“rescission”

[ortiga]

http://www.nytimes.com/2009/08/27/opinion/27kristof.html?_r=2&ref=opinion

"One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses."

[bkwits]

http://www.nytimes.com/2009/08/27/opinion/27kristof.html?_r=2&ref=opinion

"One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses."

Yes, that is what a lot of people aren't facing. Health insurance is a money-making enterprise just like other for-profit companies. My husband was denied coverage for his heart attack and subsequent quad bypass. He had changed insurance plans just 3 months before his attack so they said it was a pre-existing condition. Of course, it was pre-existing, but he didn't know it. It was terrible. He was still recuperating and had to deal with this. He couldn't work for months and was worried about how to pay the hospital bill. The insurance co. Golden Rule was so duplicitous that they put a fake name on the letter of denial.

We finally did get it paid because my husband was resourceful and aggressive in pursuing it. The bill was about 70k.

[Susan43]

http://www.nytimes.com/2009/08/27/opinion/27kristof.html?_r=2&ref=opinion

"One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses."

I have seen Wendell Potter a couple of times on TV and read his congressional testimony. What nobody sees in those ads is how much money goes to Wall St. Here is a little of his testimony and a link to it.

I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry. Insurers make promises they have no intention of keeping, they flout regulations designed to protect consumers, and they make it nearly impossible to understand — or even to obtain — information we need. As you hold hearings and discuss legislative proposals over the coming weeks, I encourage you to look very closely at the role for-profit insurance companies play in making our health care system both the most expensive and one of the most dysfunctional in the world. I hope you get a real sense of what life would be like for most of us if the kind of so-called reform the insurers are lobbying for is enacted.

Later he says this:

The average family doesn't understand how Wall Street's dictates determine whether they will be offered coverage, whether they can keep it, and how much they'll be charged for it. But, in fact, Wall Street plays a powerful role. The top priority of for-profit companies is to drive up the value of their stock. Stocks fluctuate based on companies' quarterly reports, which are discussed every three months in conference calls with investors and analysts. On these calls, Wall Street investors and analysts look for two key figures: earnings per share and the medical-loss ratio, or medical "benefit ratio," as the industry now terms it. That is the ratio between what the company actually pays out in claims and what it has left over to cover sales, marketing, underwriting and other administrative expenses and, of course, profits.

http://www.pbs.org/moyers/journal/07102009/potter_testimony.html

[Susan43]

BTW speaking of rescission. I happened to see those 3 insurance company CEO's that testified they would not stop rescission.

If you don't want to watch the whole thing just check out 4:50 where they are asked and answer the question.

http://www.youtube.com/watch?v=_29CCVI1ao4

[snookums1]

http://www.nytimes.com/2009/08/27/opinion/27kristof.html?_r=2&ref=opinion

"One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses." My sister-in-law worked for an insurance company until recently. She quit her job because she felt so guilty doing what the company wanted her to do. Her job was to deny procedures, many of them life saving procedures, if it meant that the insurance company might end up showing a loss. She also had to deny diagnostic procedures, something that if performed, could also save lives.

[Susan43]

My sister-in-law worked for an insurance company until recently. She quit her job because she felt so guilty doing what the company wanted her to do. Her job was to deny procedures, many of them life saving procedures, if it meant that the insurance company might end up showing a loss. She also had to deny diagnostic procedures, something that if performed, could also save lives.

Yes, it was guilt that drove Wendell Potter into whistleblowing. I guess if you can keep yourself from thinking that there are real, hurting people behind the numbers a person would be OK. Or some people might just be heartless or blaming the illness on the patient. But all the insurance companies do it. Even the so-called "non-profits."

And to think it all started with Nixon.