I've been selling employee benefit programs for the past 35 years. During that time I have listened to clients bitch about rate increases and occasionally a few claim problems. For the most part my clients have been more than satisfied with the benefits they received in return for their premium dollar. Most people would rather not collect a dime because they are healthy while others complain that their plan didn't cover some minor crap.
In the past couple of weeks I have been exposed to a couple of things that make me wonder how an insurance company could ever make a profit. A hunting guide/dog trainer friend of mine is a diabetic who is going through kidney dialysis. He is losing his eyesight. I have been taking him to an eye doc for shots (yep, in the eyes) once a month. These are covered but I don't have a clue how much the cost. The last time there the doc wanted to put a drop of something in each eye. $2,000 per drop! His insurance covered it all.
Today I went for my semi annual haircut. The gal that cuts my hair 13 year old grand son has a form of ecoli. This has had him hospitalized for 16+ days. They had to transfer him 90 miles from Sherman, TX to Dallas. Cost $10,000. I asked why they had air medavac him. She said that was in an ambulance. If he has ahus ecoli, there is a shot that "may" help him. The cost is $450,000. One shot. One time. It works or it doesn't. Insurance will cover all of this.
Both of these individuals have/will incurred claims in excess of $500,00-$750,000 which the insurance companies will reimburse the lions share.
How can insurance companies budget for these types of expenses? Perhaps it not the insurance companies that are to blame. Just maybe the providers have a say in this. Ya' think?