Blue Commonwealth Logo

Advanced Search
Menu

Make a New Account

Username:

Password:



Forget your username or password?


Become a Supporter
Like Blue Commonwealth? Want to help keep it running?
Contribute Today, and help keep our blog ad free!




Blog Roll
7 West
Albo Must Go
Anonymous is a Woman
Anti-BVBL
Article XI
Assembly Access
Augusta Free Press
Bacon's Rebellion
Blacknell
Blue Ridge Data
Blue Virginia
Blueweeds
Byrne-ing Up the Internet
Central VA Progressive
ChangeServant
Coarse Cracked Corn
CobaltVA
CvilleDave
The Daily Dogwood
Dem Bones
DemocracyUpsideDown
DemRulz
Equality Loudoun
Fairfax City Dems
WaPo - The Fix
Fred2Blue
Getting Around
Great Blue Heron
The Green Miles
Heartland of Va
Leesburg Tomorrow
Left of the Hill
New Dominion Project
Not Larry Sabato
Ox Road South Blog
Penning Thoughts
Powhatan Democrats
Renaissance Ruminations
River City Rapids
Rule .303
RockDem
Shad Plank
Sisyphus
SlantBlog
Southeast Virginia
Star City Harbinger
Tokatakiya
Too Progressive
United States of Jamerica
VB Dems
VB Progressives
Virginia Dem
The Virginia Democrat
WaPo - Virginia Politics Blog
Vivian Paige
Waldo Jaquith
Waldo's VA Political Blogroll
xcurmudgeon

California Nurses Study Reveals the Insurance Claim Denial System is the Real Rationioning

by: KathyinBlacksburg

Fri Sep 04, 2009 at 20:35:36 PM EDT


(This study has been reported on widely, but usually not in that much depth.   - promoted by teacherken)

There is already rationing.  And there are death panels.  The insurance industry is the culprit.  Leave it to California to show the way to examine the insurance industry (and investigate it).  Attorney General Jerry Brown is investigating the industry in California because of evidence suggesting massive fraudulent denial of claims.  

The newly released California Nurses Study here reveals the following:

KathyinBlacksburg :: California Nurses Study Reveals the Insurance Claim Denial System is the Real Rationioning

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?

Tags: (All Tags)
Print Friendly View Send As Email
I Think Boucher Is Blue Dog (0.00 / 0)
Kathy, I believe - looking at his record - that Rick Boucher is one of those Blue Dogs. However, he sure is light-years better than the last two far-righties who ran against him and spread vicious rumors about him, etc.

I would bet my last dollar that there are GOPers right now relishing what they see as a split among the Democrats, probably even stoking the fire as best they can. That way, they will make us two minorities - not the sizable majority we are.

Sorry, but I still stand with Ted Kennedy, who said that the torch had been passed. I can't rush to judgment before a bill has been passed...


Elaine, good buddy: (0.00 / 0)
Elaine:

I must have really set you off because you know me.  And you have an idea about how much I care about all of this.  So, I will give it one more try.  And then (from my perspective, at least), we will have to agree to disagree.  We are a de-facto minority now because Blue Dogs don't know whose side they are on.  Republicans plus Blue Dogs = Majority.  Progressives =Minority. If the Blue Dogs had any loyalty whatsoever to their own president and their own voters and the majority of this country, they would get their act together.  But, hey, they (most of them, anyway) get their info from the Lewin Group (owned by UHC).  What should we expect?  Max Baucus is the single worst problem in the entire Senate.  Kent Conrad is a close second.  We need to get them out of the senate by a well financed primary.  

Regarding the future, don't be mistaken, I will still speak out, write, vote.  I have said over and over I will always be a Dem.  I only twice in my life voted Rep.  One as a new voter in a governor's race in the 1960s.  That taught me to never do that again.  Though I was registered Republican for about 1 year (of my life), I was planning to vote for Democratic Candidate, Edmond B. (Pat) Brown (Jerry's father). He had been a two-term governor and there were no term limits. But he ran an ad in which he told a group of school children, "remember, it was an actor who shot Lincoln." Ronald Reagan was an actor. Many who planned on voting for Brown were so appalled they switched their vote to Reagan, and the rest is history.  After a very short time, I saw how dumb that vote was.  Reagan was trying to drown government in the bathtub way back then.  He worked probably less than 9-5.  Took a nap during the day.  Left governance to his hard-wrong-wing kitchen cabinet and was largely a front man for the cap Weinbergers etc.  And that's how he ran the US too.  As gov and Pres., he gave the only good performance he ever did. So, rest assured I would NEVER make that mistake again.  Not ever.  

Over 20 years ago, I crossed over in a GOP primary in Virginia.  We Dems had no real say (which really ticked me off.  I had always had primaries until coming to Virginia.  I felt partially disenfranchised.  So I used what little voice I had to have an effect on the GOP primary.  Neither choice was a good one, but I voted for Bob Dole because I didn't want someone allegedly associated with the October Surprise and Iran Contra.  You can see how little good that did.  I did not do it to try to make the worst person win, but rather to have what I thought was the better of the two.  But we got the Bush1 and 2 era nonetheless.

But I am weaning myself from other action.  And the Blue Dogs are why.  I am not in servitude anymore.  It is too stressful to work for nothing.  So, unless they find their inner populist between now and November, the Blue Dogs are responsible, not me.  Whoever they are.  One resident Blue Dog I quite like.  I would, of course, continue to vote for him. I will blog about why he would be better than the other side.  Being an in-service telemarketer and door-to-door salesperson is my idea of the worst job in America.  I have done it for many, many campaigns. WE do it because we hope and trust it will make our country better.  But I'm too old to keep ramming my head against a stone wall. After Nov., I will not GOTV any more.  

I will only donate to those who support people over big corporations.  I will say again, though, I will await a final verdict.  But the blue Dog Dems are on notice.  I stand with Pelosi and the House Progressives.  And I say to President Obama.  Tell the Blue Dogs to be good soldiers.  Not the progressives.  Use reconciliation.  And to hell with the Bauchman-Grassley-Coburn-Inhofe wing (i.e., all of it) of the Republican party. And cut the Snowe-Job.

"One person, one vote" died at the hands of SCOTUS, January 21, 2010


[ Parent ]
This is really, really important. (0.00 / 0)
It looks as if we are headed to mandatory coverage, with no prohibition against pre-existing condition exclusions, no guarantee of continued coverage if you get sick, and no public option to back up the uninsurable/underinsured/uninsured.  So we will all be required to buy these fraudulent "insurance" policies, at a price set by the insurers.

I'm not withholding judgment, Elaine.  I'm demanding that my "representative," Glenn Nye, who met with health insurance salesmen but not with the public, actually get off his butt and represent us.

The Democrats have a majority in both houses and have no excuse if they fail to pass real reform, with a prohibition on pre-existing condition exclusions, guaranteed coverage at an affordable price, and a real and immediate public option.  Failure WILL split the party, as it absolutely should.  If the Democrats stand for nothing, they will not stand, simple as that.

This does not affect senior citizens, who are getting the most media attention.  It affects people in their forties, fifties, and early 60s, who are not yet eligible for Medicare.  They are 80 million strong, and many are victims of health insurance companies' "adverse selection."  If the Democratic majority fails them, the Democrats will go down with them.


Nye Is Terrible (0.00 / 0)
I feel for you with Glenn Nye as representative. At least my "representative," Bob Goodlatte, doesn't pretend to be moderate on anything.

Nye, in my opinion for what its worth, has pulled a bait-and-switch" on the people who put him in office. I realize that the district was drawn to make it Republican and winning as a Democrat there is difficult (the reason I understand some of Perriello's votes in the 5th), but Nye is something else.


[ Parent ]
This from FiveThirtyEight... (0.00 / 0)
Interesting comment on FiveThirtyEight:

"There's a healthy debate to be about whether Blue Dog Democrats will be helped or hurt by voting for the President's health care package. The answer, in all likelihood, is some of each. The national environment will probably be better for Democrats - maybe much better - if some sort of health care bill passes. On the other hand, the local environment, holding other factors constant, may be worse for those who vote in favor of the package... generally speaking, for a Blue Dog in a fairly conservative district...the optimal outcome is probably that he votes against the health care bill but that the health care bill passes. That's why Nancy Pelosi and Harry Reid's vote-whipping skills are going to be so essential: they have to help Democrats out of a prisoner's dilemma in which each member's individual interest harms the party's collective interest. It's also why if a health care bill passes, it's almost certainly going to be by a very narrow margin.

I would add...with or without a public option.


Good analogy from (0.00 / 0)
soc. pscy research, Elaine.  And that's pretty much what it is.  The thing is I keep waiting to see who will but the good of the nation above their own re-election.  (most of them wouldn't lose anyway, but they think they will.)  That would be an indicator of a real hero.

Putting:
--47 million people over Big Insurance.
--40% of those whose claims were denied by a Calif. over Corporations and  -themselves.
--The sick and the dying in America above themselves.

Labeling ad Fraud the practices of:
--massive claim denial
--cancelation when someone gets sick
--refusal for pre-existing conditions.

It should be a no-brainer.  But we are increasingly hearing we won't even get this much.  



"One person, one vote" died at the hands of SCOTUS, January 21, 2010


[ Parent ]
It does make one wonder, doesn't it (0.00 / 0)
whether the so-called "centrists" and "moderates" among the Dem Congresscritters (both houses) are caving in to the Party of No or simply following their natural inclinations. And the same goes for the President...

Thanks, Kathy, for the link; I've posted it on my Facebook "wall" and hope others will pick it up. Though some of my friends might be getting sick and tired of my beating on the same drum, always playing that single note... :)


Recent Comments

Recent Diaries
Unintended Consequences
by: Elaine in Roanoke - Feb 03
3 Comments
Jim Crow Policing
by: teacherken - Feb 02
3 Comments
RoboBob in Bizarro World
by: kindler - Jan 28
8 Comments

Blue Commonwealth is a community forum for the discussion of political issues of interest to Virginians.
The opinions expressed by users of this website do not necessarily reflect the views of Blue Commonwealth or its editors.
Powered by: SoapBlox