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 

This old hat that I’ve got on,
The crown of him is gone,
And the brim is all gone to asunder.

John Conyers aptly describes our current health care-less system as “the current non-system of health care run by profit hungry insurance companies.”

Non-system indeed; it is like a shirt with more holes than cloth, a hat with no crown or brim, nothing left to reform. It’s not just the greed, it’s the patchwork nature of everything. And of course, it’s those far from the centers of power who suffer the most. Look at this story from Chillicothe in southern Ohio, i.e. Appalachia. The writer has just been informed that she must change either her doctor or her health insurer:  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 

Another failure of employer-based health insurance

If you were negotiating an employment agreement, you might consider taking an outstanding benefits package in exchange for a lower starting salary or a wage freeze. How would you feel if many years later, in retirement, some of those benefits were taken away from you?

About 3,000 former Maytag workers and family members have received letters from Whirlpool this week informing them that they are about to get cheated.

The sad fact is that under our system there is an enormous incentive to cheat workers. Canadian companies don’t have this problem.

SEIU Launches Nationwide Actions To Question Health Insurance Industry Tactics

Last month, SEIU and its allies in HCAN (Health Care for American Now) held a massive demonstration outside of the launch of the insurance industry’s sham health care “listening tour.” Along with the upcoming events beginning Tuesday, SEIU will have helped stage more than a dozen actions nationwide to highlight insurance industry tactics that prioritize profits over people.

DETAILS ON TUESDAY’S EVENTS FOLLOW:

Des Moines, Iowa

Nolan Plaza

12:00 p.m. CT

Manchester, New Hampshire

City Hall Plaza

10:00 a.m. ET

Salem, Oregon

State Capitol press conference room

10:30 a.m. PT  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 

HealthMarkets Inc., fined $20M for lax practices

The three-year examination involved 29 states and was helmed by Washington State insurance commissioner Mike Kreidler and Alaska insurance director Linda Hall.

The companies targeted sales to self-employed individuals and sold health plans through associations.

Often, the agent or company did not adequately explain the health benefits.

UnitedHealth income off 73%

On July 2, the company said it would pay $895 million to settle a class-action lawsuit led by the California Public Employees Retirement System. It also said it was cutting 4,000 jobs nationally, or just under 6 percent of its workforce, and reduced its forecast 2008 profit for the second time.

The legal problems will just keep growing:
CUOMO ANNOUNCES INDUSTRY-WIDE INVESTIGATION INTO HEALTH INSURERS’ FRAUDULENT REIMBURSEMENT SCHEME

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 

Insurance Cancellation Questions Could Spread Beyond California

Today’s Health Blog jargon of the day is rescission, the insurance industry’s practice of revoking individual insurance policies because of health-related mistakes or omissions on the application for coverage. …

… Now it looks like the push-back against rescission may be spreading. Henry Waxman, a Democratic California Congressman, held a hearing on the subject yesterday and said his oversight committee plans to investigate the issue nationally.  Read more 

So AHIP’s astroturf site, Campaign for an American Solution, aka, murder by spread sheet has a web site. Sign up if you want to. Don’t give them your address (you have to give a zip code, use theirs, 20004). Give your name as Single Payer and address as HR 676.

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.  Read more 

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?

Shakesville alerts us to Insurance industry forming activist army

“On an issue as big and far-reaching as health care reform, you need to be working with real people and you need to have a reach outside the Beltway,” AHIP spokesman Michael Tuffin told Politico in an interview outlining the industry’s strategy. “The issue isn’t going to be settled just by lobbyists in Washington. The American people are going to have their say.”

Projection, thy name is AHIP.

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 

I was going to write a great post about this idea, but readers will have to make do with slap dash. In order to pass single payer we need to completely discredit the health insurance companies. In order to achieve this we will need their help. Fortunately they are willing to cooperate.

Thus today’s disgrace: Blue Shield sued for allegedly canceling policies

The Los Angeles city attorney is suing Blue Shield of California for allegedly bilking policyholders when they tried to make claims.  Read more 

Target: Insurance companies and their lobbyists. Pretty funny.

WellPoint Agrees To Pay $11.8M to California Hospitals Over Health Insurance Policy Cancellations  Read more 

Forum set Thursday on reforming health care

A free public forum on reforming health care in California will be held Thursday at 7 p.m. in Mountain View’s City Hall, 500 Castro St.

Local health care experts and advocates for a new “single-payer” system for the state will discuss accessibility problems of today’s health care and a “Medicare-type” plan designed to make health care more accessible.  Read more 

Kevin Drum

This would be the same Medicare Advantage that supposedly harnesses the power of the free market to operate more efficiently, yet still requires sizeable subsidies because it costs considerably more per person than good ’ol big government Medicare. What’s at issue here is cutting those subsidies so that private Medicare costs only a little bit more than standard Medicare instead of the whole lot more that it costs now.

But that’s not in the cards. Forcing private insurers to operate as efficiently as the federal government is apparently asking too much of the GOP’s free market acolytes. Better to cut doctors’ fees instead.  Read more 

Via the indispensable Avedon Carol: Rich, powerful corporations can break the law

California regulators admitted Thursday that for more than a year they didn’t even try to enforce a million-dollar fine against health insurer Anthem Blue Cross because they knew they would be outgunned in court.

In early 2007, the Department of Managed Health Care pledged to fine the state’s largest insurer for “routinely rescinding health insurance policies in violation of state law.”

But it never did.

That is a real good reason to not do business with Anthem Blue Cross.