One couple with chronic conditions struggles with high premiums and high co-pays

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.” …  Read more 

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.  Read more 

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.”

…  Read more 

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:  Read more 

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.  Read more 

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:  Read more 

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.”  Read more 

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:  Read more 

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.  Read more 

N.Y. AG Prescribes Subpoenas to UnitedHealth Group, Others

The nation’s largest health care insurer, four of its subsidiaries and a number of other large insurers are being served subpoenas — 16 in all — in a suit to be brought by New York Attorney General Andrew Cuomo that charges the companies used “rigged data to manipulate the reimbursement rate to their customers who filed claims.”

At the center of the scheme, according to the attorney general, is Ingenix, Inc., “the nation’s largest provider of health care billing information, which serves as a conduit for rigged data to the largest insurers in the country.”  Read more 

Let’s talk about corporate greed. It is worse than you thought. We know that these companies make money by collecting premiums and then denying care. The question is, money for who? Let’s look at their insider trades:
Cigna’s board of directors and chief corporate officers collectively dumped 129,499 shares of Cigna stock. I tried to add that up to what it would be in dollars, got as far as $17,342,224. That is in addition to their very high salary. How much health care could your municipality buy with $17 million dollars?  Read more 

UnitedHealth CEO paid $13.1M in 2007

UnitedHealth Group Inc. CEO Stephen Hemsley received compensation valued at $13.1 million in 2007, down from the $15.5 million he got in 2006.

According to documents filed with the SEC, Hemsley received a base salary of $1.3 million in 2007, up from $1 million in 2006. He also got stock options awards valued at $8.1 million in 2007, less than the $11.3 million he got in 2006.

His compensation also included $3.6 million in cash incentives, up from $2.8 in the previous year.  Read more