For the first half of 2009, as the national debate over healthcare reform was escalating, the rejection rates are even more striking.
Claims denial rates by leading California insurers, first six months of 2009:
* PacifiCare -- 39.6 percent
* Cigna -- 32.7 percent
* HealthNet -- 30 percent
* Kaiser Permanente -- 28.3 percent
* Blue Cross -- 27.9 percent
* Aetna -- 6.4 percent
"Every claim that is denied represents a real patient enduring pain and suffering. Every denial has real, sometimes fatal consequences," said Burger.
PacifiCare, for example, denied a special procedure for treatment of bone cancer for Nick Colombo, a 17-year-old teen from Placentia, Calif. Again, after protests organized by Nick's family and friends, CNA/NNOC, and netroots activists, PacifiCare reversed its decision. But like Nataline Sarkisyan, the delay resulted in critical time lost, and Nick ultimately died. "This was his last effort and the procedure had worked before with people in Nick's situation," said his older brother Ricky.
Cigna gained notoriety two years ago for denying a liver transplant to 17-year-old Nataline Sarkisyan of Northridge, Calif. and then reversing itself, tragically too late to save her life.
Now think about this. Insurance companies are not paying legitimate claims citizens incur. Citizens are left holding the bag--and financial ruin. Most cannot absorb $30,000 for a procedure, much less a quarter of a million dollars (if insurance doesn't pay for a coronary bypass, that's what you may owe). Prices are likely to get higher, to double even over the next 10 years. Imagine how high they will get if, as teacherken reminds, the insurance industry is given two years to gouge (via a "trigger") before it activates any real reform!
Big change is needed now. The health insurance industry has brought it upon itself. And it's time for them to pay the client (who is the piper). Today we learn a Survey USA poll shows that 77% of the public thinks a public option is very important. The screamers are not the majority of Americans. The piper has spoken. Why will not Obama make a popular decision. It will never be easier to please the public. And yet he demurs to Blue Dogs and Republicans.
Instead of telling progressives in Congress to be "good soldiers," as he did today, he should be saying that to Blue Dogs. And if he won't I will. Progressives need to serve notice to Blue Dogs, not write them blank checks. Meanwhile, PacifiCare, a United Health Care Company, has a 40% claim denial rate. In what universe is that not grounds for action NOW? |