March 22, 2007
BEST HEALTHCARE IN THE WORLD....PART 87....The state of California has fined Blue Cross $1 million for illegally cancelling policies:
The investigation found that Blue Cross used computer programs and a dedicated department to systematically cancel the policies of pregnant women and the chronically ill regardless of whether they intentionally lied on their applications to cover up pre-existing medical conditions, a standard required by state law for canceling individual policies. Regulators examined 90 randomly selected cases of policy cancellations and found violations in each one.
Italics mine. According to the LA Times, the fine came about as the result of an "unprecedented investigation" prompted by a story they ran a few months ago. Maybe next time state regulators shouldn't wait.
—Kevin Drum 9:41 PM
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Say it ain't so!! Corporate America .. out to screw the little guy.
Posted by: This Machine Kills Fascists on March 22, 2007 at 9:57 PM | PERMALINK
Doesn't the fine seem rather low?
How many patients had their coverage canceled?
Posted by: Carl Nyberg on March 22, 2007 at 10:11 PM | PERMALINK
Now that's the way to pimp the LA Times, Kevin! Not some "piddling" dust-up over someone who's dating the third cousin of Paul Michael Glazer or whatever...
Seriously, I'd be willing to bet that this has happened in a lot more places in BC/BS California.
Posted by: grape_crush on March 22, 2007 at 10:14 PM | PERMALINK
I'm sorry, but what kind of Austin Powers disease is this? $1 milion? This will have zero effect on the behavior of Blue Cross.
Posted by: mso on March 22, 2007 at 10:17 PM | PERMALINK
What mso said. For $1 million, BCBS probably still comes out ahead by having this program to cancel the policies.
A class action suit is needed here.
Posted by: Tim O'Keefe on March 22, 2007 at 10:23 PM | PERMALINK
American Squawk: Okay, so they lied on their application, but Blue Cross can't use a crystal ball to prove that the lie was 'intentional'. This costs them a million bucks? Talk about some overzealous buerecrats. It would be nice if the LA Times actually outlined some of the cases, but of course doing so would show how weak the story is.
Translation: breaking the law is okay, if you are a big, conservative corporation and the requirements of the law are inconvenient or too difficult to take advantage of and you can't or don't want to get the law changed.
Posted by: Google_This on March 22, 2007 at 10:33 PM | PERMALINK
Ah, Kevin.
The plain fact of the matter is that resources are a scarce commodity. I would love for everyone to have there own airport so they could fly from place to place in luxury for free, but ain't gonna happen, becuase rescources are scarce.
Same dynamic in health care. Universal healthcare just exasterbates the problem because of moral hazard and too many people using too much resources. Basically hyperinflation. Either that, or you have to wait two years for hip replacement surgery, and the standard of care isn't that great, like in Canada.
Posted by: egbert on March 22, 2007 at 10:38 PM | PERMALINK
A million bucks? If the fines are this low, it might actually be cheaper for BCBS to continue breaking the law.
Posted by: keptsimple on March 22, 2007 at 10:41 PM | PERMALINK
A piddling $1 million? BlueCross makes that overnight.
Not enough. Jerry Brown should go after them for racketeering, the crooks.
Posted by: Old Hat on March 22, 2007 at 10:44 PM | PERMALINK
egbert: The plain fact of the matter is that resources are a scarce commodity.
Funny that they don't seem to be scarce when it comes to funneling resources down the black hole called "The Iraq War" or to Halliburton with no-bid contracts.
Posted by: Google_This on March 22, 2007 at 10:44 PM | PERMALINK
We'd have more resources if we didn't spend so much money on administration.
Posted by: mwg on March 22, 2007 at 10:46 PM | PERMALINK
Ah, Egbert.
"Resources are a scarce commodity." You could have stopped right there because though you still had more entertainment to provide, you'd marked yourself as terminally stupid well before you printed the letters "exasterbates" right next to each other, suggesting to us that you had a word in mind. And by "mind" I mean whatever is between your ears.
Posted by: Ed Bed on March 22, 2007 at 10:48 PM | PERMALINK
http://www.cmanet.org/publicdoc.cfm?article_id=290&docid=2&parent=1&templateinc=presssection2&all=yes
The report also compiles data on executive compensation for publicly traded health plans. Wellpoint Health Networks, the parent company of Blue Cross of California, reported that CEO Schaeffer received $7 million in total stock, salary and other compensation. The next highest compensation is reported for Aetna CEO John Rowe, M.D., at $3.5 million.
Posted by: Old Hat on March 22, 2007 at 10:53 PM | PERMALINK
SquawkEgg,
Why are you guys so determined to be wrong on everything? Just because the law says hey have to intentionally lie to be cancelled does not at all mean that the women lied in every case. And yet you are sure that Americans are wrong, wrong, wrong in every instance when butted up against governments, corporations, or the law. As I always say, North Korea needs more people like you.
By the way, we have seem to have the resources to kill people (including our own) in faraway places, but that´s more than okay to you pissants--if real, and we´ve all noticed that when challenged, you never bother to deliver even the vaguest of assertions as to your own existence.
Posted by: Kenji on March 22, 2007 at 10:54 PM | PERMALINK
http://www.aflcio.org/corporatewatch/paywatch/ceou/database.cfm?tkr=WLP&pg=1
Larry C. Glasscock
Chief Executive Officer
WellPoint Inc.
In 2005, Larry C. Glasscock raked in $16,277,139 in total compensation including stock option grants* from WellPoint Inc.
And Larry C. Glasscock has another $55,936,000 in unexercised stock options from previous years.
Posted by: Old Hat on March 22, 2007 at 10:56 PM | PERMALINK
...becuase rescources are scarce...
Universal healthcare just exasterbates the problem because of moral hazard and too many people using too much resources. Basically hyperinflation. Either that, or you have to wait two years for hip replacement surgery, and the standard of care isn't that great, like in Canada.
Posted by: egbert on March 22, 2007 at 10:38 PM | PERMALINK
egbert, do you ever think anything through?
Like the people in the US who NEVER get a hip replacement. Or the care here, even for vets, that isn't "that great". Or the "moral hazard" of NOT providing health care to those who cannot afford the US system? And of course we don't have "too many people" using the resources because the health insurance companies can just cut them out.
How polluted is your thought process? How?
And hyperinfaltion? And health costs have gone up by how much over the last 25-30 years compared to general inflation, CPI?
And, of course, American Hawk can't understand that the insurance company defrauded 90 out of 90. Obtuse, ignorant, or deliberately antagonistic?
Oh, and egbert, is exasterbates like masturbates but you just don't know you are doing it?
Posted by: notthere on March 22, 2007 at 10:57 PM | PERMALINK
Could be worse...
You could be a pregnant vet.
Posted by: McPundit on March 22, 2007 at 11:05 PM | PERMALINK
Like egbert knows anything about health care in Canada.
Posted by: Kenji on March 22, 2007 at 11:06 PM | PERMALINK
Universal healthcare just exasterbates the problem
Egbert, you are comedy gold.
My guess is that exasterbates means the feeling of annoyance a 15 year old feels whenever his Mum barges into his room just as he's 'almost there'.
Posted by: floopmeister on March 22, 2007 at 11:13 PM | PERMALINK
Ed Bed:"And by 'mind' I mean whatever is between your ears."
Please be advised that egbert's ears are useful only as handles.
Posted by: Donald from Hawaii on March 22, 2007 at 11:14 PM | PERMALINK
Aaarrgghhh - close the Bold tags!
That is just so exasterbating.
Posted by: floopmeister on March 22, 2007 at 11:15 PM | PERMALINK
Like egbert knows anything about health care in Canada.
Posted by: Kenji on March 22, 2007 at 11:06 PM | PERMALINK
Kenji. Normally known as short, to the point and cogent.
"Like egbert knows anything."
Tha'ya go. Improved?
Posted by: notthere on March 22, 2007 at 11:19 PM | PERMALINK
Better.
Posted by: Kenji on March 22, 2007 at 11:28 PM | PERMALINK
Not so fast, Kevin. I've seen first-hand how this operates, and it's bogus.
The exams are rigged against the companies. The way it works is that the state selects only policies on which complaints have been received. Surprise, surprise, the state finds that virtually 100% of the selected policies have violations. Then it imposes penalties based on the same percentage of the company's entire book of business. This proves that your regulators are getting the job done for consumers.
But, if you're on the receiving end of this procedure, it feels like being mugged.
Posted by: FS on March 22, 2007 at 11:34 PM | PERMALINK
My guess is that exasterbates means the feeling of annoyance a 15 year old feels whenever his Mum barges into his room just as he's 'almost there'.
Very nice. And that kind of thing is why I miss you when you deprive us of your presence - or at least I have been missing you anyway.
How the hell you been?
Posted by: Blue Girl, Red State (aka Global Citizen) on March 22, 2007 at 11:36 PM | PERMALINK
Used to be that CA had an "insurance bad faith" rule, so that when an insurance company did stuff in bad faith (drag out litigation, witholding settlement money, in the hopes that the victim would die & collect less), you could sue them for TRIPLE DAMAGES.
Maybe it was only auto/casualty insurers, and maybe it was repealed after prolonged whining by insurance criminals, but health insurers are just as slimy as other types, and someone needs to wield a BIG hammer to get them to toe the line: either regulators, or consumers via lawsuit.
Posted by: Satan luvvs Repugs on March 22, 2007 at 11:54 PM | PERMALINK
FS: if you're on the receiving end of this procedure, it feels like being mugged
Oh, the poor dears, a whole million dollars, the injustice!
Cry me a river.
Posted by: alex on March 22, 2007 at 11:54 PM | PERMALINK
...But, if you're on the receiving end of this procedure, it feels like being mugged.
Posted by: FS on March 22, 2007 at 11:34 PM | PERMALINK
Then why wouldn't you fight that argument in court? Or at appeal? I can't see what would stop a company from putting that forward as a counter.
Your ball.
Posted by: notthere on March 22, 2007 at 11:56 PM | PERMALINK
This Machine Kills Fascists wrote: Say it ain't so!! Corporate America .. out to screw the little guy.
Blue Cross is a non-profit organization, not a corporation. Don't blame corporations foe Blue Cross's flaws.
Posted by: ex-liberal on March 23, 2007 at 12:21 AM | PERMALINK
As long as the state properly follows its own procedures, the company has little or no recourse.
It didn't always work this way. Ten or twenty years ago, insurance departments would audit the company's files looking for irregularities and penalize the company based on the proportion in error. Audits are obviously much more efficient these days since every policy is automatically found to be in error.
Don't think that I'm sympathetic to insurance companies. I believe in nailing them for misconduct but not in nailing them using unfair methods. Regulators get a lot of press for penalizing companies, but from what I've seen it's mostly for innocent mistakes. Is that what you want the regulators to focus on? What they really should be doing is shutting down the crooks.
Let me add that I don't know the particulars of the story that Kevin described and I don't have an opinion one way or the other about the state's actions. My only point is that you can't rely on stories like this to prove that companies are engaged in wrongdoing when the process is designed to guarantee that the company will always be at fault.
Posted by: FS on March 23, 2007 at 12:34 AM | PERMALINK
GC - nice to know you've been missed!
I've been on holidays, actually, on tour with little floop and floopmistress in SE Asia.
Now back at the computer in the office...
Sob.
How about yourself?
BTW, Donald:
Please be advised that egbert's ears are useful only as handles.
Nice!
With that image in mind, check out this shot of Our Glorious Leader and His Deputy in Parliament...
Posted by: floopmeister on March 23, 2007 at 12:38 AM | PERMALINK
When I need the benefits of my health insurance, I need it at the time I am sick (or the pregnant woman needs it when pregnant and when giving birth.) Even if the insurance company is caught denying benefits illegally, as most are not, then they don't get sued or fined until a long time after the benefits are actually needed.
A private health insurer has one purpose. That is to make money. They are not there to help pay for your health care. They are there to collect payments on your health insurance policy and pay out as little as possible. They can make a lot of money as long as they receive the payments and don't pay the benefits. It doesn't matter to them if you don't use the benefits because you are healthy, or because they deny your policy when the benefits should have been paid. It just matters that they get richer if they do not pay out the benefits on your health insurance.
The government does not have a profit motive. The covered benefits are paid when they are needed. If they aren't, then the government is carefully watched by large numbers of people who want to catch them out. Clearly we cannot say the same for even the very best of the private insurance companies. Blue Cross/Blue Shield has usually been the very best.
The health care industry should be working to keep people healthy or make them well. They should not be working to get rich themselves. (And most aren't.) But as long as we have private health insurance companies trying to skim off the healthiest of the rate payers, health care will cost too much for those who can pay for the insurance, while leaving a lot of people out - often unexpectedly as the customers of Blue Cross in California found.
This is one more very strong argument for single-payer national health care.
Posted by: Rick B on March 23, 2007 at 12:44 AM | PERMALINK
The government does not have a profit motive. The covered benefits are paid when they are needed. If they aren't, then the government is carefully watched by large numbers of people who want to catch them out. Clearly we cannot say the same for even the very best of the private insurance companies. Blue Cross/Blue Shield has usually been the very best.
Who are these "large numbers of people" who audit government programs and guarantee that they're doing the job they're supposed to? They seem to suck at it in most other areas of government spending.
The government may not have a "profit motive," but the motives they do have aren't that laudable either.
Posted by: harry on March 23, 2007 at 12:47 AM | PERMALINK
ex-lib,
Did you read the LAT article? It's not just Blue Cross:
The investigation was fueled by a series of stories in The Times that disclosed that Blue Cross, along with other insurers such as Blue Shield of California and Kaiser Permanente, routinely canceled coverage of individual policyholders whose medical care resulted in large claims, prompting some to lose their homes or suffer other hardships.
Earlier in the article:
The report said the legal standard for cancellations is high because such action may put the policyholders' health at risk by making it difficult to obtain needed care. Such cancellations also hurt hospitals and physicians by denying them payment for treatment that was, in many cases, authorized by the health plan.
"Rescinding health care coverage is a serious action, placing the enrollee at financial risk for the full amount of billed medical charges and potentially rendering the enrollee uninsurable," the report said.
Not only do enrollees get hurt, but so do other businesses...hospitals and health care professionals. And if enrollees go bankrupt due to an uncovered medical expense, there's the impact on the businesses and services that they used...a ripple effect.
Posted by: Apollo 13 on March 23, 2007 at 12:47 AM | PERMALINK
As for a mere $1.000.000 fine, that is probably the lifetime maximum benefit payout for one of Blue Cross' low cost policies. Every case of AIDS or Leukemia costs more than that. So does a premature baby or a heart transplant.
A $million is chump change, just nibbling around the edges. It looks good in the LA Times, but it's not like a $ million is real money any more.
Posted by: Rick B on March 23, 2007 at 12:52 AM | PERMALINK
Egbert,
I know people who fly to Thailand to get transplant surgery at a price between 20% and 30% of what they would pay here - including the plane ticket and hotel expenses.
The standard of care there is as good as it is here. In fact, most of the physicians working there got their training here in the U.S.
Posted by: Rick B on March 23, 2007 at 1:01 AM | PERMALINK
Floop: Just went back to school after spring break. On the downhill slope to finals, and thinking about taking this summer off, maybe traveling a little, or just going to the country and hanging out up there.
Posted by: Blue Girl, Red State (aka Global Citizen) on March 23, 2007 at 1:05 AM | PERMALINK
The standard of care there is as good as it is here.
I used to live next door in Laos - I got dental work done in northern Thailand regularly.
$20 US per filling - done years agao, and still no problems.
I have two close friends who gave birth in Thailand - one in Bangkok and one in the regional city of Udon Thani. Good hospitals - modern, clean and well equipped.
Also, however corrupt Thaksin was (and he was!) he was elected legitimately by his power base in poor rural areas because he promised cheap quality health care. It was definitely pork barrelling, but then he delivered cheap quality health care.
Egbert is the classic ignorant provincial; the strength of his opinions is in an inverse relationship to his knowledge of the world beyond his own shrunken horizons.
Posted by: floopmeister on March 23, 2007 at 1:09 AM | PERMALINK
...his own shrunken horizons.
Clever ending that reiterates your first witty comment, floop.
Good to see you here.
Posted by: Apollo 13 on March 23, 2007 at 1:12 AM | PERMALINK
Rick B --
nice summary.
Posted by: notthere on March 23, 2007 at 1:13 AM | PERMALINK
Kevin Drum >"...Maybe next time state regulators shouldn't wait."
Well they did have to wait for the pay to play checks to bounce.
"No place is so strongly fortified that money could not capture it." - Marcus Tullius Cicero
Posted by: daCascadian on March 23, 2007 at 1:21 AM | PERMALINK
Blue Cross is a non-profit organization, not a corporation...ex-lax at 12:21 AM
Nor for profit?
Some of the state plans have been merged to achieve economies of scale. Many plans are administered by not-for-profit organizations, while others are for-profit companies. (Though all Blue Cross-Blue Shield plans must pay Federal income tax under the Tax Reform Act of 1986, some plans are still considered not-for-profit at the state level.) The 14-state WellPoint is the largest Blue Cross-Blue Shield member, and is a publicly traded company. Other multi-state organizations include CareFirst in the Mid-Atlantic and The Regence Group in the Pacific Northwest. The largest non-investor owned member is Health Care Service Corporation (HCSC), which operates four Blue Cross and Blue Shield Plans in the Midwest and Southwest.
In 2003, the Blue Cross and Blue Shield Association took in US$182.7 billion in revenue.
Perhaps it started as a fine of $1,000,000,000 and Bush's DoJ made them reduce it because Blue Cross is a good Republican campaign contributor?
Posted by: Mike on March 23, 2007 at 1:34 AM | PERMALINK
Hey, Apollo, I suck at this, but what the hell? I'm among friends...
Smart commenter's at
Political Animal
Makes it a good read
Posted by: Blue Girl, Red State (aka Global Citizen) on March 23, 2007 at 1:50 AM | PERMALINK
GC - enjoy your break... it sounds like you deserve it!
Posted by: floopmeister on March 23, 2007 at 2:01 AM | PERMALINK
Okay - I'll cease and desist with the haiku offending.
Posted by: Blue Girl, Red State (aka Global Citizen) on March 23, 2007 at 2:06 AM | PERMALINK
Anyways, off home - my journey home by tram tonight will be much slower due to this sobering reason - the sirens are still wailing through the city.
Three dead and counting...
This is the main through-city tunnel under Melbourne.
Posted by: floopmeister on March 23, 2007 at 2:08 AM | PERMALINK
Oh that is terrible. I hope they don't find more victims in the wreckage.
By the way, I saw wall of fire and tunnel and you know where my mind went, so the conditioning is working.
Damnit.
Posted by: Blue Girl, Red State (aka Global Citizen) on March 23, 2007 at 2:15 AM | PERMALINK
Yeah exactly. That's the way the conditioning works.
:(
Later.
Posted by: floopmeister on March 23, 2007 at 2:16 AM | PERMALINK
Globe that didn't suck. At. All. Don't cease. Here's your reward.
What about limericks?
Posted by: Apollo 13 on March 23, 2007 at 2:16 AM | PERMALINK
(*Smiling and curtsying*) Thank you very much. I'll treasure it.(Seriously. I already made a word document of both your comments and printed it.)
I used to be pretty good at limericks actually - I'll brush up.
Posted by: Blue Girl, Red State (aka Global Citizen) on March 23, 2007 at 2:22 AM | PERMALINK
I posted a limerick on a thread weeks ago to some wingnut with the handle of "ed"...
I once knew a dullard named ed,
Whose ass got switched with his head.
When he talked, he farted, and his ideas imparted
A stink from the shit that he said.
Posted by: Apollo 13 on March 23, 2007 at 2:28 AM | PERMALINK
But I dunno if I was ever that good!
I'll brush up...
Posted by: Blue Girl, Red State (aka Global Citizen) on March 23, 2007 at 2:39 AM | PERMALINK
OT (OT score: 80%+)
Limericks? Okay, I'm game...
A commenter, name of ex-lib
Proves so impossibly glib
That not want though they might
The others all bite
To debunk his fib, fib after fib
A commenter known as Jay
Believes that the night is as day
That white is as black
That he's not a hack
That sickness is really okay
That parody Norman is thought
By some to be real is now what
Boggles my mind
If I'm to be kind
Most surely a person he's not
Posted by: snicker-snack on March 23, 2007 at 5:08 AM | PERMALINK
You rock, snicker-snack.
Posted by: Apollo 13 on March 23, 2007 at 6:38 AM | PERMALINK
thanks, Apollo. Okay, one last stab (sorry it's a bit lame...)
When Apollo 13's on the point.
The trolls they get knocked out of joint.
They gawk and they stare
At their entrails laid bare.
I hereby troll-killer annoint.
(I endeth here!)
Posted by: snicker-snack on March 23, 2007 at 8:00 AM | PERMALINK
$ 1 million sounds like peanuts to me. Nothing compared to the advantages to criminal insurers of illegally canceling policies to defraud their clients. I think this case calls for criminal prosecution for fraud. In any case, fines have to be commensurate with the incentives to defraud and that means billions, if caught, not 1 pathetic million.
I note that my view of the miniscule size of the fine is widely shared as noted in the article "fined Blue Cross $1 million — an amount immediately criticized by canceled policyholders and consumer advocates as too small to matter to an insurer whose parent company, WellPoint Inc., earned $3.1 billion in profit last year".
The tiny fine also seems strange given precedent. Here the Department of Managed Health Care found 90 cases of fraud and strong grounds to suspect that there are around 1000 more a year and the fine is $1,000,000, yet recently they fined Blue Cross $200,000 for a single case "Blue Cross is appealing a $200,000 fine imposed in September, the first in an individual rescission case. In that matter, the department accused the health plan of illegally canceling a woman's medical policy". 200,000x90 = 1,000,000 is strange arithmetic.
Also, does the Department of Managed Health Care intend to examine the other thousands of cases given Blue Cross's perfect record of fraud ?
At $200,000 a pop for examining one person's medical and insurance records, the examination would pay for itself many times over. Now $ 200 Blue cross's attention.
Posted by: Robert Waldmann on March 23, 2007 at 8:34 AM | PERMALINK
Must. Stop. Feeding. Trolls. Can't. Stop.
Can't help trying to teach American Hawk English (not to mention a LA Times copy editor messed up)
"ALWAYS CLICK THE LINK.
'[snip] ntentionally lied [snip]'
Okay, so they lied on their application, but Blue Cross can't use a crystal ball to prove that the lie was 'intentional'. [snip]
Posted by: American Hawk"
A lie is an intentional false statement. It is not possible to lie unintentionally. The word intentionally is redundent. Correct English would be "lied" or "intentionally made false statements".
Ms Troughton has managed a determined assault on plain English with ""California law is clear that rescission generally does not require a showing of intent to deceive or willful misrepresentation," WellPoint spokeswoman Shannon Troughton said. "All that is required for misrepresentation to be 'intentional' is that the true facts be known to the applicant." That is, "intentional misrepresentation" does not imply "intent to deceive" and an action can be "intentional" without being "willful".
George Orwell is spinning in his grave.
Posted by: Robert Waldmann on March 23, 2007 at 8:44 AM | PERMALINK
Okay, so they lied on their application, but Blue Cross can't use a crystal ball to prove that the lie was 'intentional'. This costs them a million bucks?
So a woman doesn't realize she's pregnant when she gets the policy and later the policy is canceled because she had a "pre-exisitng condition".
Ain't capitlism grand ?
Posted by: Stephen on March 23, 2007 at 9:04 AM | PERMALINK
I'm not sure if this was discussed above but the article doesn't seem to indicate that the $1M will be distributed amongst the damaged citizens. The state will simply take the money and do something with it.
Years ago I was involved in starting a small busienss (less than 10 employees) and we tried to obtain health insurance for our group. Because my 3 year old son was a juvenile diabetic no insurance company would cover us. We were led down a long path to nowhere by a less than scrupulous insurance agent and I filed a formal complaint with the State Insurance Commissioner's office. The SIC was glad to get my letter, proceeded to fine the agent in question for illegal practices but stated they could do nothing to help me. We didn't even get any of the paltry fine they imposed on the agent.
BCBS is no different than any other insurance company. The LAST thing they want to do is actually insure people who need it most. And the government oversight agencies might try to punish them but that LAST people to benefit from any of this action are the poor bastards that pay their premiums.
Posted by: lamonte on March 23, 2007 at 9:05 AM | PERMALINK
So AmericanHawk says someone starts getting cancer before they get a new job and the new Blue Cross insurance policy. Often it takes months for symptoms to show up. So three months on the job, the person feels ill, feels a lump somewhere and goes to the doctor and discovers he or she has cancer. He didn't know he had it when they started the new job and reported he was perfectly healthy to the insurance company. Because the cancer *might* have started before this person got the insurance policy, according to American Hawk, they deserve to have their policy cancelled and be accused of lying. And then go into bankruptcy to pay those medical bills and be accused of irresponsible because he didn't have $100,000 laying around just in case.
Yeah, wonderful system we have here.
Posted by: lou on March 23, 2007 at 9:15 AM | PERMALINK
Blue Cross didn't even blink at the million dollars.
Posted by: crooked pinky on March 23, 2007 at 10:07 AM | PERMALINK
I have a conservative friend with an underdeveloped empathy gland. He didn't believe that poor people should have affordable medical care. He wanted doctors to treat him first when he needed help.
He went to Canada to get his empathy gland enhanced. Now he is a much more pleasant person with more friends and a winning personality. He no longer pushes people out of his way to get what he wants.
Posted by: deejaays on March 23, 2007 at 10:13 AM | PERMALINK
I've been thinking lately of political initiatives that would be sure barn-burning electorate-pleasers and have come up with two:
1) (on topic here) would be legislation and bureaucracy to take the side of the insured person to enforce timely, complete and unweaseled medical coverage and recompense. Fr'instance I have my own personal health insurance from my job and secondary coverage through my wife's state family policy. Result: I can't either to pay much of anything and mounting fury on my part
2) Credit card reform that would cap interest, make late fees reasonable, etc. etc.
These are vote-for-the-candidate-in-a-hearbeat measures............
Posted by: Stewart Dean on March 23, 2007 at 11:23 AM | PERMALINK
Instead of fining Blue Cross, the company should be shut down, its assets seized, and its corporate officers and board of directors imprisoned. Otherwise, the fine should have been a billion dollars.
Posted by: Brojo on March 23, 2007 at 12:30 PM | PERMALINK
A commenter named snicker-snack
And all of his liberal claque
...Attempt to defuse
...Conservative views
By using a personal attack.
Posted by: ex-liberal on March 23, 2007 at 12:35 PM | PERMALINK
Apollo, neither Blue Cross, Blue Shield nor Kaiser are corporations. Corporations earn profits that go to their owners. These 3 large non-profit organizations do not have owners that take profit out of the proceeds, even though they do pay income tax.
Most of the large health insurance providers are not corporations. The complaint here is against large organizations, not against corporations.
Posted by: ex-liberal on March 23, 2007 at 12:44 PM | PERMALINK
When the government runs health care, what you rail against as happening at Walter Reed will be the norm everywhere.
No, not when "the government" runs health care. When a deeply corrupt Republican government runs health care. Politicians who actually care get the job done.
It's already been established that at Walter Reed, Dubya's privatization is a big cause of the depth of the mess. Whereas under Clinton, the system turned around to become one of the premier systems in the nation, with top marks for patient satisfaction. Can't find a link just now but Kevin's already pointed this out numerous times.
Posted by: Baxil on March 23, 2007 at 1:10 PM | PERMALINK
ex-liberal:
Unted Healthcare IS a corporation and their Chairman, Wlliam McGuire, was given billions (with a b) of dollars in compensation and stock options for doing nothng more than committing piracy by servng as an unnecessary mddleman and inflating the costs of healthcare. Time to let government do what the pirates of the so-called free enterprise system caannot.
TCD
Posted by: The Conservative Deflator on March 23, 2007 at 1:12 PM | PERMALINK
Leaving aside the problems involved when people employ the almost meaningless 'average'...it's the Bill Gates walks into Burger King and - presto! - the average income of everyone in the place soars if only for an instant...
'And the fact is, $1 million doesn’t go as far these days as it used to. For one thing, it’s vulnerable to inflation — someone who bought $1 million worth of goods in 1957 would need $7.3 million to buy the same goods today, according to Federal Reserve figures.
“Take a baby boomer who has less than $50,000 in savings — which is what the average baby boomer has — and tell them they need $1 million, you might as well give them a gun and tell them to shoot themselves,” [David Bach] said.'
http://www.msnbc.msn.com/id/17706852/page/2/
Posted by: MsNThrope on March 23, 2007 at 1:37 PM | PERMALINK
Apollo, neither Blue Cross, Blue Shield nor Kaiser are corporations.
Yes, they are.
Corporations earn profits that go to their owners.
Wrong. Maybe you need to go learn what a corporation is and get back to us. Your first clue should be this: the phrase "nonprofit corporation" is not an oxymoron.
Posted by: cmdicely on March 23, 2007 at 2:08 PM | PERMALINK
Apollo, neither Blue Cross, Blue Shield nor Kaiser are corporations. Corporations earn profits that go to their owners. These 3 large non-profit organizations do not have owners that take profit out of the proceeds, even though they do pay income tax. ...Most of the large health insurance providers are not corporations. The complaint here is against large organizations, not against corporations.
Organization, smorganization. And this exempts them from fucking over consumers how?
And why are you knit-picking about nonprofit organizations versus corporations? As if this somehow lessens the wrong-doing?
Technically speaking, because that seems to be the road you want to travel, nonprofits are corporations...Wiki:
In the United States, nonprofit organizations are normally formed by incorporating in the state in which they expect to do business. The act of incorporating creates a legal entity enabling the organization to be treated as a corporation under law and to enter into business dealings, form contracts, and own property as any other individual or for-profit corporation may do. ...A primary difference between a nonprofit and a for-profit corporation is that a nonprofit does not issue stock or pay dividends, (for example, The Code of the Commonwealth of Virginia includes the Non-Stock Corporation Act that is used to incorporate nonprofit entities) and may not enrich its directors. However, like for-profit corporations, nonprofits may still have employees and can compensate their directors within reasonable bounds."
Ever heard of a the tax-exempt
501 (c) (3) nonprofit corporation? Yes, ex-lib, even tax-exempt charities are legally
corporations.
If you're quibbling over TMKF's "Corporate America .. out to screw the little guy comment, I don't see how you have dismissed the screwing over of the little guy with your red herring about organizations that are nonprofit corporations versus for-profit corporations.
How about this: Organization America ...out to screw the little guy! Feel better now? Sheesh. I don't. And I bet the enrollees who were dropped from their health care plan don't appreciate the frigging difference either.
Secondly, which you conveniently ignored, see Mike's post at 1:34 AM.
Now add to Mike's post, TCD at 1:12 PM and cmdicely at 2:08 PM.
Posted by: Apollo 13 on March 23, 2007 at 2:19 PM | PERMALINK
thanks, Apollo. Okay, one last stab (sorry it's a bit lame...)
snicker-snack...Lame? I humbly bow with gratitude to you, a limerick master.
Posted by: Apollo 13 on March 23, 2007 at 2:35 PM | PERMALINK
Apollo 13 wrote: Organization, smorganization. And this exempts them from fucking over consumers how?And why are you knit-picking about nonprofit organizations versus corporations? As if this somehow lessens the wrong-doing?
It places blame where it belongs -- on the organizatio, rather than on the profit motive.
Technically speaking, because that seems to be the road you want to travel, nonprofits are corporations...Wiki:
In the United States, nonprofit organizations are normally formed by incorporating in the state in which they expect to do business. The act of incorporating creates a legal entity enabling the organization to be treated as a corporation under law and to enter into business dealings, form contracts, and own property as any other individual or for-profit corporation may do. ...A primary difference between a nonprofit and a for-profit corporation is that a nonprofit does not issue stock or pay dividends, (for example, The Code of the Commonwealth of Virginia includes the Non-Stock Corporation Act that is used to incorporate nonprofit entities) and may not enrich its directors. However, like for-profit corporations, nonprofits may still have employees and can compensate their directors within reasonable bounds."
Fair point.
If you're quibbling over TMKF's "Corporate America .. out to screw the little guy comment, I don't see how you have dismissed the screwing over of the little guy with your red herring about organizations that are nonprofit corporations versus for-profit corporations.
When we think of corporations, we think of companies like General Motors or IBM. Harvard University is (I think) a non-profit corporation. When Harvard increases its tuition, we don't describe it as "corporate greed."
How about this: Organization America ...out to screw the little guy! Feel better now?
Yes, I do. If the problem is corporate greed, than government-supplied health insurance is a good alternative. If the problem is large organizations, then a huge governmental insurance program is apt to make matters worse.
Secondly, which you conveniently ignored, see Mike's post at 1:34 AM. Now add to Mike's post, TCD at 1:12 PM and cmdicely at 2:08 PM.
The 1:34 AM post emphasized how large some of these not-for-profit organizations are. I agree. His 1:12 PM post gave an example of a for-profit health care provider. It doesn't contradict my assertion that the not-for-profit firms are more significant.
cmdicely at 2:08 correctly pointed out that not-for-profit corporations are still corporations. He is correct and I was technically wrong.
Posted by: ex-liberal on March 23, 2007 at 5:21 PM | PERMALINK
ex-lib: It places blame where it belongs -- on the organizatio, rather than on the profit motive.
No, it doesn't. A nonprofit corp as well as a for-profit corp can be motivated to make money and run afoul due to corruption, greed, mismanagement, etc. A nonprofit case and point: United Way of America, whose board included CEOs from Microsoft, Exxon, Johnson & Johnson, J.C. Penney, and Sears, the IBM chairman; presidents of unions, and the NFL commissioner. Funny that.
Also from the LAT article:
...the Department of Managed Health Care on Thursday said that it had fined Blue Cross $1 million — an amount immediately criticized by canceled policyholders and consumer advocates as too small to matter to an insurer whose parent company, WellPoint Inc., earned $3.1 billion in profit last year on revenue of $57 billion.
Wellpoint, the parent company of Blue Cross, had a profit motive. Furthermore:
The state investigation found that Blue Cross used computer programs and a dedicated department to systematically investigate and cancel the policies of pregnant women and the chronically ill regardless of whether they intentionally lied on their applications to cover up preexisting medical conditions — a standard required by state law for canceling individual policies.
You explain to me...what was their motive to "systematically" cancel eligible enrollees? And please, this isn't about an accounting terminology...gross or net profits...this about who profits from scrubbing sick enrollees off the accounts of claims to pay. Who would profit from that practice? Maybe employees received bonuses or raises for having low claims. I dunno. But I don't think eligible enrollees were dropped just for shits and giggles. Do you?
Here's the link to BC of California's Corporate Profile in which it states that BC is a subsidiary of "WellPoint Health Networks Inc. (NYSE:WLP), one of the nation’s largest publicly traded health care companies." BC employs nearly 7,000 across the state. Also, "Blue Cross of California, BC Life & Health Insurance Company and WellPoint Health Networks Inc. are Independent Licensees of the Blue Cross Association."
When we think of corporations, we think of companies like General Motors or IBM. Harvard University is (I think) a non-profit corporation. When Harvard increases its tuition, we don't describe it as "corporate greed."
I am not part of your "we." I would describe it as "corporate greed" because again, let me reiterate, even a nonprofit is a corporation.
If the problem is corporate greed, than government-supplied health insurance is a good alternative. If the problem is large organizations, then a huge governmental insurance program is apt to make matters worse.
Greed, size, gross mismanagement, and incompetence are not mutually exclusive to either corporations (nonprofit or for-profit) or government. Enron was huge and look at its history of fraud, corruption, and greed. OTOH, having a "CEO president" has given us a poorly-run federal government (Katrina, waste, war-profiteering fraud) with mind-boggling deficits. Let me repeat: funny that.
I also do not accept your premise that a huge government insurance program would make matters worse. And guess what? Neither do most Americans, who according to Kevin's recent posts on the Pew surveys, give more support for government programs. From Pew, page 20 of the PDF report:
Despite being divided on government size, Americans are overwhelmingly in favor of the U.S. government guaranteeing health insurance for all citizens, even if it means raising taxes.Two-thirds of the public (66%) – including a majority of those who say they would prefer a smaller government (57%) – favor government-funded health insurance for all citizens.
What is at issue big-picture is keeping agreements, delivering value, minimizing waste, fostering trust, and providing competent service. And that is something I think you would agree is something "we" all desire from corporations and government. Well, maybe not all of us.
Posted by: Apollo 13 on March 23, 2007 at 8:11 PM | PERMALINK
You'd think the trolls would learn to stop using hip replacement therapy as an example of how good the US health care system is:
Hip replacements/100000
US: 102,
OECD average:138
So those damn socialists manage to do a third more hip replacements than we do.
Posted by: mcdruid on March 24, 2007 at 3:01 AM | PERMALINK
There is no one single healthcare system in the industrialized world worse than ours. you can cherry pick bad parts of this system and that, but you're being a dishonest hack when you do so.
Also, there is a good chance that this is the death of blue Cross in california. 1 million in fines won't kill them, but the trillions they'll be shelling out for wrongful death, contract violations and fraud will likely outweigh any profits they can hope to make. Out of 90 randomly chosen cases were picked, 90 cancellations were found to violate state law. This leads one to suspect that there is an extremely high rate of wrongful cancellations and it won't be long before jury's default to guilty in cases involving blue Shield.
Posted by: soullite on March 24, 2007 at 9:00 AM | PERMALINK
Conservatives continually lie about health care in Canada. They have to because the Canadian reality completely destroys their argument. The most down-and-out person in Canada has better health care than what you guys call "Gold-plated plans". Canada provides excellent health care from cradle-to-grave for the entire population and does it for about two-thirds the amount of money per capita as the USA spends. I've said it before, even most of you lefty Americans have no idea just how badly you're getting screwed.
Posted by: Von Rex (who loves Digby) on March 24, 2007 at 12:08 PM | PERMALINK
You just know that with these conservatards that someone in there life, some long-suffering liberal mother, spouse, or the like, is paying their freight so they can pontificate on the internet about their self-righteous conservative virtues. The minute they get a boo-boo it's off to use the insurance provided by someone whose job still offers medical benefits and time to compose some excuse deflecting criticism for their weakness.
Posted by: Biff Spaceman on March 24, 2007 at 3:35 PM | PERMALINK