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  • Retired_1998T Retired_1998T Apr 21, 2010 7:17 PM Flag

    Micheal Moore is laughing at everyone...

    As ridiculous as his claims were regarding the Health Care and GM...

    HE WON!..

    To think Obama has catered to the lowest form in our country..Says a lot about him..

    It should be fun to see "Over turning" of lots of, the so called, laws.

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    • What a bunch of junk!

    • One sided...Need more info.

    • WellPoint routinely targets breast cancer patients

      pART 8

      Technically, rescission was not the reason Reilling lost her health insurance, according to correspondences with the company she provided to Reuters. Rather, it was canceled because she did not answer letters from her insurance company requesting information about her employment history.

      Reilling says the letter was sent to an address which she hadn't lived at it for some time, and she never even saw it until recently. When she brought this information to WellPoint's attention, she said, the company COMPLETELY IGNORED HER ....!

      "Rescission is just one method to get rid of someone or no longer provide them coverage," says Isaacs, the deputy Los Angeles city attorney. "They can say forms are not filled out properly; they will just find any pretext."

      Congressional investigators for the House Energy and Commerce Committee who have investigated Reilling's claim say they have concluded that WellPoint improperly canceled her insurance. The company declined to comment at all on her case, saying that client confidentiality precludes them from doing so, although Reilling says she welcomes the company to talk publicly about the matter.

      On her living room table still sits correspondence with her former insurance company.

      Deb Moessner, the company's president and general manager, wrote Reilling last July 13 :
      "Ms. Reilling, please know that is never pleasant to deliver unfavorable news to our members. However, there are situations that occur, such as yours, that leave us with no alternatives. Because you or your agent did not provide this vital information, your ... health coverage terminated effective July 1, 2009."

      In the letter, Moessner added: "Please know that we wish you the best in regaining the healthy lifestyle you described prior to your recent illnesses." ........

    • WellPoint routinely targets breast cancer patients

      PART 7


      Reilling suffered a horrific staph infection caused by her stay in the hospital. She was rushed back there in the early morning of January 15 and was admitted shortly after 5:30 a.m.

      The incision from her reconstructive breast surgery was reopened. Her abdomen was flushed with six full liters of antibiotic fluid until the incision was closed. Two days later, her condition worsened, requiring yet another emergency surgery.

      This second surgery necessitated multiple blood transfusions simply to keep her alive. The infection was so severe her entire umbilicus -- the interior of her belly -- button, had to be removed, as well as many abdominal muscles, because the infection had already eaten away most of it.

      While recovering, Reilling started having trouble with her insurance. Her medication after the surgery cost $4,446 a month. But Anthem would only pay for 10 days and then no more, she recalled in an interview.

      Luckily, one doctor gave her free samples and another found a dispensary where could obtain the medication at a reduced price. But other days she would go without.

      In June 2009, she was informed that her insurance was being canceled -- just before she was about to undergo another reconstructive surgery, which she was forced to postpone. She has now gone 16 months without the necessary surgery.

      As a result, she is severely disabled. The pain and discomfort often only allow her to be able to stand for 20 or 30 minutes a day, sometimes even less.

      Reconstructive surgery might help her to become mobile again and perhaps go back to work full-time. She once enjoyed successful careers as an art gallery owner, interior decorator, and as a writer. She had plenty of money, drove a Mercedes and traveled the world on whim. Not anymore.

      Today she is on food stamps. She has taken her Social Security early, which means that when she is older, she will be eligible for fewer benefits. She buys clothes from consignment stores she once donated to. She recently got some part-time work as a copywriter, which she can do from home, but that barely pays for her drug prescriptions, let alone surgery.

      She spends her days calling pharmaceutical companies because many now have programs to assist indigent customers.

      Reilling waits hours to be seen by a doctor at a clinic, if she can be seen at all. "The thing I didn't understand about going poor is that your time no longer has value to others," she says.

      She seeks out religious charities to pay the rent. "Some have rules that they will only give to people who belong to that church or of their faith."

      One charity she contacted after being informed that it provides financial assistance to breast cancer patients told her that it does so only for women of color and of a certain age. "This is my full-time job now. You go around and around and around," she says, her voice trailing off.

    • WellPoint routinely targets breast cancer patients

      PART 6

      Why would WellPoint on the one hand work to improve health care for women with breast cancer while automatically investigating every single woman diagnosed with breast cancer for possible cancellation of their policies?

      Karen L. Pollitz, a research professor at the Health Policy Institute at Georgetown University, offers one possible explanation: "It is important for these companies' profit margins that they get rid of policyholders with expensive diseases," she said. "If one company were to stop, it would no longer be competitive with the others. They argue they have to do this to stay in the game."

      The investigation last year by the House Energy and Commerce Committee determined that WellPoint and two of the nation's other largest insurance companies -- UnitedHealth Group Inc and Assurant Health, part of Assurant Inc -- made at least $300 million by IMPROPERLY RESCINDING MORE THEN 19,000 POLICY-HOLDERS OVER ONE FIVE-YEAR PERIOD....!!!

      WellPoint itself profited by more than $128 MILLION from this practice, and the committee suggested that the figure might be largely understated because the company refused to provide information about cancellations by several subsidiaries....!!

      During the yearlong debate over health care reform, as the White House and Democrats in Congress savaged insurance industry practices, WellPoint took as much heat as any company. Among other things, it was slammed for trying to raise premiums by as much as 39%..... yes, THIRTY-NINE PERCENT!!! for some customers.
      One in nine of all Americans are policyholders with WellPoint or one of its subsidiaries.

      Braly, who was named CEO of the Indianapolis-based company in February 2007, appeared before a U.S. congressional hearing two months ago and defended the rate hikes as reflecting higher medical costs.


    • WellPoint routinely targets breast cancer patients

      LOS ANGELES (Reuters) – Shortly after they were diagnosed with breast cancer, each of the women learned that her health insurance had been canceled. There was Yenny Hsu, who lived and worked in Los Angeles. And there was Patricia Reilling, a successful art gallery owner and interior designer from Louisville, Kentucky.

      Neither of these women knew about the other. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.

      The women paid their premiums on time. Before they fell ill, neither had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

      They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

      Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women's specific cases without a signed waiver from them, citing privacy laws.

      That tens of thousands of Americans lost their health insurance shortly after being diagnosed with life-threatening, expensive medical conditions has been well documented by law enforcement agencies, state regulators and a congressional committee. Insurance companies have used the practice, known as "rescission," for years. And a congressional committee last year said WellPoint was one of the worst offenders.

      But WellPoint also has specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies, federal investigators told Reuters. The revelation is especially striking for a company whose CEO and president, Angela Braly, has earned plaudits for how her company improved the medical care and treatment of other policyholders with breast cancer.

      The disclosures come to light after a recent investigation by Reuters showed that another health insurance company, Assurant Health, similarly targeted HIV-positive policyholders for rescission. That company was ordered by courts to pay millions of dollars in settlements.

      In his push for the health care bill, President Barack Obama said the legislation would end such industry practices.

      But many critics worry the new law will not lead to an end of these practices. Some state and federal regulators -- as well as investigators, congressional staffers and academic experts -- say the health care legislation lacks teeth, at least in terms of enforcement or regulatory powers to either stop or even substantially reduce rescission.

      "People have this idea that someone is going to flip a switch and rescission and other bad insurance practices are going to end," says Peter Harbage, a former health care adviser to the Clinton administration. "Insurers will find ways to undermine the protections in the new law, just as they did with the old law. ENFORCEMENT IS THE KEY" !

      • 2 Replies to mocdesire
      • LMAO! And obullwinkle hand delivered customers, ie indentured servants, to these companies. He's a hoot.

      • WellPoint routinely targets breast cancer patients

        part 2

        In a statement to Reuters, WellPoint said various specified criteria trigger rescission investigations, including certain types of medical claims. The company said it changed its rescission practices to ensure they are handled appropriately after a 2006 review of its policies prompted by public concern over rescission.

        WellPoint also said it created a committee which includes a physician for making rescission decisions. The company also noted that it established a single point of contact for members undergoing an investigation and enacted an appeals process for applicants who disagree with the original determination.

        During the recent legislative process for the reform law, however, lobbyists for WellPoint and other top insurance companies successfully fought proposed provisions of the legislation. In particular, they complained about rules that would have made it more difficult for the companies to fairly -- or unfairly -- cancel policyholders.

        For example, an early version of the health care bill passed by the House of Representatives would have created a Federal Office of Health Insurance Oversight to monitor and regulate insurance practices like rescission. WellPoint lobbyists pressed for the proposed agency to not be included in the final bill signed into law by the president.

        They also helped quash proposed provisions that would have required a third-party review of its or any other insurance company's decision to cancel a customer's policy.

        A WellPoint spokeswoman on Thursday denied such lobbying took place.

        The new law does leave open the possibility of reform in this area, these sources say. The reason, they say, is that much of the new legislation is essentially a roadmap, with regulations to be decided later.

        "The lack of specificity doesn't mean that nothing is going to be done," said a senior congressional staffer who has played a key role in the health reform debate. "The law grants HHS (the Department of Health and Human Services) the discretion to promulgate regulations. This is very much a work in progress."

        Among other things, the staffer said, the White House could revisit proposing tough new regulations requiring third-party review of policy cancellations.

        Victoria Veltri, the general counsel of Connecticut's Office of Healthcare Advocate, a state agency that investigates complaints by policyholders, says she has seen the success of such a process in her home state. One company, Aetna, has voluntarily agreed to engage in the third party review, with what she described as favorable results.

        "I haven't seen an Aetna case in our office since they went to the third party review process," she said. "It's a powerful tool to have a third set of eyes required before someone is rescinded."

        For its part, WellPoint said it began offering third-party reviews in 2008.

        A senior Obama administration official said he remained confident that mandatory third-party reviews of rescissions is not entirely out of reach.

        "It might take some wrangling with the insurance industry, some strong-arming, maybe even use of the presidential bully pulpit," he said on condition of anonymity.



    • Except the Health Care...

      Can modify, but impossible to repeal...IMO

      • 1 Reply to Retired_1998T
      • <Can modify, but impossible to repeal...IMO>

        Not impossible but tend to think you are right when looking at DC legislative branch. Starting to see some Rep's say that there are a few things good in the new Healthcare law and they should be kept. Basic language meets yours. Modify.

        But there are 2 other places that may change the dynamics. First the Supreme Court. In the past the Supreme Court has stated that "portions" of a new law may be "Unconstitutional" but allowed the rest to remain. But there is a twist to that today. It comes from the NY vs Clinton striking down the line-item veto and the President having to accept a submitted Bill as issued or to veto it with noted objections. Now that same argument can be used to say that a Bill submitted with parts being later ruled Unconstitutional is no longer the same bill that the President signed into law and thus now not being complete is no longer valid. Great Constitutional issue but like I said the 1997 NY vs Clinton has addressed this.

        The final part is the States. Some States has already internally Legislated that parts of the new law will not be recognized. Many have already filed for Federal Judicial review. But there always is a Constitutional Amendment that if passed by the States, nobody, not Congress, not the President, not the Supreme Court, can do a damn thing about.

        If it gets to the last part, watch for the pendulum to swing extremely fast to the right.

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