Thursday, June 18, 2009

Meet Some Slippery Weasels Who Run The Health Insurance Industry


Why do Americans have so much mistrust for their for-profit insurance companies-- almost as much, in fact, as they mistrust congressional Republicans? Yesterday, after a year long investigation, the Energy and Commerce Subcommittee on Oversight and Investigations held a hearing on rescissions of coverage after policyholders become ill. Bart Stupak (D-MI) questioned 3 insurance company CEOs whose companies were responsible for 20,000 individual insurance policyholders having had their policies rescinded in the past year. One of the slippery weasels-- at least one of them (WellPoint)-- has an internal policy in place that evaluates employee performance (i.e., suitability for bonuses and even retention) partially based on the amount of money the employees saved the company through retroactive rescissions of health insurance policies. In other words, those lovely bureaucrats who ill people have to deal with on the phone and who seem better equipped to have worked for Dick Cheney in Guantánamo, are incentivized to deny treatment. These are who have bought out members of the Senate like John McCain ($2,895,602), Ben Nelson ($1,196,799), Max Baucus ($1,184,113), Arlen Specter ($1,035,530), Joe Lieberman ($1,036,302), Mitch McConnell ($929,207), Chuck Grassley ($884,724), Kent Conrad ($824,837), Jim Bunning ($781,016), Orrin Hatch ($661,807) and other declared opponents of a single-payer health care system-- or even the compromise position of a public option! Oh, and Blanche Lincoln ($456,533), who is remarkable not because she's gotten millions over her career but because this year-- the health insurance industry's crunch year-- they've decided to focus in on her, a well known shill for any corporate entities willing to write big enough checks, and have given her the second largest amount in donations of any member of the Senate! They're counting on Blanche to cross over to the Republican side of the aisle and vote for the Insurance Industry agenda, not matter how badly it hurts Arkansas working families. Would she do that? You bet! She always does. And that's why Blue America is busy producing TV ads for saturate the Arkansas air waves with. I know I've mentioned it before, but could you consider chipping in on our Blue America Health Care page?

Of course, there are some people who think the health care system is working just fine-- or can just use a little tinkering around the edges like the GOP is proposing-- and then Blue America's accountability initiative is probably not for you. The chair of the committee, Henry Waxman, explained how the for-profit insurance system is a dysfunctional mess:
One of the biggest problems is that most states allow insurance companies to deny coverage for people with preexisting conditions. So if you lose your job, and you can’t qualify for a government program like Medicare or Medicaid, it’s nearly impossible to get health insurance if you are sick or have an illness.

This creates a perverse incentive. In the United States, insurance companies compete based on who is best at avoiding people who need life-saving health care. And this incentive manifests itself in a wide range of controversial practices by the insurance companies.

When people with individual policies fall ill and submit claims for expensive treatments, some insurance companies launch investigations. They scour the policyholder’s original insurance application and the person’s medical records to find any discrepancy, any omission, or any misstatement that could allow them to cancel the policy.

They try to find something-- anything-- so they can say that this individual was not truthful. It doesn’t have to relate at all to the medical care the person is seeking, and often it doesn’t. You might need chemotherapy for lymphoma, but the insurance company can cancel your coverage because you failed to disclose your gall stones.

It may come as a surprise to most people, but the insurance companies believe they are entitled to cancel policies even when these omissions or discrepancies are unintentional. They believe they have the right to cancel policies even when someone else, like the agent who sold their policy, was responsible for the discrepancy in the first place. In addition, they can terminate coverage not just for the primary policyholder, but for the entire family, including innocent children who did nothing wrong.

While sleazy political operators like Ben Nelson, Chuck Grassley, Mitch McConnell, Joe Lieberman, Arlen Specter, John Cornyn, Blanche Lincoln and Tom Daschle earn their keep by undermining health care reform-- many wonder about Obama's commitment to real health care reform (watch the video below)-- polling consistently shows that the American public wants it. One poll today shows that 83% of Americans want the public option, regardless of all what all the pompous, paid off shills in the House of Lords say to the contrary. Another poll shows that 76% favor it.

In today's Washington Post trusted health care expert Ezra Klein writes that health care reform is in danger and the photo? Insurance Industry shill Max Baucus on the phone, probably thanking some CEOs for the generous payments they've been lavishing his coffers with. He explains how Baucus' Finance Committee will destroy any chance of effective reform:
Put simply, the Finance Committee wanted its bill to cost $1 trillion over 10 years. The CBO returned an early estimate to the panel on Tuesday night: $1.6 trillion over 10 years. The specifics of the estimate have not been made public. But the final number changed everything. Max Baucus, the chairman of the committee, pushed markup back behind the July 4th recess. He has promised to get the bill below $1 trillion over 10 years.

That's very dangerous... Right now, I'm told Finance is going down the road of less reform. They're cutting the subsidies, cutting the generosity of the basic benefit package and cutting the number of people who will ultimately be insured by their proposal. This reflects a simple reality: If you're going to try to leave the central features of the health-care system untouched, you can't get to universal coverage, or even anywhere near it, on $100 billion a year.

Few members of the Senate are on the side of their constituents on this. A handful-- Bernie Sanders (D-VT), Dick Durbin (D-IL), Jeff Merkley (D-OR), Sheldon Whitehouse (D-RI), Jack Reed (D-RI), Sherrod Brown (D-OH), the People's Tribunes-- are. If you care, your should contact your two and tell them you'll never vote for them again if single payer or the public option fails. The plan of the senators who have been bribed by Big Insurance and the Medical-Industrial Complex is to force us all to hand over more money to incompetent, greed-obsessed and crooked insurance companies who are slobbering over the billions they stand to make while they think of all the ways they can cut back on service.

One Senate candidate who gets it is Ohio Secretary of State Jennifer Brunner. She's very clear that health care reform must include a robust public option.
"Without health insurance coverage, the vast majority of Americans cannot afford to pay for health care. Even many with health care take shortcuts in getting health care for themselves and their families. Those without, go without needed services, or they go bankrupt or lose their homes because of medical bills they can’t pay,

"All Americans must have access to quality, cost-effective health care, and this should be the guiding principle of any federal legislation. In Ohio, many job losses have occurred from the collapse of the auto and related industries and from tax incentives to corporations who have outsourced manufacturing jobs to other countries whose governments cover health care expenses.  

“Many opponents of a public option blithely confuse the government’s direct payment for health care services with some countries’ governments that actually provide health care services. This is irresponsible. Millions of dollars have been spent to run TV ads that scare everyday Americans into thinking that health care reform is the equivalent of socialism. Nothing could be further from the truth.

“It is time for Democrats and Republicans alike to step up and give Americans real choices for health care for themselves and their families, and it needs to happen now. A public option has existed for years for older Americans through Medicare, which has successfully been providing decent health care to millions. Extending this type of model as a choice of coverage to the more than 46 million Americans without health coverage is not earth shattering-- it’s a choice and one we’ve been doing with success for years... We need to keep what works and expand that to those who now lack access to health care. A public option is simply one way to do that among many. It’s time that Americans be unshackled from the fear, ignorance and gridlock of past practices. Let Americans keep the health insurance they have if they like it, but let’s use the public option as a way to make health care available to all Americans while making it easier to account for how money on health care is spent."

This is why we liked Obama and why we elected him. What happened? (Please help us with our carrot and our stick approach-- whichever you prefer.)

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At 3:08 PM, Blogger Jack Jodell said...

Citizens! Man the guillotines! These piggish health care millionaires are depriving people of needed health care and are making it impossible for 1 in every 6 of us to afford their insurance! They are enemies of the people---off with their heads!

If only it were that easy. Regrettably, Obama has backed off single-payer insurance. Get ready for a summer full of disgusting, lying TV and radio ads designed to scare the public away from ANY type of public plan. If Rick Scott and those other conservative opponents of national health care are successful, then we the people WILL have to take matters into our own hands! The idea that insurance company execs are paying themselves millions each year while limiting and denying coverage to millions is immoral. And the idea that these people are profiting immensely off the illness and discomfort of others is unforgivable and indefensible! Public health programs should be heavily regulated and run just like public utilities!

At 6:08 PM, Blogger Bruce said...

40 million citizens marching on Washington ought to do something. If 1 million Iranians can march in their country to protest a corrupt government, why can't we do even more? Our Congress is no different than a corrupt parliament in any two bit formerly iron curtain country. These people need to be shown the door, immediately. Put THEM out of work so they lose THEIR health care, just like they have deliberately done to so many of us!

At 12:25 AM, Blogger vanya said...

Right on Jack!

At 8:17 PM, Anonymous Anonymous said...

I sit on the board with Utah association of Health underwriters and as well as and for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year that seems all too familiar on the federal level. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a "no loss" or "no gain" over competing carriers in the insurance exchange portal which is On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that need to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.
In which is the beginning of a state sponsored program addresses issues on a local state level that the federal level might look at. Coming from an underwriting background I know where the dime falls. I am of the opinion that large waste occurs from providers billing for procedures that developed "no outcome". Insurance carriers are not the only bad guys on the block. In most of our purchasing decisions....don't we pay ONLY when we know that we will get a desired outcome? Why is it if you ask the doctor how much a particular test or procedure is he doesn't know? Shouldn't providers be held to a transparent cost standard?
You must be in the health care business from some interaction point to make statements of fact in the face of historical changes. When you are in the system from any touch point (insurance, provider, hospital, Medicare or patient) you get the “real issues” because of real time experience.
I often quote the Switzerland health care system as an example of tough questions that we will have to face at some point down the time line. Did you know that premature babies are not resuscitate upon birth if they cannot draw breath? Did you also know that is the same with “senior care” experiencing system failure or failures? They don't extend life of a senior with multiple failures like intubation as example. Anyone in the business of paying claims knows that the single most expensive bills in what we call “shock loss” is within NICU for newborns and seniors in acute / intensive care / hospital.
The Swiss apparently made decisions made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or to define when to incubate, resuscitate a newborn or a senior? To define the conditions and rules of practice? With a litigious society I think not. This is why we need tort reform. Without tort reform medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. With health insurance carriers it translates to about 10% of every premium dollar collected.
I don't think we are hearing about tort reform because most of the house and senate on the federal level are lawyers and have practicing law firm interests / ownership. In the healthcare system there is no total innocence. Insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their door with no insurance. The lawyers are there to stir the pot and promise lavish fortune at the end of the PERCEIVED misery chain. Am I saying we don’t need them? No, but I am saying there is clear and documented abuse of the legal system that awards outlandish claims in the millions for a $20,000 mistake. Ambulance chasers being the most abusive. What about those that educate their clients on defraud and then use the legal system to pirate insurers?

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