Comment by jeffwass | Hacker News Reader

Comment by jeffwass | Hacker News Reader

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"Once again: the worst that an insurance salesperson can do is sell you bad insurance. They're not actually involved in medical procedures, so any harm they can do is financial."

Sorry, there are very clear knock-on health effects here you're sweeping under the rug. Eg, if you're expecting to be covered for an urgent emergency life-saving procedure. Maybe you personally have sufficient cash on hand to pay for any required emergency surgery, that doesn't mean it's just a 'financial' problem to everybody else.

Do you really think it's appropriate to have someone be denied a medical procedure, and hope they survive so they can go through a legal challenge afterwards for 'fraud', and hope they can successfully provide proof of fraud over incompetence based on some phone conversation several years ago?

Instead of the much simpler solution of requiring some minimum license for the insurance seller?

I'm not sure about your online purchase example. Are you 100% sure these are the same insurance products requiring licenses as mentioned in the article, that no human sanity checks the product during the purchase process, or that the online algorithm itself didn't go through a sufficient license-compliant certification process?

> if you're expecting to be covered for an urgent emergency life-saving procedure

You will never be refused emergency treatment just because your insurance doesn't cover it. That's the law in the United States.

You will get a huge bill afterwards and there will absolutely be financial consequences, but not medical ones.

It's illegal for a hospital ER to refuse you due to lack of sufficient insurance. The point is that you won't die, so you will be around to come back and sue the broker. (In fact, insurance lawsuits are super common.)

Not to mention that we're dealing with a hypothetical case where you do actually have insurance but it's somehow insufficient (which, by the way, is unlikely under Obamacare). In that case, you would absolutely get treated, but your insurer would refuse to cover the bill and would pass it on to you. You could then sue Zenefits for misrepresenting the product and seek damages to cover the bill.

> same insurance products requiring licenses as mentioned in the article

They're not the same in that I'm talking about individual insurance and the article is group insurance, but that's irrelevant to the point. If there are serious medical consequences to buying insurance without licensed supervision, I shouldn't be able to buy my own insurance online.

FYI I believe they meant emergencies as in, any kind of medical service or procedure that your life may depend on. Which does not automatically mean the "emergency room." I.e. a much-needed surgery, drug, testing, etc.

This happens all of the time, people cannot go see a doctor or receive a medication because of an insurance goof up. And then they have to wait. And wait. And legal remedies are not guaranteed to solve the problem, and such remedies should not be relied upon as a fallback for untrained insurance salespeople.

What exactly are you trying to convince us of? That insurance sales should be have no licensing requirements? And you're hinging your argument on the fact that it is "financial" and not "health" related (which like I said above is not true). In that case are you also in support of getting rid of licensing and other regulations in the banking and finance industry?

   You will never be refused emergency treatment just because your insurance 
   doesn't cover it. That's the law in the United States.
   You will get a huge bill afterwards and there will absolutely be financial 
   consequences, but not medical ones.

Even ignoring the financial consequences, you literally have no idea what you're talking about. Hospitals are required to patch you up this second, yes -- but they don't have to treat underlying conditions until you're going to die from them. Regardless of how much damage that does. You can certainly die of very treatable diseases. Need a ct/mri, blood scans, cancer tests? Well, unless you're going to die of it this second, a hospital is not (and often won't) required to perform them.

The law you're citing -- EMTALA -- merely requires hospitals to stabilize patients.

> The law you're citing -- EMTALA -- merely requires hospitals to stabilize patients.

Yes, and that's what's necessary in an "urgent emergency."

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