Thursday, September 24, 2009

Just a reminder

Of what kind of amoral, thieving shitbags we are up against in the healthcare fight.

This committee has concluded an investigation into the practice of health insurance rescission, and results are alarming. Over the past five years, almost 20,000 individuals, insurance policyholders have had their policies rescinded by three insurance companies who will testify today; Assurant, UnitedHealth Group, and WellPoint.

From a review of case files, the committee has identified a variety of abuses by insurance companies, including conducting investigation with an eye toward rescission in every case in which a policyholder submits a claim relating to leukemia, breast cancer, or any of a list of 1,400 serious or costly medical conditions. Rescinding policies based on alleged failure to disclose a health condition entirely unrelated to the policyholder's current medical problem.

Rescinding policies based on policyholders' failure to disclose a medical condition that their doctors never told them about. Rescinding policies based on innocent mistakes by policyholders in their applications. And rescinding coverage for all families for -- excuse me, rescinding coverage for all members of a family based on a failure to disclose medical condition of one family member.

The investigation has also found that at least one insurance company, WellPoint, evaluated employee performance based in part on the amount of money its employees saved the company through retroactive rescissions of health insurance policies. According to documents obtained by the committee, one WellPoint official was awarded a perfect score of five for exceptional performance based on having saved the company nearly $10 million through rescissions.

These practices reveal that when an insurance company receives a claim for an expensive, life-saving treatment, some of them will look for a way, any way, to avoid having to pay for it. This is eerily similar to what we found last year in our investigation of long term care health insurance policies where unscrupulous sales people would sell policies to seniors, then change or revoke the policies once the enrollee was locked into a plan and making payments.

The companies who engage in these rescission practices argue that they are entirely legal, and to an extent they are. But that goes against the whole point of insurance. When times are good, the insurance company is happy to sign you up and take your money in the form of premiums. But when times are bad, and you are afflicted with cancer or some other life-threatening disease, it is supposed to honor its commitment and stand with you in your time of need.

Instead, some of these companies use a technicality to justify breaking its promise, at a time when patients are too weak to fight back.
Some people offer firsthand accounts of their dealings with their insurance companies:

In its rescission letter, Blue Cross said it would have never accepted me for coverage if it had known that I had polycystic ovaries. This letter was the first time I had ever heard about this condition.

I later learned that polycystic ovaries, or PCOS, as it is known, is a diagnosis of exclusion and very difficult to prove. Doctors often proceed on suspicions of a person having it without actually having proven it.

This is what happened in my case. My doctor suspected I might have PCOS, wrote it down in her notes, then told me she was prescribing glucophage for weight management. I never knew what she wrote down in her notes because she never told me.

After I was rescinded, I had two of my doctors write letters to Blue Cross telling them this, but they didn't care. They just wrote back that they were upholding their decision to rescind.

After being rescinded, I showed my original application to my sister and her husband, both radiologists, to ask them what I could have possibly done wrong in filling out the application. They felt that the application was worded in such a way as to be purposefully confusing and that it asked the same question in multiple ways to trip people up. I'm a college graduate, and no dummy, and I still couldn't make sense of Blue Cross' tricky application.

The worst part about my rescission is that I have been unable to get insurance anywhere else. I applied for individual insurance through Blue Shield. But on their application, they ask if the applicant has ever had insurance rescinded. When they learned that I had, they informed me that they would not accept me for coverage.

Every insurance company asks if you've ever had health care coverage rescinded. For the rest of my life I will never be able to get individual coverage again because of Blue Cross.

Can you imagine having to walk around with cancer growing in your body with no insurance? It's the most terrible thing in the world to not have anybody to turn to, not have anywhere to go. So I just can't even say how bad it was.

The sad thing is Blue Cross and Blue Shield took my high premiums the very first time I ever had a claim, the very first time, and was suspected of cancer. They took action against me searching high and low. They turned over every single thing they could in my medical history to pull out anything that would cause any suspicion on me, so they didn't have to pay for my cancer.
Contact your representatives and tell them you aren't going to accept snake oil disguised as meaningful healthcare reform.

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