Product failure

When you pay for something, you expect it to work – especially if you’re forking over lots of money.

But as some of us know, procedures we thought were covered – in my case, a blood test — can end up costing us a lot more than we bargained for.

A new report, “The Illusion of Coverage: How Health Insurance Fails People When They Get Sick” is being released by the Boston-based Access Project today. (Read the report at http://www.accessproject.org/). The report details the stories of real people who have struggled with their insurance companies – and why.

One woman, who was diagnosed with multiple sclerosis, was denied coverage to go to a rehabilitation hospital. Instead, she got a walker. Naturally, she thought the walker was covered. It was not. She later received a bill for the walker as well.

One California man is struggling paying off a $150,000 equity loan that was used to pay for his late wife’s bypass surgery and pacemaker.

Reading through the report, you really get the sense of helplessness that an individual feels battling doctors, hospitals, collection companies and insurance companies all at the same time – while they’re recovering.

What gets me, though, is how many individuals blame themselves when they get into this situation. I had interviewed this California man with the $150,000 debt. At the time, he told me “Maybe we should have read the fine print,’’ and found out ahead of time about the $100,000 lifetime cap on his wife’s insurance. Or, he said, maybe she should have taken better care of herself.

Others have echoed the same things: “I wasn’t taking very good care of my weight,’’

When you buy a car, and your car doesn’t work, you don’t blame yourself for being too hard on the car or driving poorly. You drive straight back to the dealer and demand that it be fixed.

Many stores and companies stand behind their products and will refund your money or exchange the product.

But for some reason, insurance and health aren’t the same.

When health coverage doesn’t work, people end up with more hassles, more headaches – and debt. And many blame themselves.

The truth is, as the report details, the policies are written in confusing language, and often change from year to year. Employers and insurers don’t educate consumers about changes, leaving many in the dark about what exactly their policies cover.

Just as government steps in to protect consumers against “lemon’’ vehicles, we need the government to step in and protect consumers against “lemon’’ insurance policies.

Health Access California promotes quality, affordable health care for all Californians.

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