Awhile back I wrote, trying to figure out how my adopted parasite had managed to have a better-than-(Wall-Street)-expected first quarter:

I have tried, and failed, to understand or find out what "disciplined pricing and operating improvements in senior and local group businesses and more favorable prior-period claims development" means. I'm especially curious about that "more favorable prior-period claims development" part. Sounds suspiciously like not paying old claims, to me. But you know how I am...

Dearie me, not suspicious enough, perhaps. Could this be part of what it means?

Last week Wellpoint (the parent company of my own adopted parasite, Empire Blue Cross Blue Shield) posted a first quarter net income which had gone down from the previous quarter, but not so much of a decline as Wall Street had expected.

WellPoint Inc.'s (WLP) first-quarter net income fell 1.3% Wednesday on sharply higher investment losses and amid continued enrollment declines, but the health insurer's strong operating performance offers further encouragement for the pressured industry.

I'm so relieved!

Retiree Hires Attorney to Keep Her Coverage

“I was promised lifetime insurance by my employer (USA Today). In May, my employer farmed out billing to Aetna and refused to take my check,” said Coline George of Camarillo, California. “Aetna had no record of me. The only informed person I talked to said that Aetna only did my employer's COBRA account.” ...

Karen George is in extreme pain, taking "daily doses of Klonopin, Flexeril, and Lortab", but Aetna won't cover surgery to correct her disconnected jawbone, because it is "cosmetic".

Now that I have your attention, I want to change the subject from bashing Aetna.

At American Medical News, a website of the American Medical Association, Emily Berry does some pretty good low-flying snark as she reports on the latest marketing ploys of "health plans":

Health plans are on a marketing mission. They "want you to know" how to "thrive" by turning to them for "guidance when you need it most" because "it's time to feel better," and their business is "helping people live healthier lives."

...

The Medical Quack explains some of the ins and outs of the insanity induced in our health "care" system by corporate bureaucracy. To try to sum up a bizarre situation, it seems the HMOs want to reward or punish doctors based on their effectiveness at getting patients to take their medication. The purchase of $4 generic prescription drugs through outfits like Wal-Mart destroys the paper trail that makes it possible to apply the incentives. So there are some efforts by the bureaucrats to get this information out of the patients:

or, Why Does Aetna Hate Ruth Kaufman's Toe?

There are two strands here: denial of care, and lack of transparency.

My health insurance, for which I pay $395 per month, will not cover the foot surgery my doctor says I need: a toe joint replacement that is supposed to last 20 years and which will restore mobility and reduce pain.

According to Market Watch, Aetna CEO Ronald Williams "earned" nearly $43 million in total compensation in 2007. The census bureau set the 2007 poverty line for a single person at $9944 (over 65) or $10,787 (under 65); let's just call it a nice round $10,000.

Meanwhile, this painter/sculptor might dispute the use of the word "earned" in the Market Watch story:

My very own corporate parasite, Aetna, is losing the battle for public opinion in the pages of New Jersey's Bridgeton News. In a story on the reaction to Aetna's decision to drop The Center for Diagnostic Imaging (CDI) of Cumberland County from its network, Andrea Scapellato, whose husband has been depending on CDI for regular ultrasounds, is quoted:

"First you have to pay for insurance, and then you can't even go where you want to go," she said. "We live in the United States, not communist China or Russia."

Stock prices of Aetna and other health insurers are up. How nice for them and their shareholders.

Meanwhile, the lowly life-forms who actually need health care abandon all hope in the health (couldn't) care (less) system:

Adopt-a-parasite? The whole health (couldn't) care (less) system is a parasite on the body politic. At Salon, a doctor lays out the obscenity: (via Suburban Guerilla)

As a resident in a Los Angeles hospital, he tries to get the on-call orthopedic surgeon to come in the middle of the night to treat a five-year-old with a severe broken leg.

Tragedy!

Poor William L. Jews. His compensation package for leaving his position as CareFirst CEO has been cut by more than half. This means Mr. Jews will not get the $18 million severance he was expecting, but will receive less than 9 million bucks. Can you imagine having to get by on just shy of 9 million bucks? I mean, you can't even buy a decent Santa Barbara estate for that kind of money anymore.

Why was this outrage perpetrated? Well, it seems CareFirst is a nonprofit health provider

How much health care does $9 million buy in California?

Why was Caitlin White's $113,000 brain surgery delayed for more than two months? Would she ever have had the surgery without the intervention of TV news?

It's really not clear from the linked story, but this much is clear: Caitlin's mother believes the "claim came in too late" for her to have the surgery scheduled for May. She also believes that the insurer denied coverage altogether when she rescheduled the surgery. The insurer, Aetna, disputes the circumstances, but according to the story it took pressure from a local TV station and a four-day investigation to get Aetna to "change its tune" and "partner" with Tampa General Hospital to fully cover the costs.