 9.

    Jim, Foolish Literalist

    June 8, 2021 at 10:36 pm

    not a surprise I guess, but one time villainous Clintonite Neo-liberal Terry McAuliffe has handily won the Dem primary for the VA gov race.

    and for those who know who Lee Carter is…

    Dave Wasserman @Redistrict 2h
    Unless there’s some type of reporting error, Michelle Lopes-Maldonado (D) appears to have defeated Del. Lee Carter (D) in #HD50. This is Carter’s second defeat today.

    (he was also in the gov primary, and came in a fourth fifth you can’t see in your rearview mirror– edited)

  10. 10.

    John Revolta

    June 8, 2021 at 10:37 pm

    @Chetan Murthy: Yeah, by the time I got to the bottom I forgot that she had opted out of an Obamacare plan.

  11. 11.

    Gin & Tonic

    June 8, 2021 at 10:38 pm

    Anyway, my old man had a saying that poorly translates as “stupid people shouldn’t play cards.”

  12. 12.

    CaseyL

    June 8, 2021 at 10:38 pm

    Maybe I’ve missed something, but there doesn’t seem to be anything in the excerpt or the story itself that indicates Ms. Hargreaves is a GOPer, or opposed to the ACA.  She switched plans to save money.  That’s certainly a cautionary tale about buying insurance, but not necessarily a political one.

  13. 13.

    patrick II

    June 8, 2021 at 10:38 pm

    She might not have been thinking that pre-existing conditions are a problem anymore since there has been so much publicity about it in the last few years. I did not realize that the law was specific to ACA policies and not the law in general.

    Also, pain in both hips doesn’t normally come on overnight.  If I was thinking about surgery it would not be a good time to switch to cheaper insurance.

  14. 14.

    M31

    June 8, 2021 at 10:41 pm

    good old-fashioned affinity fraud

  15. 15.

    debbie

    June 8, 2021 at 10:48 pm

    @patrick II:

    At 58 years old, her strategy seems … non-strategic.

  16. 16.

    Chetan Murthy

    June 8, 2021 at 10:49 pm

    @patrick II:

    I did not realize that the law was specific to ACA policies and not the law in general.

    IANAInsuranceGuy, but IIRC, the law said that all health insurance policies had to have certain attributes (e.g. pre-existing condition protections, community rating, limits on profits), and only really short-term policies could lack them.  But then TFG came in, and opened up that latter category a whole bunch — they’re called “affinity” or “association” health plans, or some such.  The *responsible* thing to do, was to continue going to the Obamacare marketplace.

  17. 17.

    dnfree

    June 8, 2021 at 10:52 pm

    @patrick II: pre-existing conditions is the law for any insurance, not just the ACA. What she bought was explicitly not insurance. She didn’t understand the reason for the distinction.

  18. 18.

    Tom Levenson

    June 8, 2021 at 10:52 pm

    @CaseyL: You’re right, and I didn’t mean to imply that she was a GOPster.

    It’s just her assumption that they would see the light and pay her claim once she explained it all to them.

    It’s the assumed specialness that seemed to make her a Leopard Face-Eating-Party member.

    Perhaps a better way to see it, now that I think on it, is this is what happens when you bring late-stage-capitalism’s emphasis on quarterly or even weekly numbers into personal finance.

  19. 19.

    Chetan Murthy

    June 8, 2021 at 10:54 pm

    @dnfree:

    She didn’t understand the reason for the distinction.

    And yet

    At the bottom of its website homepage, OneShare says it is not an insurer.

    There’s that old saying: “if it sounds too good to be true, it probably is”.  Lotta people doing a lotta wishful thinking instead of being careful and cynical.

  20. 20.

    Chetan Murthy

    June 8, 2021 at 10:55 pm

    Reading the Globe article, I learned that she was buying insurance thru a “broker”.  I mean ….. she’s a real estate agent: doesn’t she have even an *iota* of comprehension that going to a salesman for your critical health needs isn’t a good way to ensure you get honest answers?  Crrrikey.

  21. 21.

    RaflW

    June 8, 2021 at 10:57 pm

    @Chetan Murthy: Yup. And before the GOP and their operatives weakened it by ending the mandate, overall the insurance world was ok – because even if you changed policies two months before the surgery, you were paying into the system — writ large — even if not this company.

    Hopefully, for each person who switched in and then needed big care, someone else switched out. I’m sure Mayhew on Insurance can explain that smart people even then were going from Tin plans to Double-Platinum right before big expenses, and I’m sure that’s true, while many others didn’t.

  22. 22.

    Gvg

    June 8, 2021 at 11:04 pm

    It sounds to me like the not insurance was doing a whole lot to look like insurance and only putting in small inconspicuous disclaimers. It acted exactly like insurance with copays and all. I think it was intentionally on their part and fraud. Whether the states AG or insufficient commission can prove it and has the will to is the question. There are plenty of people who are below average intelligence and that doesn’t mean it’s OK to allow con men to go after them. Also people get tired and worried about money and have a lot of other competing responsibilities that can take away the time to notice a scam. Society needs to prosecute companies like this. Also herbal supplements and a bunch of other fraud.

    And it can happen to you and yours too, if you don’t weed bad apples out before they take over the whole ecosystem. People get less mentally sharp as they get older. It is not a good idea to just let con games happen.

  23. 23.

    Steeplejack

    June 8, 2021 at 11:05 pm

    @John Revolta:

    According to the story, she “switched to OneShare at the beginning of 2020,” over a year before the operation.

  24. 24.

    Ken

    June 8, 2021 at 11:08 pm

    @Gin & Tonic: Anyway, my old man had a saying that poorly translates as “stupid people shouldn’t play cards.”

    My favorite is “If you sit down at the table and can’t tell who’s the mark, you’re the mark.”

  25. 25.

    CaseyL

    June 8, 2021 at 11:10 pm

    @Tom Levenson: Ah, I see.

    Clearly she doesn’t remember what things were like pre-ACA, when “mainstream” insurance companies routinely pulled the same crap.  Or worse crap, like rescission.

  26. 26.

    Chetan Murthy

    June 8, 2021 at 11:13 pm

    Too many people think that their health insurance should cost a pittance and be gold-plated.  Anybody with half a brain can see that the health care biz is about 10% of the economy, so their health insurance ought to be *at least* 10% of their gross income.  And then b/c of families and such, some of us will pay more (as singles).  It’s ….. unpleasant but fucking obvious.

    But hey, she’s a *real estate agent*: her *job* is to pick people’s pockets (like all relationship salesmen) so I get it: she thinks somehow she can magick a good outcome for herself.

  27. 27.

    Nettoyeur

    June 8, 2021 at 11:15 pm

    It could have been even worse. My second hip implant got infected a few weeks after the operation. This is a rare complication (~0.1% of cases) but potentially VERY serious. So more surgery, plus two months on a wound vacuum pump with IV antibiotics, plus months more of follow up, plus months of physio. The pre insurance cost for all this (which I saw ) was ~ $200K. Insurance contracts lowered that, and I paid only the remainder of that year’s out of pocket max, maybe 3K. Lack of proper insurance is life threatening.

  28. 28.

    David ? ☘The Establishment☘? Koch

    June 8, 2021 at 11:16 pm

     She was saddled with nearly $75,000 in medical bills.

    She should ask Mexico to pay for it

  29. 29.

    Suzanne

    June 8, 2021 at 11:22 pm

    It’s the “I’ll win on appeal” assumption that gets me.

    WTF I don’t have any conception of this line of thinking.
    As someone who always thinks she’s gonna get fucked over in, like, every situation ever…. I do not understand the blithe confidence, like, at all.

  30. 30.

    Chetan Murthy

    June 8, 2021 at 11:24 pm

    @Suzanne:

    I do not understand the blithe confidence, like, at all.

    It is a necessary part of being a salesman.  E.g., TFG.

  31. 31.

    Suzanne

    June 8, 2021 at 11:29 pm

    @Ken: I am anxious, and probably a misanthropic douchebag…. But I never assume that I will ever get lucky. Maybe I should more often, because I’m not in a bad position, by any means. I would probably be happier. But I would also be dumber.

  32. 32.

    John Revolta

    June 8, 2021 at 11:35 pm

    @Steeplejack: Well I just assumed that “in March” referred to that same year. In my defense, I haven’t been the same since I saw <a href=”https://twitter.com/AmazingPosts_/status/1399444495410864128″this thing.​

  33. 33.

    Jim, Foolish Literalist

    June 8, 2021 at 11:38 pm

    @John Revolta: Can you imagine if those birds could be kept as… well, not pets.

    “Smithers! Release the shoebills!”

  34. 34.

    Mart

    June 8, 2021 at 11:46 pm

    @John Revolta: Not an expert but think no they won’t pitch a fit if in a non-“skinny” plan. ACA extends pre-existing condition coverage to employer and most ACA plans. Thanks to tfg & the turtle they were able to revise bill to allow skinny plans; which is what I think this woman bought. Think this was added when they ditched the mandate that they used to try and have the USSC to scuttle the entire ACA. Who says R‘s can’t legislate for the little people?

  35. 35.

    eclare

    June 8, 2021 at 11:59 pm

    @John Revolta:  That bird is terrifying to look at, let alone hear!

  36. 36.

    Kent

    June 9, 2021 at 12:04 am

    @Chetan Murthy:The reign of TFG has destroyed so many things, including many people’s ability to feel even one iota of compassion for Face-Eating Leopard Party voters.  I’m glad (for his sake) that Tom still has that ability.

    This is actually one of the things for which I am most resentful about Trump.  I dislike the fact that I no longer give the slightest fuck about any of my MAGA relatives when I used to care about them to some extent at least.   He has poisoned even that.

    I swear to God, the first time one of my “vaccine hesitant” MAGAt cousins gets Covid and dies this fall, long after Covid is a preventable disease I’m going to be on Facebook with “Well, on the bright side, at least he didn’t have to suffer from any vaccine side effects”

    Sheesh.

  37. 37.

    Omnes Omnibus

    June 9, 2021 at 12:08 am

    @Mart: No, health care sharing ministries have been around for a while.  Membership in one provided a exemption to the ACA’s individual mandate.

  38. 38.

    Kent

    June 9, 2021 at 12:10 am

    @patrick II:She might not have been thinking that pre-existing conditions are a problem anymore since there has been so much publicity about it in the last few years. I did not realize that the law was specific to ACA policies and not the law in general.

    The pre-existing conditions law does apply to all insurance as part of the ACA.

    What this woman bought was not health insurance.  It was a religious-affiliated scam designed to look like insurance.  That Trump opened the door for in the guise of “religious liberty” and pandering to the fungelical base.

  39. 39.

    Omnes Omnibus

    June 9, 2021 at 12:14 am

    @Kent: Not quite.  As I mentioned above, healthcare sharing ministries have been around since before Trump.

  40. 40.

    different-church-lady

    June 9, 2021 at 12:18 am

    I’d say I don’t have any sympathy for her, except that even normal “above-board” insurance companies make it utterly impossible to find out what you’re really buying, whether your care is covered, how much of it you’re on the hook for, and who you’re supposed to be able to get this information from. So in most ways it probably didn’t seem any different from legit insurance on the surface.

  41. 41.

    eclare

    June 9, 2021 at 12:23 am

    @Omnes Omnibus:  Are they considered a 501(c)(3)?

  42. 42.

    Kay

    June 9, 2021 at 12:24 am

    These “sharing” plans have been around for a while but they really took off under Trump. 

    This article says there are at least 5 states investigating the plans- Washington has already sanctioned some of them and imposed fines for misleading advertising, but I don’t think a 150k fine is even going to slow them down. They have to hammer them or they’ll keep ripping people off.

  43. 43.

    Omnes Omnibus

    June 9, 2021 at 12:29 am

    @eclare: To be exempt from the mandate, they needed to be.

  44. 44.

    eclare

    June 9, 2021 at 12:34 am

    @Omnes Omnibus:  Thanks.

  45. 45.

    Kay

    June 9, 2021 at 12:35 am

    I just love this, I must say. We’ll scream and yell to get a religious exemption to regulation and then IMMEDIATELY use that to trick people and rip them off.

    These are the exact people regulations were invented for – they’re the bottom 10% who have to be watched constantly.

    Insurance regulation came about because of abuses in life insurance – they didn’t have the reserves necessary to pay the claims. Those were “religious” plans too. 70 years later and they’re running the same scam except health insurance.

  46. 46.

    Another Scott

    June 9, 2021 at 12:37 am

    @Gvg: +1

    As we discuss on Mayhew’s posts, even experts cannot pick out optimal insurance plans.  We should not go easy on those who swindle while pretending to be wrapped in the protection of “religion”.

    Cheers,
    Scott.

  47. 47.

    Mary G

    June 9, 2021 at 12:41 am

    @Gin & Tonic: This, my bill for one hip replacement in 2008 was $60,000, and nothing unusual happened except blood transfusions due to chronic anemia. Between Medicare and my gold-plated supplement (expensive but worth it for my chronic conditions) I paid zero, nada, nil, nothing.

  48. 48.

    Omnes Omnibus

    June 9, 2021 at 12:42 am

    This is an explanation of these plans vs health insurance from the horse’s mouth.  You have to pretty much either buy into the religion bit or not look past the price.  They basically tell you they will fuck you over if they get a chance.

  49. 49.

    eclare

    June 9, 2021 at 12:50 am

    @Omnes Omnibus:  Wow, I can’t believe anyone signs up for them.  No guarantees of any coverage.

  50. 50.

    Omnes Omnibus

    June 9, 2021 at 12:54 am

    @eclare: Inorite?

  51. 51.

    ?BillinGlendaleCA

    June 9, 2021 at 12:57 am

    @Omnes Omnibus: Ya gotta have Faith.

  52. 52.

    Mary G

    June 9, 2021 at 12:57 am

    This has just made me see red. The Bolsa Chica Ecological Reserve was kept preserved from development with battles that were going on in 1959 when we moved to the OC. It is a wondrous place if you know what you are seeing, and the last big coastal wetland in Southern California, full of species that are almost extinct elsewhere. Kevin Drum posts photos from there a lot.

    Some idiot illegally flying a drone there crashed it:

    Eggs littered the sand, but there was no sign of life around or in them.

    The seabirds that should have been keeping watch had taken off, terrified by a drone that crash-landed into their nesting grounds on an island at the Bolsa Chica Ecological Reserve.

    “We’ve never seen such devastation here,” said Melissa Loebl, an environmental scientist who manages the Huntington Beach reserve. “This has been really hard for me as a manager.”

    Some 3,000 elegant terns fled the reserve after the drone crashed May 12, leaving behind 1,500 to 2,000 eggs, none of them viable. It was the largest egg abandonment that scientists who work there can recall.

    The terns are not an endangered species (yet) but have only four nesting grounds and this year have not used one in LA County that may be too close to humans, so this means the loss of at least half a generation of these beautiful guys.

    eta: forgot the LA Times link, which is in the tweet below, along with a picture of the birds, which for some reason the LAT didn’t include in its story.

    Some 3,000 birds known as elegant terns — fled an Ecological Reserve in SoCal after a drone crashed there, leaving behind 1,500 to 2,000 eggs. These birds have very limited locations where they can breed. https://t.co/QvqkbPKQig pic.twitter.com/kfwKUPRU6k— chris evans (@chris_notcapn) June 9, 2021

  53. 53.

    patrick II

    June 9, 2021 at 1:06 am

    @Omnes Omnibus: ​
     

    Compensation guarantees: traditional insurance companies are held to the guarantee that they will compensate their members in return for a monthly premium payment. When it comes to Christian Healthcare Sharing programs, this guarantee does not exist.

    You weren’t kidding. They straight out say can’t be counted on to pay the bills.

  54. 54.

    eclare

    June 9, 2021 at 1:07 am

    @Mary G:  Infuriating and sad.  Hopefully police can catch the operator.

  55. 55.

    lgerard

    June 9, 2021 at 1:08 am

    In the plus side, OneShare has a Prayer Line

    I’m sure Ms. Hargreaves can get her moneys worth from that feature

  56. 56.

    JCJ

    June 9, 2021 at 1:23 am

    @Omnes Omnibus: yup.  I have a current patient going through “total neoadjuvant therapy” for rectal cancer with this type of insurance.   This consists of FOLFOX chemotherapy followed by chemotherapy with radiation and ultimately surgery.  The total  bills will be enormous.

  57. 57.

    Omnes Omnibus

    June 9, 2021 at 1:24 am

    @?BillinGlendaleCA: She was one of my  favorite characters on Buffy.

  58. 58.

    Delk

    June 9, 2021 at 1:27 am

    I just can’t imagine having double hip replacement in March. I waited until last week to have my teeth cleaned.

  59. 59.

    Anotherlurker

    June 9, 2021 at 1:34 am

    @Omnes Omnibus: Reading that explanation, right from the Grifters mouth has caused me to vomit up a good meal.  They  tell the marks exactly what they are yet these sheep still sign up.

    I have no sympathy for the fleeced.  Flock of sheep, indeed.

  60. 60.

    ?BillinGlendaleCA

    June 9, 2021 at 2:02 am

    Great shot on APOD that I wanted to take of the lunar eclipse, but couldn’t due to cloud cover that extended over pretty much all of Southern California.  A photographer from Australian got the shot.

  61. 61.

    Dan B

    June 9, 2021 at 2:11 am

    @?BillinGlendaleCA: Gorgeous photo on just aesthetician merits but in addition the process of creating it and the cause of the “corona” is fascinating.  It also looks as though it’s not real, not possible.

  62. 62.

    KrakenJack

    June 9, 2021 at 2:15 am

    @John Revolta: Could be handy on a drug lord estate, however…

  63. 63.

    ?BillinGlendaleCA

    June 9, 2021 at 2:16 am

    @Dan B: I’ve shot lunar eclipses before, the moon gets very dark and the stars near it become visible, that shot is exactly what I was expecting to see and shoot, but clouds(shakes fist).  My shot would have also included some foreground since the moon was pretty low in the sky here.

  64. 64.

    The Pale Scot

    June 9, 2021 at 2:35 am

    @Suzanne:

    I am anxious, and probably a misanthropic douchebag…. But I never assume that I will ever get lucky.

    Are you single? I’m sensing a connection

    :)

    Weren’t there emoticons available in this function?

    (Not that I’d know how to use them)

  65. 65.

    Ruckus

    June 9, 2021 at 2:44 am

    @Suzanne:

    If I didn’t have bad luck, I’d have no luck at all.

    So, a pretty lucky guy…..

    On second thought, that’s a bit much. Just a bit.

    One of the things is though, most of the people I know have good things and bad things happen to them. Sometimes it’s their fault, sometimes it’s not. There are people who are exceptionally lucky in a positive way and those who are exceptionally unlucky. I’m probably in the middle.

  66. 66.

    The Pale Scot

    June 9, 2021 at 2:46 am

    @Omnes Omnibus:

    They basically tell you they will fuck you over if they get a chance.

    On the plus side I really don’t have a problem with this. It’s Evolution in Action. If your superstitious beliefs are so irrational, well too bad for you. The world is likely better off

  67. 67.

    Enhanced Voting Techniques

    June 9, 2021 at 3:16 am

    Then, in March, she had double hip-replacement surgery to relieve acute pain, followed by a four-day stay in the hospital and extensive physical therapy.

    After what mother went threw, hip replacement isn’t some unexpected surgery.

  68. 68.

    Enhanced Voting Techniques

    June 9, 2021 at 3:21 am

    @RaflW: There was a time in this country when at least a decent number of people understood that most regulations existed because someone previously had been scammed, harmed, or otherwise victimized by folks lacking scruples.

    Those people lived threw the Great Depression and WWII and got to see first hand the kind of damage this crap does. Meanwhile their children utterly convinced themselves that their parent’s generation was just hidebound, scared of change and hated fun.

  69. 69.

    Sloane Ranger

    June 9, 2021 at 3:33 am

    @Delk:

     

    I just can’t imagine having double hip replacement in March. I waited until last week to have my teeth cleaned

    I had osteoarthritis in one hip and I would have gone ahead even if they’d scheduled my surgery in the middle of a battlefield. It was bloody agony!

  70. 70.

    Delk

    June 9, 2021 at 3:46 am

    @Sloane Ranger:  I had one hip replaced already and need the other one done. Three decades of various HIV meds have destroyed my bone density. Not doing much walking the past year has bought me some time so I’m aiming for nest spring for the second replacement. Hope your replacement was successful in relieving your pain!

  71. 71.

    Baud

    June 9, 2021 at 4:23 am

    Balloon Juice should have non-insurance plan.

  72. 72.

    ?BillinGlendaleCA

    June 9, 2021 at 4:24 am

    @Baud: Then we won’t have to have ads.

  73. 73.

    Mary G

    June 9, 2021 at 4:48 am

    This is a lovely thread about a daughter using Twitter to try to get her dad his dream job at Costco:

    my dad has been laid off due to covid and now that he's vaccinated he's itching to go back to work, so i told him i'd help him with his resume. i asked him where he wants to work, and he said, SO earnestly, "costco seems like a nice place" i'm gonna cry lol— rebecca mix, proud daughter of a costco employee (@mixbecca) May 6, 2021

  74. 74.

    NotMax

    June 9, 2021 at 4:48 am

    @Dan B

    It also looks as though it’s not real, not possible.

    “All photographs are accurate. None of them is the truth.”
    — Richard Avedon
    .

  75. 75.

    VeniceRiley

    June 9, 2021 at 4:54 am

    I don’t know what I would have done to preserve income flow if faced with a global pandemic lockdown while living on commissions. But this lady? WTF if you cannot wait for open enrollment to come back around. LOL at win on appeal.

  76. 76.

    eclare

    June 9, 2021 at 4:54 am

    @Mary G:  How sweet!

  77. 77.

    Sloane Ranger

    June 9, 2021 at 5:00 am

    @Delk: The relief was amazing! No complications and I can now walk without any pain at all but my gait is better, as I had been born with a dislocated hip, which was the reason for the osteoarthritis.

    The only problem now is that I am out of condition – lockdown!

  78. 78.

    rikyrah

    June 9, 2021 at 5:25 am

    @Mary G:

    Just dust????

  79. 79.

    germy

    June 9, 2021 at 6:05 am

    Sure, you say you want healthcare, but what you really want is a rich man in a spaceship.

    — Kristopher Michael Wood feat. Pfizer Vaccine (@KristopherWood) June 8, 2021

  80. 80.

    Ramalama

    June 9, 2021 at 6:07 am

    @CaseyL: Right. How do we know she’s of the Leopard Face Eating society of America?

  81. 81.

    Chris Johnson

    June 9, 2021 at 6:48 am

    @The Pale Scot: The thing is, even if the people are so bad that they don’t deserve to be protected from horrible con artists… which is debatable… the con artists sure as FUCK don’t deserve to easily prey on people like that and prosper.

    Letting the dumb people get basically devoured, makes the con artists entitled and bold, and they start acting like they own the place and teaching other people to be like them, and reconfiguring everything to cater to themselves.

    Fuck that noise.

    CAGE the fucking leopards.

  82. 82.

    Booger

    June 9, 2021 at 6:57 am

    JESUSCARE! We offer you…NOTHING! And pass the savings on to…US!!

  83. 83.

    Chief Oshkosh

    June 9, 2021 at 8:38 am

    @Gvg: There are plenty of people who are below average intelligence

    Yes, exactly 50% minus one person.

  84. 84.

    Chief Oshkosh

    June 9, 2021 at 9:06 am

    @Mary G: Sounds like state and county need to get the FAA to change the airspace designation. At some level of use, drone flying requires FAA certification. It’s basically a form of what is commonly referred to as a pilot’s license. It’s a real thing. FAA also has purview over airspace. Doesn’t really matter what signage LA County has up about a wildlife preserve. If they want to stop drone flights, they need FAA to designate the airspace as such. And that’s just to “keep the honest man honest.

    ETA: And to be clear, I see red about this sort of thing, too. I HATE drones (unless I’m watching a YT vid made using a drone…), for this and privacy reasons and safety reasons, and…

  85. 85.

    brantl

    June 9, 2021 at 9:22 am

    @John Revolta:  Sure, but they would still have to pay it.

  86. 86.

    brantl

    June 9, 2021 at 9:23 am

    @Gin & Tonic: It is, If I hadn’t been insured, the single I had in 2007 would have been $45,000.

  87. 87.

    fancycwabs

    June 9, 2021 at 9:44 am

    …“religious” business will be as vicious as any secular one in defense of the bottom line.

    In my experience, “religious” business is far more vicious than secular business, because it expects employees and customers to make sacrifices in order to support the “mission” of the business, which is generally the enrichment of the business owner with some charity work thrown in.

  88. 88.

    matt

    June 9, 2021 at 10:11 am

    If they’re babbling about religion while selling you their product, it’s probably a rip off.

  89. 89.

    Ruckus

    June 9, 2021 at 10:15 am

    @Enhanced Voting Techniques:

    Those young people also didn’t seem to understand how much the world had changed from when their parents were born to when they were. And yes the major things changed life, but I’m also talking about the less obvious things, the day to day life, job safety, job stability, housing, the economy, education, the automobile, etc. All of them changed, some rather a lot. My parents generation, those born over 100 yrs ago saw changes, hell I’ve seen a lot of changes in those things and more sense I was born, in the first half of the last century. Medicine, education, are two more that have changed a lot. And even as the heads in the sand (or up their asses) people try to go back to crappy times, far more are not willing to make that trip.

  90. 90.

    Ruckus

    June 9, 2021 at 10:20 am

    @matt:

    That probably is doing a hell of a lot of work. Look at the businesses that religions are in – hospitals for one – they likely will not allow practices that are legal and normal now because they “interfere” with their beliefs, even though they take public money. If a religious owned hospital is all you’ve got, you likely are being denied legal heath care practices.

  91. 91.

    apocalipstick

    June 9, 2021 at 10:44 am

    @Gvg: I know people who are in these systems. They specifically state that they are not insurance; they are “associations” (many/most faith-based) that are not obligated to pay for any services. One family had a son who required ACL surgury. He was an all-state basketball player; there were no issues with payment. It seems everyone wants to help an All-American boy. Other folks with mental health or long-term diagnoses (think diabetes) caused the good folks of faith to decide they didn’t want to shell out. Don’t even ask what happens if you have a child with autism.

    IANAL, but these are less frauds and more “wow, sucks to be you” operations.

  92. 92.

    apocalipstick

    June 9, 2021 at 10:53 am

    These faith-based associationa are also about to become fat targets for vulture capital, at least I think so. When an FBA is $300,000-400,000 total, it’s small potatoes. Let it rise to $30,000,000 and it becomes attractive. Remember, HMOs were a smart alternative some 35 years ago when they were new and small. Once they became consequential players, the buzzards smelled money and began to alight.

  93. 93.

    dp

    June 9, 2021 at 11:50 am

    I never realized that coverage for pre-existing conditions was a matter of theological contest.

  94. 94.

    JAFD

    June 9, 2021 at 12:03 pm

    @Gin & Tonic: Best advice I ever got from my father:

    “Never play cards for money with people who don’t have to work for a living.”

  95. 95.

    Jess

    June 9, 2021 at 12:55 pm

    It’s the “I’ll win on appeal” assumption that gets me. I can think of ways to describe the thoughts and emotional perspective that might lead one to bet on that assumption, but perhaps that should be an exercise for the commentariat.

    She does sound generally…unwise. However, chronic pain and immobility, and the sleeplessness that goes with it, will undermine anyone’s judgement and common sense. At that point, the day before surgery (which takes time and a lot of hoop jumping to set up), I’m sure all she could see was the blessed relief of pain on the other side, and all else faded into insignificance. I’m surprised the hospital went forward with it, though, since it’s unlikely they’ll recover the full payment.

  96. 96.

    planetjanet

    June 9, 2021 at 1:20 pm

    @Jim, Foolish Literalist: ​
      Carter has always been more interested in getting attention than affecting change. Congrats to Michelle Maldonado, another woman who is also POC.

  97. 97.

    Feckless

    June 9, 2021 at 1:28 pm

    Where’s your God now, eh Moses?

    She shoulda listened to Edward G.

  98. 98.

    Gemina13

    June 9, 2021 at 1:49 pm

    @Nettoyeur: ​ I had triple-bypass surgery last December. Two months later, the incision got infected, and I had to go back for an exhision of the tissue. The cost of both surgeries, plus the wound-vac, antibiotics, and new medication cost around $90K. I have excellent insurance through my job, but I also pay a pre-tax amount for the coverage. It’s about what I’d pay for an ACA Silver plan. I don’t care, because I’m still paying off the $29K from a thyroidectomy back in 2013, when I had *no* insurance.

  99. 99.

    susanna

    June 9, 2021 at 2:23 pm

    Tom, good article, with informative comments.

    To me, this is all about decency and regulations, particularly regarding necessity of both by corporations, politicians, etc., which is assumed to be for the general, greater good (for?).

    The Bank sent a letter out within this past year.  Lots of small print.  One was that if the bank makes a mistake, it is the account owner who is responsible for finding and alerting said bank of the error.  Secondly, that must be done within 14 days, again shortening the time from previously changed limits.  Long cry from another letter I came across dated in the 1990s from the bank informing me that some of my check numbers weren’t ‘in order.’

    It takes little to find out about your own bank.  Then check out the shenanigans at Wells Fargo some years ago (twice, I believe!!?) and you get the winner/loser aspect, and who came out waaay ahead.  I swear, those who get to the top or near to it in large corporations or politics are  greedy and personally jaded from having to sell their values out along the way.

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