BRIAN ROSS REPORTS
- Like Jay-Z + the Beatles, But Worse
- Update: Help for Homeless Children
- Bush Era, Revised -- and with More Barbeque
- The Tax Woman Cometh
- Paging Mr. Stanford: Antigua Called
- Who Are You Calling Partisan?
- Update: IRS Won't Use Private Debt Collectors
- But Is It Art?
- PMA Scandal a Sore Point for Dems in 2010?
- Down in Flames
- A New Mystery for RNC Chief
- PMA Clients Were Big Givers
- Raided Lobby Firm Still a Force on Capitol Hill
- Stanford Update: Another $143 Mil Found
- Cheney, Hooked on Controversy
TOP BLOTTER CATEGORIES
- Abramoff Lobbying Scandal
- American Al Qaeda
- Avian Flu
- Beirut Hospital Out of Gas
- Cheney
- CIA
- CIA Secret Prisons
- D.C. Madam Affair
- FBI
- Federal Air Marshal Service
- Homeland Security
- Hurricane Katrina
- IRS
- Mark Foley Internet Scandal
- Millionaire Sex Scandal
- Nigerian E-mail Scams
- Norman Hsu, Clinton Fundraiser
- NSA: Wiretapping
- Osama bin Laden
- Payola
- Pharmacy Investigation
- PMA
- Speaker of the House Dennis Hastert
- Stanford
- Steele
- Terror
- Troopergate
- U.K. Airline Terror Plot
- U.K. Bombing Attempts
- Wen Ho Lee
- William Jefferson
- Zarqawi
« Previous | Main | Next »
Insurer Dropped Sick Patients to Save Money
November 09, 2007 11:00 AM
In the middle of her expensive, months-long chemotherapy regimen, a Los Angeles hairdresser with breast cancer learned her insurer had abruptly decided to cancel her policy.
The decision ultimately left the 51-year-old hairdresser, Patsy Bates, with nearly $200,000 in debt, according to the Los Angeles Times today, but it helped win $20,000 in bonuses for the employee who made the call to cut Bates' coverage.
By dropping Bates' policy and those of roughly 1,600 others, the employee helped the insurance company, Health Net, save more than $35 million from 2000 to 2006, the paper reports.
Click Here for Full Blotter Coverage.
The company's own policies awarded cash bonuses to employees who dropped policyholders whose costly medical bills triggered the company's review of the policyholders' applications, even if they had serious illnesses -- part of what the paper calls an "industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized."
Overall, Health Net dropped roughly 1,600 policies from 2000 to 2006, the Times reports, noting that "state law forbids insurance companies from tying any compensation for claims reviewers to their claims decisions."
The company said the law did not apply in this case because Fowler was an underwriter, not a claims reviewer, and the goals she was given and which she met were reasonable. It said it cancelled Bates' policy because she had not disclosed a pre-existing heart condition in her application. Bates said any information left off the application was inadvertent.
Bates, whose treatment was partially funded by charities, still cannot afford tests to find out if her cancer has returned, the paper says. She is suing the company, who turned over documents revealing their bonus policy in court proceedings.
Do you have a tip for Brian Ross and the Investigative Team?
November 9, 2007 | Permalink | User Comments (31)
You can follow this conversation by subscribing to the comment feed for this post.
Failure to disclose a pre-existing heart condition, inadvertant or not, would get any of us dropped from any insurance company, once they found out. It's considered fraud. The fact that she's undergoing chemo allows the story to be spun in an inflamatory manner, but truth is, she would've gotten dropped even if healthy.
Posted by: Otis | Nov 12, 2007 1:10:52 PM
A maze of uniformed, Fox couch educated citizens running their mouth on a subject they know absolutely nothing about. Abominable, provincial ignorance.
Go live in any developed western society, use the gov't controlled medical system there and then make the claim of the 'superiority' of the great rip called the American Health Care System.
Posted by: Wolf | Nov 12, 2007 2:06:45 PM
From Samatha (above) "Susan, Americans have a right to fear government run health programs. In Great Britain, the wait to see a specialist even for life threatening conditions is months - and that's just for a consultation."
Lies, Lies, Lies...I have relatives in Great Britain...They would not immegrate to the US specifically because of our health care system. They all go to the doctor when they want. If they call that morning, they get in that day. My neice was brought to the emergency room for stitches...drive down, procedure, get home - 1 hour 15 minutes...try that here in the states.
Posted by: Kathi | Nov 13, 2007 8:36:42 AM
I'm sorry, I credited the above statement to the wrong person. Samatha did not make that statement, VA did, and I apologize to Samatha.
Posted by: Kathi | Nov 13, 2007 9:24:52 AM
IF THEN STATEMENTS can clarify things rather well: If...Donald Rumsfeld brought private corporation health care persons into the government in order to reduce the costs of health care for our military...THEN it follows that private insurers would do this or have done this rather well and even reward their employees to do it better. So much for whistleblower protections...
Posted by: daddy | Nov 13, 2007 11:28:17 AM
Yup, although Great Britain and other countries have a few issues with over stretched national health care and waiting lists, I would still choose this over private insurance any day of the week. You have to understand that when people go on wait lists it's because they don't have something that's critical. Everyone is prioritized and guess what, if you really want it done quickly why not pay to go private with all the health insurance money you haven't had to pay?!
Americans have long been hoodwinked into believing that they get better care for their money.
Posted by: Oli | Nov 13, 2007 12:16:45 PM
What is Medicare if not government run healthcare? As one person said, most of the statements against government run healthcare are based on fear. The fact remains, we spend more money on killing people than helping people--and in the process, the CEO's of healthcare insurances are taking home $40M bonuses--that's bonuses! And look at publicly reported outcomes & shorter life expectancy--then come back and say the European system doesn't work.
Posted by: Tim | Nov 15, 2007 3:18:59 PM
After talking to several conservatives who think national health insurance would be nothing less than evil, I finally figured out why they think this way. They are proud to be paying their monthly health insurance premium. It is a symbol of their rugged individualism, that they've pulled themselves up by the bootstraps and take care of and are responsible for only themselves. And they're petrified that the taxes that would go toward national health insurance would help pay for someone who didn't deserve it or work hard enough for it. They can't stand the idea of any of their money going toward someone who may have less than they do or might not have worked as hard as they do, but who would get the same benefits. All having access to the same health care flies in the face of their world view that we all reside at different levels depending on our resourcefulness, and money is the equivalent of virtue. To the most deserving and virtuous goes the better health care. It is to them a priviledge, not a right.
Posted by: mlk | Nov 17, 2007 2:54:03 AM
Those who fear government running the medical system don't seem to use the same argument for government run military...they don't balk at that but when it comes to poor people getting anything that the hypocritical right-wing judgmentalists fear they should not get, then all of a sudden, potential government abuse, inefficiency and waste becomes a huge issue. I don't see these same 'efficiency watchdogs' being such watchdogs over government involvement with fat cat socialism: corporate tax write offs as part of the government run IRS system, or government involvement in military defense, police,
agriculture, and a host of other programs involving government subsidy and administration of services...that doesn't bother the conservatives...but they're afraid of some poor person (remember: to them, 'poor' equates with 'lazy') might get some care that they didn't 'work hard enough for'. I don't see the same work and efficiency standards applied to Bush and his many fat cat cronies that benefit from government subsidy, administration and oversight. Just no 'universal medical care' because that smacks of 'welfare' and we all know 'welfare' is for bums and lazy and unwanted ethnic minorities we don't approve of.
Posted by: JL | Nov 18, 2007 9:54:02 PM
quality health care should be a right
not a priviledge. and i mean birth
right. for the working class the
employer must have employee health
care insurance.before he can hire
anybody and there is no deductibles
it should cover a family of four.
i think every business should pay
a health care tax into a national
pool.that would be managed by private
interprise.
and if the company outsouce fine them
and put that money into health care -
pool. and there should be a pay-
scale for health specialist. they
can't get no more then what the scale
pay. a merit board make the decisions
no unions. and there will be a bonus
for quality work. and the pool will
be self insured.
Posted by: pete | Nov 21, 2007 1:46:41 AM
Why doesn't Congress hold hearing about this topic? Is Congress so "sold-out" to the health care lobby that they are afraid they will lose their payola? Is the pay-off money that good? Where is the leadership in Congress to hold these health care insurers accountable? Where are our the heros we sent to Congress? Where can we find a member in Congress that is not on the take? I regret to say, there are none! Congress is completely sold-out to the lobbies and the American people can go to hell!
Posted by: Tony | Feb 24, 2008 6:56:39 AM
Post a comment
