From Lisa Girion at the Los Angeles Times, a report on the apparently criminal behavior of Blue Cross in California:
... The state investigation found that Blue Cross used computer programs and a dedicated department to systematically investigate and cancel the policies of pregnant women and the chronically ill regardless of whether they intentionally lied on their applications to cover up preexisting medical conditions — a standard required by state law for canceling individual policies.
Regulators examined 90 randomly selected cases of policy cancellations — out of about 1,000 a year in California — and found violations in each one.
"This looks like 'Rescission Inc.,' " said Bryan Liang, director of the Institute of Health Law Studies at California Western School of Law in San Diego. "It's clear if 100% of these individuals had their policies illegally pulled, that means that there's a problem. These are just the tip of the iceberg."
The state report said the legal standard for cancellation was high because it put plan members at great risk — financially and medically — and because it left physicians and hospitals holding the bag for services rendered in good faith and often with prior authorization from the insurer.
"Rescission is the harshest possible punishment," Department of Managed Health Care Director Cindy Ehnes said. "It leaves providers unpaid and it leaves the enrollee uninsurable. ...
They targeted the chronically ill and pregnant women. They left them uninsurable. The culture of life marches on.
Did I say criminal? I did. Good. Not only did they break the law, they caused material harm to others. But this sort of behavior doesn't end at the borders of the State of California. Companies like Blue Cross are opening banks to sell junk insurance that doesn't really cover much and still costs a veritable fortune. UnitedHealth of New York was sued for racketeering, as another example, which just reaffirms the perception that these companies are ear deep in corruption and fraud could be discovered just about anywhere an investigator gets a chance to look. Citibank has even discovered a new class of
victims customers in people who can't afford the health care they need in the first place. Our healthcare system is a reeking travesty from top to bottom.
Bonddad explained a while ago why a financially healthy insurance system means lots of untreated, sick people, by definition and as a logical consequence of trying to make large profits off the unwell. So because people make money on this vile, brutal, murder by spreadsheet system that we have, we're stuck with it. In spite of the fact that single-payer systems are better, cheaper, and more competitive. In spite of the fact that it leaves pregnant women uninsurable, precisely because pregnancy is statistically speaking the most expensive medical condition most people ever go through. In spite of the fact that in the richest country in the history of the entire, goddamn world, a child can die of a toothache because his mother didn't have insurance. No, somebody makes, literally, a killing off of it, so we're sodding well stuck with private insurers and poor or no healthcare that someone's getting paid obscenely not to deliver.
It's a disgrace and an outrage. Am I shrill enough yet? I don't think so. Shrill enough is whatever someday gets Congress to toss for-profit healthcare to the curb and give us a national, single-payer plan.
Disclosure: The author of this totally unhinged and unrepentant rant hasn't had health coverage since 2005 and has also racked up thousands in dental bills over the last short span of years. She has a friend worried about leaving a job they hate because they can't afford the thousands of dollars per year in medical bills their chronic illness would require for treatment if they wound up with a company that didn't offer as full an insurance plan. She can in no way be described as an objective or disinterested bystander.Posted by natasha at March 23, 2007 08:16 AM | Health/Medicine/Health Care | Technorati links |