Monday, February 2, 2009

Workers Compensation? Not if you’re the Worker.

NRS 616D.030 Limitation of liability of insurer or third-party administrator; administrative fines are exclusive remedies.
1. No cause of action may be brought or maintained against an insurer or a third-party administrator who violates any provision of this chapter or chapter 616A, 616B, 616C or 617 of NRS.
2. The administrative fines provided for in NRS 616B.318 and 616D.120 are the exclusive remedies for any violation of this chapter or chapter 616A, 616B, 616C or 617 of NRS committed by an insurer or a third-party administrator.

The above provision in the Nevada Revised Statutes is a nasty bit of legislation designed to allow an insurance carrier to lie, cheat, steal, and even commit third-party murder and get away with it. Section 1 says that the policy holder cannot sue the insurance company or any of its agents even if they act in bad faith. Section 2 says that the fines the administration, read insurance commissioner, a politician reliant on the industry for his office, is all that can be done.
So, if a health insurance company or a workers compensation carrier decides that cheating a policyholder is more profitable than paying for desperately needed care, there is nothing the injured party can do. The Nevada Legislature, slave to dishonest business interests, said so.
As a Nevada Assemblyman, I was given a tour of the executive offices of Health Plan of Nevada, the state’s largest HMO. The office of HPN’s CEO was a single room larger than my house and outfitted in a splendor that would have embarrassed royalty. That is where the majority of your insurance premiums go. Why do you think the legal profession has made itself rich by building a business squeezing out a slightly larger award than what the insurance company wants to hand out?
An insurance policy is a contract and in any other circumstance a contract binds both parties equally. Somehow, in this case, the odds have shifted over toward one side. Now insurance is not a promise of coverage but more of a ponzi scheme. The policy holder saves a tiny percentage over what they may have paid for their loss while the CEO of the company issuing that coverage buys a new corporate jet.
One of the most prestigious hospitals in the world is the Mayo Clinic. That clinic is non-profit because those who started it felt that it would be immoral to profit off of peoples’ suffering. I tend to agree. In fact, the medical profession should no more be a path to wealth than being a pastor in a church. Health Insurance and Workers Compensation Insurance should also be non-profit industries. I ran a quick check of the numbers. If health insurance and hospitalization went non-profit and its staff was paid a decent wage, the cost of healthcare would drop by over 50%.
Some claim that if such a program were implemented, we would descend into the same morass that Canada’s socialized system endures. Not true, people would still have to pay, but they would be paying less for more. Not more for less, which is what we have now. All we would be doing is removing the sharks from the pool, and that is not a bad thing.

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