Friday, April 18, 2008

Private Healthcare scam factory

You're an American health insurer and you find discrepancies in your customer's policies, pre-existing conditions for example, that would void their coverage and allow you to reject any claims they made.

Do you
A: Advise the customer of the discrepancy and tell them that they aren't covered and need to revise their plan with you or find another insurer?

Or
B: Quietly keep raking in their premiums, sometimes for years, and wait for them to submit a claim which you already know you have grounds to deny?
For the second time, City Attorney Rocky Delgadillo is suing a health plan provider, the first being Health Net Inc. in February. Today, the announcement to sue Anthem Blue Cross of California and Anthem Blue Cross Life & Health came after launching http://www.protectingtheinsured.org/, a city website to "law enforcement investigation regarding denial of health insurance claims or coverage due to unlawful, fraudulent or unfair practices."
The website lets consumers directly make complaints to the city."The company has engaged in an egregious scheme to not only delay or deny the payment of thousands of legitimate medical claims but also to jeopardize the health of more than 6,000 customers by retroactively canceling their health insurance when they needed it most," Delgadillo told the LA Times. "We further allege that more than 500,000 consumers have been tricked into purchasing largely illusory healthcare coverage based upon the company's false promise."
Blue Cross, of course, disagrees. If Los Angeles wins, Delgadillo says after a fine of $2,500 to $5,000 per violation, the maximum penalty could be more than $1 billion.

And still groups like the Fraser Institute carry the private insurance industry's water, pushing the idea that what Canada's health system really needs is more of this kind of 'innovative' private sector thinking.

11 comments:

Keith said...

You use one relatively isolated incident to condemn the entire private sector of modern health care? Come on...

Cliff said...

It's thousands of cases nationwide, and yes, I do.

Keith said...

But still, the actions were performed by a single company. It's not as if dozens of private companies were working together to coerce and trick consumers across the nation.

No offense, but you seem to have a deep bias against private enterprise of any sort in the health care system. Sure, America's health care system has some flaws. However, that doesn't necessarily mean that a universal program is the only, or even the best answer. Heck, why should I trust the government, of all organizations, to effectively run something as important as health care?

Cliff said...

Yet apparently you are quite willing to put your life in the hands of the insurance industry.

And it's many companies all engaging in similar practices. Do some research.

The Canadian system isn't government run healthcare. Doctors are private businesses simply dealing with one insurer rather than dozens of them and having to spend less money on administration as a result.

So in other words letting government 'run' healthcare has meant less bureaucracy, less redtape and less mismanagement.

Our universal system started in one province against stiff resistance, and then was slowly but surely taken up nationwide when it became clear how vastly superior a system it was.

And according to the polls the vast majority of Americans agree with the idea of universal healthcare, more every year. The myth of 'conservative America' is predicated on the media ignoring and downplaying the real beliefs of the vast majority of Americans.

You are in a shrinking minority Keith - the truth of which will be becoming harder and harder to ignore as time goes on.

Cliff said...

Oh, and someone who clearly has an almost pathological bias against public healthcare telling me I have a bias against private medicine is more than a little funny. ; )

Keith said...

I love how you quote mediamatters, a far left character assassination site, in order to prove your point about a mythical "conservative America". Hell, the site itself is kept alive by the purse strings of one George Soros, one of the most disgustingly liberal men alive.

Tell me, if America is truly so moderate and liberal, then why did it re-elect George Bush in 2004? Why is John McCain such a major candidate for the 2008 election? Both of these men are fairly conservative, and yet they are garnering approximately half of the public's vote.

Cliff said...

Ah if you don't like the facts attack the source. Classic.

McCain's the candidate because the line up of Republicans was the saddest collection of freaks, water-heads and has-beens America has ever seen. Republicans were left with only barely viable option the oldest candidate for President ever. A man with a temper problem so bad even fellow Republican legislators have expressed dread at the thought of him in the White House, a man with so many contradictions, compromises and outright falsehoods in his record that along with his severe attitude problem that, the media's obsequious worship for him aside, will cause him to self destruct long before election day.

Oh, and a man who has enjoyed government run healthcare his entire life (Son of a naval officer, member of the military, member of congress.) but can't explain why it would be bad for other Americans to have the same medical advantage he's had.

And as you yourself admitted earlier - since 2004 American voters have soured badly on the excruciatingly awful Bush administration and McCain has explicitly promised more of the same.

Keith said...

Oh please. If you can't recognize the lost legitimacy of a source with a biased agenda, then there's no real point.

As for the politics of it all, it's not as if the Democrats had it much better. John Edwards represented a fringe of far-left America, and his abysmal poll numbers represented him as such. Hillary Clinton, ironically running as the "first woman president", has been riding on the political value of her husband's fame. Barack Obama, meanwhile, has been passively leveraging his status as a "post-racial America" icon in order to deliver shallow, if not articulate, speeches.

In a straight comparison, McCain has more experience than Hillary and Barack combined. His character is pristine, and his moniker of the "Straight Talk Express" speaks of his honesty and trustworthiness. Even some of his most virulent opponents have conceded that in terms of character, the Republican party made a smart nomination.

On the other hand, the Democrats have more than a few skeletons in their closets. Hillary Clinton's already been embarrassed out of her mind by the ridiculous Bosnia incident, and it appears that a day cannot go by without another hidden correlation found between Barack Obama and another radical sect. Reverend Jeremiah Wright was bad enough, leading his congregation in singing "God Damn America", but Obama's meetings with former members of the Weathermen was simply heinous. If anyone is going to suddenly self-destruct before election day, it will be Obama.

Plus, McCain hasn't exactly promised 4 more years of Bush, even though his opponents have made such fallacious claims. On the contrary, he's made significant efforts to distance himself from the Bush Administration on several key issues. However, regardless of the negative press he may receive, he is remaining firm on America's stance in the War in Iraq, and I personally agree with him. Regardless of your personal beliefs on America's international role in foreign affairs, McCain's continue stance in what he believes reflects the strength and virtue in his character, something that very few candidates have.

Cliff said...

"His character is pristine, and his moniker of the "Straight Talk Express" speaks of his honesty and trustworthiness."

Heh. Absolutely hilarious.

Obama never sought the endorsement of Reverend wright and promptly denounced his statements when they became public. McCain actively sought out the endorsement of Pastor Hagee who has made hateful comments about women Jews and Catholics - for example calling the Catholic Church 'The Great Whore'.

McCain's teflon media profile is already starting to fray and the process will not be kind.

His stance on Iraq is opposed by the overwhelming majority of Americans, it will cost him.

Keith said...

I particularly enjoy how you ended your post arguing that McCain's stance against the "overwhelming majority" of Americans on Iraq will cost him.

It's as if you believe that the majority of Americans sing "God Damn America" in their spare time, condemn "white society", support radical terrorist groups of the 60's, and support amnesty for illegals.

If anyone has a teflon media profile, it's Barack Obama. Once the majority of Americans recognize his radical leanings, his inexperience in combination with his far leftism with alienate him from his voter base.

Plus, at some point during this election, he's going to have to do more than simply deliver stunning speeches.

With McCain, all he's done is seek one mistaken supporter. Does this singular mistake destroy his decades of political and military service? Even if it does, at least he has extensive political and military service to speak of. What does Obama have to speak of? His white "racist" grandmother? Honestly...

Cliff said...

Fascinating. The best argument you can make against Obama is the statements of somebody else, statements he has denounced.

The Republicans are in trouble if all you've got is damning him by association, according to the polls the only people the Wright controversy had any lasting effect on were never going to vote for Obama anyway. Iraq on the other hand, is a gushing open wound in the polity and will destroy the GOP for a generation.

But why don't we just wait and see? By all means, drop by here again in the second week of November Keith, I expect to be throwing a party.

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