Bust the Health Care Trusts

[Homer_Rice]

Started probing my file cabinets and library for material today. Came across a number of things I've written that are pertinent (albeit a few are tangential) to the general state of affairs. Will post some of them here as time allows. All of these are pretty old, most over 20 years, so I might say a few things differently today than I did then. Nonetheless, fwiw, etc...

This first piece is an editorial exchange that took place in Spring 1993. The first part is the letter to which I replied and what follows is my reply. Names/identifications have been replace by brackets. Also, to correct one erratum on my part: I reference the G-S Act of 1932; actually there were two Acts and the 1933 Act is the one we associate with today's debates.



****
[b]State bank bad idea[/b]

I was incensed to read that the [newspaper] advocates the establishment of a government-owned bank in the state of Connecticut. The April 19 editorial supported the idea of taking $100 million of taxpayer money to establish a state-operated bank, which would provide loans to small businesses--no doubt those businesses with political clout. It seems ridiculous to have to point out the basic facts of the matter: the function of government is not to "operate," "stimulate," or otherwise manipulate the economy; its function is to protect the individual rights of its citizens. When instead it violates those rights by seizing their money and property, it is no longer a government whose powers are derived from its citizens. The right to steal is not a right. Government does not have the right to use forciby obtained funds to go into business in competition with privately owned enterprises. Even if it did, such action would be a very bad idea.

Free and unfettered capitalism uses markets to allocate resources to the most economically effective pursuits. As we have seen in Eastern Europe, the former Soviet Union, Socialist England, Mexico and Canada, government-managed enterprises depend on centralized decision-making and are prone to political agendas that have nothing to do with economic benefit. The result: economic mismanagement and eventual disaster.

Banks are making small business loans, and the needs of small business can be met in the marketplace. But they must be met at a rate of return commensurate with risk. It is important to remember that many small businesses fail during a recession, thus the risk of lending to them is higher.

Perhaps it is tempting to regard banks as magical entities that create money out of thin air. They are not. They are businesses, and when they fail to make a profit for too long, they then fail.

As the editorial states, regulation is stifling the willingness of banks to recover from natural recessionary caution, but the answer the [newspaper] editorial should be advocating is to remove the regulation, not to give the government more power to "modify" the economy to its liking. It is the government's continual intervention in the banking system that has led to the current state of fragility among banks, not any problem inherent in the banks themselves.

In fact, prior to government intervention, bank failures were few and far between. The Depression of the 1930s was the culmination of years of government intervention in banking, and our recent recession was caused and prolonged in the Northeast by government intervention in the real estate market.

Remember, government produces nothing. It creates nothing--not goods, not wealth, not jobs. Government is not the great father taking care of its barely competent citizens, molding and guiding their lives toward a greater good. Its function is to protect our property from violation, our businesses from theft and fraud, and our lives from assault and compulsion. It is irresponsible to suggest it should further intrude into our lives when every evidence shows its effect on economics is damaging, short and long-term. Wake up, [newspaper], advocate something people really want: freedom and liberty.



My reply:

[b]Facts don't back state bank argument[/b]

On May 7, [XXX] attempted to discredit the [newspaper]'s editorial proposal to establish a state bank. He presented a purely ideological argument, which, of course, it is his right to do. However, [XXX] misrepresented a few facts of history to support his argument. As a result, [XXX]'s argument cannot be taken seriously. In fact, it is precisely his sort of carelessness that has contributed to the decline of this nation. Quite simply, it is not permissible to change facts to suit one's pet theory or ideology.

[XXX] believes that government ought not intervene in economic affairs because that would violate basic precepts of freedom and liberty. Aside from his confusion regarding these two concepts, he clearly does not understand that government is merely levers of power--levers that are used by people.

People animate the structure we call government, and people are responsible for the policies promulgated by a government. Consequently, it is people who determine the content of our concepts of freedom and liberty, not government. That is the great debate our form of government nurtures in our Constitution, and [XXX]'s contribution to that debate is welcome, provided it is thoughtful and earnest in pursuit of truth.

[XXX] wants us to believe that it is government intervention that has brought about the hardship in our banking system. To support his claim, he asserts that "prior to government intervention, bank failures were few and far between. The Depression of the 1930s was the culmination of years of government intervention in banking..."

Let's look at this closely to see if history supports this claim. Between 1864 and 1896 there were 11,562 bank failures. Between 1897 and 1920 another 1,433 banks failed. Between 1921 and 1929 still another 5,411 banks failed. And between 1930 and 1933 8,812 more banks failed. That's 17,218 bank failures from the time of the establishment of the National Banking Act in 1864 until just after passage of the Glass Steagall Act of 1932. Between 1934 and 1950 only 415 banks failed. Clearly, there must be something about the Glass-Steagall Act that changed the myriad of circumstances which led to the high number of bank failures previous to that act.

Was the Depression the result of government intervention in banking? True, the National Banking Act of 1864 was a form of government intervention, as was a lot of subsequent, legislation, including the Federal Reserve Act of 1913. Yet, another form of government intervention in 1932 halted the pace of bank failures.

The lesson to be learned here is that government intervention, per se, is not to be considered a blanket cause for the failures, or health, of banks. One must examine the causes more closely, and the only way to do that is to put aside one's ideological preferences and consider actual events.

It would be a lot closer to the truth to assert that the principal cause of the Depression was the rampant "Market" that pervaded the 1920s. This claim is supported by considering the Florida real estate boom of the period, as well as the activity of the stock market in the late '20s. When you buy on margin, you better be sure you can make the call.

So, if 17,218 bank failures represent [XXX]'s "few and far between," then he is correct. And if the Glass-Steagall Act is not a form of government intervention, then, once again, [XXX] is correct. Both these claims would stretch the imagination, however.

Insofar as the [newspaper]'s proposal to form a state bank to stimulate the economy is concerned, that could be a good proposal or a bad proposal, depending upon the provisions of its charter. One thing is certain: Such a proposal does not warrant rejection based on some vaguely ideological prejudices, or on a misrepresentation of history.

Ironically for [XXX]'s point of view, it is conceivable that the establishment of a state bank might increase our degrees of freedom without harming our liberty. Economic growth and "good times" tend to have that effect in a society.

[CTBengalsFan]

[media]http://www.youtube.com/watch?v=d0nERTFo-Sk[/media]

[Jamie_B]

[quote name='CTBengalsFan' date='01 March 2010 - 12:23 PM' timestamp='1267464222' post='866228']
[media]http://www.youtube.com/watch?v=d0nERTFo-Sk[/media]
[/quote]




That was awesome

[sois]

The system is broken. I don't know much about this issue, but there is something wrong when I go to the dr and the visit costs $300 bucks for two cortizone shots. I only paid $15 bucks thanks to insurance, but it's easy to see with examples like these why health insurance costs so much.

Doesn't that seem out of whack?

My idea: Flood the market with doctors/medical researchers. Offer full tuition to anyone who wants to attempt to go to medical school. If you dip below a 3.5 GPA at any time, you are on your own, tuitionwise. Otherwise, US and A foots the bill. This way, we have all of our smart people actually doing something productive instead of getting shitty MBA's that don't help society at all.

What do yall think?

[CTBengalsFan]

[quote name='sois' date='04 March 2010 - 01:54 PM' timestamp='1267728866' post='866963']
The system is broken. I don't know much about this issue, but there is something wrong when I go to the dr and the visit costs $300 bucks for two cortizone shots. I only paid $15 bucks thanks to insurance, but it's easy to see with examples like these why health insurance costs so much.

Doesn't that seem out of whack?

My idea: Flood the market with doctors/medical researchers. Offer full tuition to anyone who wants to attempt to go to medical school. If you dip below a 3.5 GPA at any time, you are on your own, tuitionwise. Otherwise, US and A foots the bill. This way, we have all of our smart people actually doing something productive instead of getting shitty MBA's that don't help society at all.

What do yall think?
[/quote]

I think you're on the right track. The costs and rigors of med school make investment banking a more attractive career path for many of our best and brightest. Making med school cheaper or more accessible to those smart enough to go through it would be a positive change. That alone won't fix the system, but I do think it addresses a problem.

[sois]

[quote name='CTBengalsFan' date='04 March 2010 - 10:59 AM' timestamp='1267729170' post='866967']
I think you're on the right track. The costs and rigors of med school make investment banking a more attractive career path for many of our best and brightest. Making med school cheaper or more accessible to those smart enough to go through it would be a positive change. That alone won't fix the system, but I do think it addresses a problem.
[/quote]

I just see O'bama and co attacking an effect rather than the source of the problem. The problem it that it costs too much to get meds/treatment. There is no reason a shot should cost $300 bucks. I feel many of my office visits are representative of this issue.

[BengalRep85-9]

[quote name='CTBengalsFan' date='04 March 2010 - 01:59 PM' timestamp='1267729170' post='866967']
I think you're on the right track. The costs and rigors of med school make investment banking a more attractive career path for many of our best and brightest. Making med school cheaper or more accessible to those smart enough to go through it would be a positive change. That alone won't fix the system, but I do think it addresses a problem.
[/quote]
I like sois's idea quite a bit. The cost of med school is astronomical and that is a big reason why many do not go this route. It simply costs too much. Also, all the hoops they make you jump through is ridiculous.

Getting into med school is more luck than anything else. I was on track to go to med school, but after an advising meeting I had to switch majors. I was always very skeptical of taking on all the loans I would have to take but I figured I would easily be able to pay that back after graduating since I would be going the neurosurgery route. But seeing the screening process, interviewing process, then overall crossing of fingers hoping someone with better connections doesn't come along I thought my god how does anyone get accepted? Then of course, comes the acceptance rates.

Most students that would make excellent doctors are kept out of med school based on slight differences between candidates. Oh your mcat was slightly below this guy, better luck next year. This guy has a 4.0 and you only have a 3.9, better luck next year. There really is no significant difference between the two yet one becomes the doctor and another doesn't based on very minute differences. Maybe one guy did better in his freshman english class, does that have anything to do with medicine? Not at all. Maybe one guy bombed a semester because a parent died or whatever. Does this mean he won't make a good doctor? Not at all.

Ease up on the pre-req's, stop looking so much at the black and white and start looking at the color in between the lines, throw in some gov assistance, and you will see MANY more good doctors graduating.

[Jamie_B]

http://www.thenation.com/blogs/thebeat/542054/kucinich_will_vote_for_reform_then_fight_for_more

[quote]Kucinich Will Vote for Reform, Then Fight for More

Like tens of millions of Americans, Ohio Congressman Dennis Kucinich does not believe that the health care reform legislation proposed by President Obama and Democratic leaders in the House and Senate goes far enough.
On this, Kucinich is, unquestionably, correct.

Real reform would take the shape of a single-payer "Medicare for All" program, which would provide health care to every American at an affordable rate -- for consumers and for taxpayers.
Kucinich's frustration with the compromises made by Obama -- a former single-payer backer -- and most of his fellow Democrats caused him to question whether he could vote for the bill that did not include a public option to counter the abuses of private insurers.

But as it became clear that the former Cleveland mayor's vote could be critical in getting Democrats to the 216 majority they need in the House, he came under pressure from the White House.
Obama knows Kucinich well. When both were bidding for the 2008 Democratic presidential nomination, the pair maintained a steady conversation on their personal cell phones, regularly joking with one another and comparing notes from the campaign trail. With Kucinich's encouragement, his backers provided Obama with critical support in the Iowa caucuses.
So there is mutual regard and respect between the two men.

Obama understood that he could not merely demand Kucinich's vote and get it; he recognized that the Ohioan was serious about the flaws in the bill as it is now written.
The case Obama needed to make was a specific one, which acknowledged that the current legislation is imperfect and portrayed it as a foundation for developing a more equitable and fiscally-sound health care system.
Obama flew to the Cleveland area to make that case earlier this week, telling a crowd at a senior citizens center in Kucinich's district that the legislation is a necessary step on the road to any sort of broad reform.
At the rally, someone in the crowd shouted, "Vote yes!"

Obama asked Kucinich if he heard the call.

Kucinich did.

"I have doubts about this bill," the congressman acknowledged Wednesday morning. "This is not the bill I wanted to support."
"However, after careful discussions with President Obama, Speaker Pelosi, my wife Elisabeth and close friends I have decided to cast a vote in favor of the legislation," said the congressman, who added, "If my vote is to be counted, let it count now."

That said, Kucinich has already signed on as a co-sponsor of Florida Congressman Alan Grayson's legislation proposing an expansion of Medicare to provide the public option that progressives thought needed to be in the health-care legislation.
In other words, Kucinich will vote "yes" for some a reform that he finds insufficient and then fight for more.

Here are his prepared remarks from Wednesday morning's press conference:
Each generation has had to take up the question of how to provide for the health of the people of our nation. And each generation has grappled with difficult questions of how to meet the needs of our people. I believe health care is a civil right. Each time as a nation we have reached to expand our basic rights, we have witnessed a slow and painful unfolding of a democratic pageant of striving, of resistance, of breakthroughs, of opposition, of unrelenting efforts and of eventual triumph.

I have spent my life struggling for the rights of working class people and for health care. I grew up understanding first hand what it meant for families who did not get access to needed care. I lived in 21different places by the time I was 17, including in a couple of cars. I understand the connection between poverty and poor health care, the deeper meaning of what Native Americans have called "hole in the body, hole in the spirit". I struggled with Crohn's disease much of my adult life, to discover sixteen years ago a near-cure in alternative medicine and following a plant-based diet. I have learned with difficulty the benefits of taking charge personally of my own health care. On those few occasions when I have needed it, I have had access to the best allopathic practitioners. As a result I have received the blessings of vitality and high energy. Health and health care is personal for each one of us. As a former surgical technician I know that there are many people who dedicate their lives to helping others improve theirs. I also know their struggles with an insufficient health care system.

There are some who believe that health care is a privilege based on ability to pay. This is the model President Obama is dealing with, attempting to open up health care to another 30 million people, within the context of the for-profit insurance system. There are others who believe that health care is a basic right and ought to be provided through a not-for-profit plan. This is what I have tirelessly advocated.

I have carried the banner of national health care in two presidential campaigns, in party platform meetings, and as co-author of HR676, Medicare for All. I have worked to expand the health care debate beyond the current for-profit system, to include a public option and an amendment to free the states to pursue single payer. The first version of the health care bill, while badly flawed, contained provisions which I believed made the bill worth supporting in committee. The provisions were taken out of the bill after it passed committee.

I joined with the Progressive Caucus saying that I would not support the bill unless it had a strong public option and unless it protected the right of people to pursue single payer at a state level. It did not. I kept my pledge and voted against the bill. I have continued to oppose it while trying to get the provisions back into the bill. Some have speculated I may be in a position of casting the deciding vote. The President's visit to my district on Monday underscored the urgency of this momen.

I have taken this fight farther than many in Congress cared to carry it because I know what my constituents experience on a daily basis. Come to my district in Cleveland and you will understand.
The people of Ohio's 10th district have been hard hit by an economy where wealth has accelerated upwards through plant closings, massive unemployment, small business failings, lack of access to credit, foreclosures and the high cost of health care and limited access to care. I take my responsibilities to the people of my district personally. The focus of my district office is constituent service, which more often then not involves social work to help people survive economic perils. It also involves intervening with insurance companies.

In the past week it has become clear that the vote on the final healthcare bill will be very close. I take this vote with the utmost seriousness. I am quite aware of the historic fight that has lasted the better part of the last century to bring America in line with other modern democracies in providing single payer health care. I have seen the political pressure and the financial pressure being asserted to prevent a minimal recognition of this right, even within the context of a system dominated by private insurance companies.

I know I have to make a decision, not on the bill as I would like to see it, but the bill as it is. My criticisms of the legislation have been well reported. I do not retract them. I incorporate them in this statement. They still stand as legitimate and cautionary. I still have doubts about the bill. I do not think it is a first step toward anything I have supported in the past. This is not the bill I wanted to support, even as I continue efforts until the last minute to modify the bill.

However after careful discussions with the President Obama, Speaker Pelosi, Elizabeth my wife and close friends, I have decided to cast avote in favor of the legislation. If my vote is to be counted, let it now count for passage of the bill, hopefully in the direction of comprehensive health care reform. We must include coverage for those excluded from this bill. We must free the states. We must have control over private insurance companies and the cost their very existence imposes on American families. We must strive to provide a significant place for alternative and complementary medicine, religious health science practice, and the personal responsibility aspects of health care which include diet, nutrition, and exercise.

The health care debate has been severely hampered by fear, myths, and by hyper-partisanship. The President clearly does not advocate socialism or a government takeover of health care. The fear that this legislation has engendered has deep roots, not in foreign ideology but in a lack of confidence, a timidity, mistrust and fear which post-911 America has been unable to shake.

This fear has so infected our politics, our economics and our international relations that as a nation we are losing sight of the expanded vision, the electrifying potential we caught a glimpse of with the election of Barack Obama. The transformational potential of his presidency, and of ourselves, can still be courageously summoned in ways that will reconnect America to our hopes for expanded opportunities for jobs, housing, education, peace, and yes, health care.

I want to thank those who have supported me personally and politically as I have struggled with this decision. I ask for your continued support in our ongoing efforts to bring about meaningful change. As this bill passes I will renew my efforts to help those state organizations which are aimed at stirring a single payer movement which eliminates the predatory role of private insurers who make money not providing health care. I have taken a detour through supporting this bill, but I know the destination I will continue to lead, for as long as it takes, whatever it takes to an America where health care will be firmly established as a civil right.
[/quote]

[Jamie_B]

[media]http://www.youtube.com/watch?v=lLHi3W7hWTc[/media]

[|Elflocko|]

Free market all the way, baby! Fuck regulation!




[quote][size="5"][b]Insurer targeted HIV patients to drop coverage[/b][/size]

By Murray Waas
Wed Mar 17, 1:40 pm ET
WASHINGTON (Reuters) – In May, 2002, Jerome Mitchell, a 17-year old college freshman from rural South Carolina, learned he had contracted HIV. The news, of course, was devastating, but Mitchell believed that he had one thing going for him: On his own initiative, in anticipation of his first year in college, he had purchased his own health insurance.

Shortly after his diagnosis, however, his insurance company, Fortis, revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that.
So he hired an attorney -- not because he wanted to sue anyone; on the contrary, the shy African-American teenager expected his insurance was canceled by mistake and would be reinstated once he set the company straight.
But Fortis, now known as Assurant Health, ignored his attorney's letters, as they had earlier inquiries from a case worker at a local clinic who was helping him. So Mitchell sued.

In 2004, a jury in Florence County, South Carolina, ordered Assurant Health, part of Assurant Inc, to pay Mitchell $15 million for wrongly revoking his heath insurance policy.

In September 2009, the South Carolina Supreme Court upheld the lower court's verdict, although the court reduced the amount to be paid him to $10 million.

By winning the verdict against Fortis, Mitchell not only obtained a measure of justice for himself; he also helped expose wrongdoing on the part of Fortis that could have repercussions for the entire health insurance industry.
Previously undisclosed records from Mitchell's case reveal that Fortis had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators.
The revelations come at a time when President Barack Obama, in his frantic push to rescue the administration's health care plan, has stepped up his criticism of insurers. The U.S. House of Representatives is expected to vote later this week on an overhaul of the health system, which Obama has said is essential to do away with controversial and unpopular industry practices.
Insurance companies have long engaged in the practice of "rescission," whereby they investigate policyholders shortly after they've been diagnosed with life-threatening illnesses. But government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

In his previously undisclosed court ruling, the judge in the Mitchell case also criticized what he said were the company's efforts to cover its tracks.

Assurant Health said that as a matter of policy it did not comment on individual customer claims.
"We disagree with certain of the court's characterizations of Assurant Health's policies and procedures in the Mitchell case," it said in a statement provided by spokesman Peter Duckler, adding: "The case continues to progress through the appellate process."

"REPREHENSIBLE" CONDUCT

Much of the trial record of the Mitchell case is bound by a confidentiality order and not available to the public. But two orders written by the presiding judge, Michael G. Nettles, a state circuit judge for the 12th Judicial District of South Carolina, of Florence County, describe the case in detail. Judge Nettles wrote the orders in response to motions by Assurant that the jury's verdict be set aside or reduced.
In the motions, Nettles not only strongly denied Fortis' claims but condemned the corporation's conduct.
"There was evidence that Fortis' general counsel insisted years ago that members of the rescission committee not record the identity of the persons present and involved in the process of making a decision to rescind a Fortis health insurance policy," Nettles wrote.
Elsewhere in his order, Nettles noted that there were no "minutes of actions, votes, or any business conducted during the rescission committee's meeting."

The South Carolina Supreme Court, in upholding the jury's verdict in the case in a unanimous 5-0 opinion, said that it agreed with the lower court's finding that Fortis destroyed records to hide the corporation's misconduct. Supreme Court Chief Justice Jean Hoefer Toal wrote: "The lack of written rescission policies, the lack of information available regarding appealing rights or procedures, the separate policies for rescission documents" as well as the "omission" of other records regarding the decision to revoke Mitchell's insurance, constituted "evidence that Fortis tried to conceal the actions it took in rescinding his policy."
In affirming the trial verdict and Nettles' order, Toal was as harsh in her criticism of the company as Judge Nettles had been. "We find ample support in the record that Fortis' conduct was reprehensible," she wrote. "Fortis demonstrated an indifference to Mitchell's life and a reckless disregard to his health and safety."

Fortis canceled Mitchell's health insurance based on a single erroneous note from a nurse in his medical records that indicated that he might have been diagnosed prior to his obtaining his insurance policy. When the company's investigators discovered the note, they ceased further review of Mitchell's records for evidence to the contrary, including the records containing the doctor's diagnosis.
Nettles also suggested that Fortis should have realized the date in the note was incorrect: "Not only did Fortis choose to rely on one false and unreliable snippet of information containing an erroneous date to the exclusion of other information which would have revealed that date to be erroneous, Fortis refused to conduct any further investigation even after it was on notice the evidence which aroused its suspicion to be false," the judge noted.

Fortis "gambled" with Mitchell's life, Nettles wrote.

Their motive, according to the judge, was obvious: "The court finds that Fortis wrongfully elevated its concerns for maximizing profits over the rights and interest of its customer." In upholding Nettles' verdict, the South Carolina Supreme Court similarly ruled that "Fortis was motivated to avoid the losses it would undoubtedly incur in supporting Mitchell's costly medical condition."
While declining to comment on specific cases, Assurant said in the statement: "All insurance companies have processes to review claims to ensure their accuracy, completeness and compliance with policy provisions and we evaluate all claims on an individual basis."

CEO DEFENDED RESCISSION

On June 16, 2009, the House Energy and Commerce Committee, held a hearing on the practice of rescission by health insurance companies, and among the industry executives who testified was Don Hamm, the CEO and President of Assurant Health.
Hamm insisted before the committee that rescission was a necessary tool for Assurant and other health insurance companies to hold the cost of premiums down for other policyholders. Hamm asserted that rescission was "one of many protections supporting the affordability and viability of individual health insurance in the United States under our present system."

He also suggested that those who had their policies rescinded by Assurant had attempted to intentionally mislead his company: "Unfortunately, there are times when we discover that an applicant did not provide complete or accurate medical information when we underwrote the risk," Hamm said.
But state regulators, federal and congressional investigators, and consumer advocates say that in only a tiny percentage of cases of people who have had their health insurance canceled was there a legitimate reason.

A 2007 investigation by a California state regulatory agency, the California Department of Managed Health Care, bore this out. The DMHC randomly selected 90 instances in which Anthem Blue Cross of California, one of WellPoint's largest subsidiaries, canceled the insurance of policy holders after diagnoses with costly or life-threatening illnesses to determine how many were legally justified.
The result: The agency concluded that Anthem Blue Cross lacked legal grounds for canceling policies in every single instance.
"In all 90 files, there was no evidence (that Blue Cross), before rescinding coverage, investigated or established that the applicant's omission/misrepresentation was willful," the DMHC report said.

WRONG DATE

The Fortis underwriter who recommended Mitchell's policy be rescinded had her own doubts that it was correct to do so, according to records the company did produce at trial.
In a reference to the nurse's note with the wrong date, the underwriter wrote to her superiors: "Technically, we do not have the results of the HIV test. This is the only entry in the medical records regarding HIV status. Is this sufficient?"
Relying on the note was dubious, Judge Nettles wrote, because it was included in records from 2002, when Mitchell was in fact diagnosed with HIV, and not in 2001, when he purchased his policy. "The chronological sequence of those records raises an inference that the date on the handwritten note may be erroneous," he wrote.

Moreover, Nettles said, if Mitchell's HIV diagnosis had been a year earlier, as the erroneous note said, Mitchell's medical records would have shown other references to that diagnosis and treatment and he would have sought reimbursement for expenses related to them.
Sallie Phelan, an attorney who represented Mitchell, says her client was bewildered as to why his insurance was canceled -- at first not even contemplating the possibility that there was anything improper going on: "We began representing Jerome when he was still just a boy, really," she said. "He was just this sweet kid with all these drives and ambitions."

Then Mitchell felt betrayed, Phelan says. "He had done everything he was supposed to. He went out and got insurance on his own, at 17. He was a trusting person, perhaps too trustful. And as they kept slamming doors in his face, he thought at first there was some misunderstanding. He couldn't understand what was going on, because he is such an honest person himself. And when they accused him of lying, that was the most harmful to him. He didn't understand why they were accusing them. He didn't understand why people weren't listening to him."
Like other major health insurance companies, Fortis has a "rescission committee" that reviews recommendations to cancel a policyholder's insurance. But in the case of Fortis, Nettles wrote, the committee rarely did more than "rubber stamp" already flawed recommendations.
"There were no rules, no minutes, no notes, and, in accordance with instructions from general counsel not even a record of who was present," the judge wrote about the committee.

During the meeting in which Mitchell's insurance was rescinded, "there were more than 40 other customers, whose cases appeared before the rescission committee for review in no more than one and one half to two hours, representing an average of three minutes or less per customer," he wrote.
According to Nettles, Fortis concealed information through its document retention practice. The company's "stated policy for the last nine years has been to microfilm and destroy all documents," the judge said. "There was also evidence that documents and/or records regarding (Mitchell's) policy were deleted; and that telephone logs and recordings contained key omissions." Fortis also "shredded" documents, he said.
Regarding another piece of key evidence, the judge concluded that "a jury could easily infer that Fortis destroyed and/or concealed" crucial evidence.

Overall, Nettles asserted, a "pattern of secrecy and concealment by Fortis in this case ... supports a high award of punitive damages."
After his insurance was canceled, a case worker with a social agency who works with HIV patients named Mary Wiggins worked tirelessly for Mitchell to find him medical care and to have Fortis reinstate his insurance. Despite deluging Fortis with records and information that should have led to a reversal of the decision, the insurance company simply ignored her. Wiggins found a local clinic that agreed to provide care for Mitchell, in the process very likely saving his life.
Eventually, Mitchell retained legal counsel to have his health insurance reinstated, but Fortis ignored them as well. It was only after the insurance company was sued -- some 22 months after his HIV diagnosis -- that Mitchell's insurance was reinstated.

COST CONTAINMENT

In his order, Nettles said Mitchell's treatment was typical of how Fortis treated patients recently diagnosed with HIV and other life-threatening diseases.
"In addition to these acts toward (Mitchell) there was evidence that Fortis has for some time been making recommendations for rescission, and acting on those recommendations, without good-faith investigation conducted fairly and objectively ... Fortis pre-programed its computer to recognize the billing codes for expensive health conditions, which triggers an automatic fraud investigation by its "Cost Containment" division whenever such a code is recognized."
A federal investigator who has reviewed Assurant's remaining records says that they showed that once a person with HIV was targeted with a fraud investigation, the company made a greater effort than usual to cancel the person's insurance. Policies and medical records were scrutinized to a greater extent than others being scrutinized, he said.
The investigator, who spoke on condition of anonymity, said that the motive for focusing on people with HIV was simply the high cost of treating the illness: "We are talking a lifetime of therapy, a lifetime of care ... a lot of bills. Nowadays someone with HIV can live a normal life for decades. This was about money."

No evidence has emerged that any other major American company purged policyholders simply because they had HIV. But an investigation last summer by the House Energy and Commerce Committee as well as earlier ones by state regulators in California, New York and Connecticut, found that thousands of vulnerable and seriously ill policyholders have had their coverage canceled by many of the nation's largest insurance companies without any legal basis. The congressional committee found that three insurance companies alone saved at least $300 million over five years from rescission. One of those three companies was Assurant.

The committee estimated that Assurant alone profited by more than $150 million between 2003 and 2007 from rescission.
During his appearance on June 16 before the House Energy and Commerce Committee, Hamm, the CEO and President of Assurant, urged Congress to pass the new health care legislation, in part, to prevent such practices.

"We can achieve the goal we share -- providing health care coverage for all Americans," Hamm said. "If a system can be created where coverage is available to everyone and all Americans are required to participate, the process we are addressing today, rescission, becomes unnecessary."
(Additional reporting by Lewis Krauskopf, editing by Jim Impoco and Claudia Parsons)[/quote]

[Jamie_B]

[quote name='Elflocko' date='17 March 2010 - 05:22 PM' timestamp='1268860963' post='871248']
Free market all the way, baby! Fuck regulation!


[/quote]


Whooo yeah, fuck those socialists who dont trust the market!!!

[sois]

[quote name='Elflocko' date='17 March 2010 - 01:22 PM' timestamp='1268860963' post='871248']
Free market all the way, baby! Fuck regulation!


[/quote]

Step back. What caused this? The problem isn't regulation or lack thereof. The problem here is sleazy executives. The problem here is trying to please the shareholders and not your customers.

One consumer behavior area I think needs to be driven into a different direction is investing. Right now, most people's paradigm of investment is equivalent to gambling. Buy low sell high. That type of stupid thinking has strayed too far from the entire meaning of the word "investment". Hell, private equity and alternative investments hold more true to the meaning of investing than plain old stocks and fixed income vehicles.

How does it get fixed? Well my idea to change investor behavior is to entice investors to invest again instead of gamble. If you hold the stock or fund for five years, gains are taxed at 0% tax rate. You can write off the losses against ordinary income as usual. Any stock, bond of fund held less than five years, is taxed at (5 - years held rounded down) * 10%. You can not write off losses. For example, you hold a stock for one day, BAM 50% tax hit on your gains. If you lost money, you are SOL as you would be at the black jack table.

How does this figure into health care? You won't see as much dumbass policy in public companies. You will see companies shift their focus from shareholders to customers. The goal will shift from focusing on the bottom line to raising customer satisfaction. Executives will be gauged on retention, customer reviews and public perception.

Just another muscle relaxer fueled idea for you good folks at Go-Bengals.

[Sox]

It's scary to see so many people that think giving the Federal Government the power to FORCE you to purchase something is a good thing.

[|Elflocko|]

[quote name='Sox' date='21 March 2010 - 08:33 AM' timestamp='1269185614' post='871932']
It's scary to see so many people that think giving the Federal Government the power to FORCE you to purchase something is a good thing.
[/quote]

The purchase requirement is asinine...

[CTBengalsFan]

[quote name='Elflocko' date='21 March 2010 - 04:45 PM' timestamp='1269204306' post='871970']
The purchase requirement is asinine...
[/quote]

It equates to an insurance company bailout. Time to buy some health insurance stocks?

[Jamie_B]

[quote name='CTBengalsFan' date='21 March 2010 - 06:05 PM' timestamp='1269209159' post='871996']
It equates to an insurance company bailout. Time to buy some health insurance stocks?
[/quote]


If that were the case why did they spend so much to fight it?

[CTBengalsFan]

I'd be speculating, but it provides political cover for politicians to vote for the bill. I also guess they wouldn't like the extra rules, but 30 million customers either forced to or subsidized to buy their insurance makes up for it in my opinion.

[BengalRep85-9]

With the vote coming tonight and most likely being passed doesn't this seem like a good time to buy health care stock?
With passing or not passing of this bill the uncertainty the market doesn't like would be gone and the stocks would start to move.

The way I see it(and I could be completely wrong here) but either it doesn't pass and insurance co's continue raping people OR it does pass and they rape people less but there's more of them... with gov money to spend.
Seems to me like either way stocks prices would go up pretty quickly and possibly substantially.

Opinions/thoughts?

[Jamie_B]

Interesting link.

http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/?hpid=topnews

[sois]

[quote name='Sox' date='21 March 2010 - 08:33 AM' timestamp='1269185614' post='871932']
It's scary to see so many people that think giving the Federal Government the power to FORCE you to purchase something is a good thing.
[/quote]

Do you feel people should not be forced to purchase liability insurance on their vehicles? I like that the government forces people to be responsible because they wouldn't if given their own choice.

[CTBengalsFan]

[quote name='sois' date='22 March 2010 - 02:56 PM' timestamp='1269284215' post='872163']
Do you feel people should not be forced to purchase liability insurance on their vehicles? I like that the government forces people to be responsible because they wouldn't if given their own choice.
[/quote]

That analogy does not compute. Not having car insurance means if you crash into another car, they're screwed because you might not be able to pay for their damages out of pocket. Forcing people to have car insurance means that you, as a victim, are covered as well.

And your premise that people wouldn't be responsible if given a choice is bullshit.

I graduated from college, couldn't continue on my mom's insurance because I was no longer a full-time student, and did the unthinkable - purchased insurance with my own money. It costs me about $1300/year for catastrophic coverage.

[sois]

[quote name='CTBengalsFan' date='22 March 2010 - 12:12 PM' timestamp='1269285147' post='872168']
That analogy does not compute. Not having car insurance means if you crash into another car, they're screwed because you might not be able to pay for their damages out of pocket. Forcing people to have car insurance means that you, as a victim, are covered as well.

[b]And your premise that people wouldn't be responsible if given a choice is bullshit.[/b]

I graduated from college, couldn't continue on my mom's insurance because I was no longer a full-time student,[b] and did the unthinkable[/b] - purchased insurance with my own money. It costs me about $1300/year for catastrophic coverage.
[/quote]

Your own wording shows how dire the situation is. People are fucking idiots. They don't plan ahead, they don't think about others, they are generally bastards.

[sois]

[quote name='BengalRep85-9' date='21 March 2010 - 07:38 PM' timestamp='1269225503' post='872035']
With the vote coming tonight and most likely being passed doesn't this seem like a good time to buy health care stock?
With passing or not passing of this bill the uncertainty the market doesn't like would be gone and the stocks would start to move.

The way I see it(and I could be completely wrong here) but either it doesn't pass and insurance co's continue raping people OR it does pass and they rape people less but there's more of them... with gov money to spend.
Seems to me like either way stocks prices would go up pretty quickly and possibly substantially.

Opinions/thoughts?
[/quote]

I was wondering that as well. Who is going to cash in here? What insurance co. will get to reap these rewards?

[Vol_Bengal]

[quote name='sois' date='22 March 2010 - 02:56 PM' timestamp='1269284215' post='872163']
Do you feel people should not be forced to purchase liability insurance on their vehicles? I like that the government forces people to be responsible because they wouldn't if given their own choice.
[/quote]

Do you understand the concept of liability insurance on a vehicle??? It protects the other person, not you... the government is only requiring you to protect the wronged party. You go out and hit a guardrail and screw up your vehicle - your vehicle isn't getting shit done to fix it - from insurance money anyway. Your insurance would only compensate the utility (probably state) that had to go maintenance that guardrail and any other incidental damage your vehicle created.

What part of required healthcare coverage is going to protect another person? Two entirely different concepts... your closest way to equate it would be the government requiring you to purchase collision coverage on your vehicle. Which they don't.

[Vol_Bengal]

[quote name='sois' date='22 March 2010 - 03:15 PM' timestamp='1269285313' post='872170']
Your own wording shows how dire the situation is. People are fucking idiots. They don't plan ahead, they don't think about others, they are generally bastards.
[/quote]

Which is why you're required to purchase only liability - to protect the victim...


As for healthcare... how is forcing them to purchase insurance helping anything? If they eat 20 twinkies a day, smoke 3 packs a day, etc., etc., etc. how is any of that going to be fixed? It isn't.