From Matthew Yglesias:
“It’s the logic of the system and on some level it’s no different from any other business. But whereas Apple or Toyota or Starbucks make money by delivering their products to people, insurance companies make money by not delivering health care to sick people.”
It sort of reminds me of Crash where Matt Dillon’s character can’t get his dad the medical help he needs. Of course part of the movie is that Dillon’s character is a racist jackass and therefore his own worst enemy in dealing with the system, but regardless his nemesis (the black woman he offends) is merely playing by the private health insurance rules by not approving care not included in the father’s coverage.
It’s the same anywhere in the insurance business, not paying a claim is the way to profit – even if the claim is 100% legitimate. Members of my family attempted to make a perfectly legitimate homeowners claim a few years ago and sure enough, the insurer attempted to use language that was patently absurd to re-categorize flooding as “seepage.” I’m just glad it was over a carpet and not, say, cancer that this problem occurred.