Healthcare in the US

Harms · 12-05-2006, 02:33 PM

DOes anyone else think that healthcare in the US is a crime? There is nothing more important to someone then their health, and ppl shouldn't have to go broke or bankrupt to have medical procedures. Insurance companies are covering less and less and forcing ppl to have to decide on rent or their health. I think everyone knows where I am going with this: Socialized medicine.

waltky · 11-10-2007, 09:59 PM

Cuttin' health care costs...

Insurer Dropped Sick Patients to Save Money
November 09, 2007 - In the middle of her expensive, months-long chemotherapy regimen, a Los Angeles hairdresser with breast cancer learned her insurer had abruptly decided to cancel her policy.

Quote:

The decision ultimately left the 51-year-old hairdresser, Patsy Bates, with nearly $200,000 in debt, according to the Los Angeles Times today, but it helped win $20,000 in bonuses for the employee who made the call to cut Bates' coverage. By dropping Bates' policy and those of roughly 1,600 others, the employee helped the insurance company, Health Net, save more than $35 million from 2000 to 2006, the paper reports.

The company's own policies awarded cash bonuses to employees who dropped policyholders whose costly medical bills triggered the company's review of the policyholders' applications, even if they had serious illnesses -- part of what the paper calls an "industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized." Overall, Health Net dropped roughly 1,600 policies from 2000 to 2006, the Times reports, noting that "state law forbids insurance companies from tying any compensation for claims reviewers to their claims decisions."

The company said the law did not apply in this case because Fowler was an underwriter, not a claims reviewer, and the goals she was given and which she met were reasonable. It said it cancelled Bates' policy because she had not disclosed a pre-existing heart condition in her application. Bates said any information left off the application was inadvertent. Bates, whose treatment was partially funded by charities, still cannot afford tests to find out if her cancer has returned, the paper says. She is suing the company, who turned over documents revealing their bonus policy in court proceedings.

The Blotter: Insurer Dropped Sick Patients to Save Money

waltky · 11-17-2007, 02:03 AM

Health Net fined...

Insurance Co. Fined Million Dollars for Cancelling Insurance
Nov. 16, 2007 - Follows Lawsuit Filed By Gardena Hairdresser With Breast Cancer

Quote:

The largest fine in the history of the California Department of Managed Health Care has just been slapped on Health Net, the Woodland Hills-based insurance company.

Ten days ago, Eyewitness News consumer specialist Ric Romero broke a story about a $6 million lawsuit filed by a Gardena hairdresser with breast cancer who found out her health insurance had been cancelled right in the middle of her chemotherapy treatments.

Health Net claimed Patsy Bates made mistakes on her application. But later it was learned Health Net paid bonuses to employees based on how many policies they cancelled. Now the state of California has fined Health Net $1 million. The Woodland Hills company has agreed to pay the fine and stop the policy of compensation tied to coverage cancellations.

Source

waltky · 02-22-2008, 10:57 PM

HealthNet also loses arbitration...

Health Net ordered to pay $9 million to cancer patient
Fri Feb 22, 2008 - A California arbitrator ordered Health Net Inc to pay $9.4 million in damages and expenses for what he described as "reprehensible" conduct in canceling the policy of a cancer patient after she fell ill, according to documents made public on Friday.

Quote:

The award to Patsy Bates, 51, included $8 million in punitive damages and raised concerns about the company's practice of retroactively canceling policies of individuals who make large claims and paying bonuses to underwriters for meeting cancellation targets. Health Net said in a statement that, while it does not agree with some of arbitration judge Sam Cianchetti's conclusions, it will immediately adopt a review process for all policy cancellations.

The multimillion-dollar punitive damages award, the first in a so-called recision case, is sure to send a message to other large health insurers who face lawsuits over the practice, said Bates attorney William Shernoff. "Let's see if these other big health carriers will change their practices, then we will have done something," Shernoff told Reuters. "Until this punitive damages award came down, nobody was doing anything."

Shernoff has three proposed class actions over retroactive cancellations pending in California courts against Health Net, Blue Cross and Blue Shield, as well as a case involving a newborn boy whose Health Net coverage was canceled after he was born blind and with cerebral palsy. The Bates case brought to light a bonus system in which Health Net set annual policy cancellation targets that it described in terms of numbers of canceled policies and millions of dollars in savings in medical expenses.

MORE

waltky · 08-12-2008, 02:34 AM

Health care costs goin' up...

More health care cost pain seen in 2009
Mon., Aug. 11, 2008 : 10 percent expected rise the smallest in 6 years, according to survey

Quote:

Health care costs are expected to rise more than 10 percent into next year, according to a survey of insurers by Aon Consulting Worldwide. But that increase is the smallest Aon has seen in six years. Experts say it shows that efforts to tame costs, such as employee wellness or disease management programs, may be paying off. "There's a variety of tactics that employers have been employing over the last 3 to 6 years that has had an impact on the market," said study director Bill Sharon, an Aon Consulting senior vice president.

Aon Consulting surveyed about 70 health insurers around the country, including companies such as Aetna Inc. and Cigna Corp. It found that actuaries expect costs to rise an average of 10.6 percent during 12-month rating periods starting this year between April and September. That represents a slight drop from last year's forecast of 10.9 percent and a bigger fall from 2002, when health care costs were expected to rise by more than 16 percent.

But the percentage likely won't be what the average employee faces for a premium hike next year. It doesn't reflect insurance plan designs or changes an employer might make to benefits plans. "Pretty much every employer has to do something or is doing something in an effort to bring that number down," Sharon said. He said actual cost increases have wound up being three to four percentage points lower than preliminary estimates in the past couple of years. Still, he said Aon Consulting's survey gives employers a benchmark to use as they consider premium renewals.

More More health care cost pain seen in 2009 - Health care - MSNBC.com

david.hussey · 08-22-2008, 08:44 AM

The best way I can think of to improve health care is to completely remove the government from it. Competition among various private practitioners will drive out the bad doctors: as people realize that a certain person's care is much better than another's, they will patronize the better business more. Eventually, you'll have a bunch of really good doctors competing for your business by offering you better prices, better care, etc., and you won't have to worry about the quacks so much anymore. Canada's socialized system does not work: they concentrate more on healing those who will be more beneficial to the system over the long term (the young and relatively hale) than they do on those who often genuinely need it (the elderly). Also, if you visit a Canadian hospital, they will heal the person with a scrape before they get to your broken arm if the scrape came in before you did.

By letting businesses tend to themselves, the businesses in turn will eventually be able to care better for their customers.

waltky · 09-27-2008, 12:20 AM

ER Death Points to Growing Wait-Time Problem...

Patient Died in ER After a 19-Hour Wait
Sept. 25, 2008 - Family, Doctors Say Deadly 19-hour Wait Is an Example of a Nationwide Problem

Quote:

With notoriously crowded U.S. emergency rooms, chances are most American families have a story of someone waiting. It could have been half a day for a sore throat or perhaps hours for stitches or a sprained ankle. But for 58-year-old Michael Herrara of Dallas help never came. He died of a heart attack last week an estimated 19 hours after he arrived at Parkland Memorial Hospital's emergency room waiting room complaining of severe stomach pains, according to reports from WFAA News in Dallas.

Members of the Herrera family said they know they aren't alone in facing dangerously long emergency room waiting times in this country. Emergency physicians say the problem is getting worse. "He's not here because they let him die, pretty much," Edward Marquez, Herrara's nephew, told WFAA. "That's awful to know that people are treated that way," he said. "If someone can be helped by this, I think he would be happy." Representatives of Parkland Health & Hospital System said they are reviewing the case.

"It's important to also understand that, as with all emergency rooms, patients in Parkland's ER are treated based on the severity of their medical condition rather than the length of time they've waited to ensure that the most urgent cases receive proper attention," Dr. Ron J. Anderson, president and chief executive officer of Parkland Health & Hospital System wrote in a prepared press statement. Anderson told WFAA he knew the medical team marked Herrara's symptoms as a "level 5" case, rather than the most urgent "level 1." "This incident is a tragedy and our hearts are with the family," Anderson said. "We always strive to deliver the best care to all our patients."

More ABC News: ER Death Points to Growing Wait-Time Problem