Theft of Health Care

California court rules against insurer over policy cancellations By Amy Lynn Sorrel, AMNews staff. Jan. 21, 2008.

"...On Dec. 13, 2007, the California Dept. of Insurance levied a $12.6 million fine against Blue Shield for a host of violations regarding improper policy cancellations and claims processing. Duncan Ross, president of Blue Shield of California Life & Health Insurance Co., contested the allegations in a statement. He called them a "radical departure from the department's longstanding interpretation of the law..."

Bear in mind, this is just a small sample of what they have been caught doing. The problem is far bigger than we can possibly see in one glimpse. It's the nature of the beast. The mega-Health-Conglomerates, whether they are for-profit institutions or so-called non-profit HMO's, are at odds with the system of providing health care to those who pay for it, the need to fund their institution, and/or providing profit to their numerous gluttonous shareholders. Kaiser-Permanente is a good example of an HMO/for-profit institution that does a lot of good work, interspersed with some really reprehensible behavior. From dumping patients on skid row (Kaiser Permanente is accused of leaving a homeless woman to wander on skid row. By Richard Winton and Cara Mia DiMassa, Times Staff Writers November 16, 2006 ), mismanaging their kidney transplant program Kaiser mismanages Kidney Program, gets 2M$ fine. htttp://www.mercurynews.com/mld/mercurynews/news/breaking_news/15245674.htm to allowing their facilities to fall into medical bedlam, Kaiser takes the cake, as noted below;

12/20/07 - A physician who sued Southern California Permanente Medical Group (Medical Group) and Kaiser Foundation Health Plan, Inc. (Kaiser) (collectively, defendants) based on claims that his employment was terminated in retaliation for "advocating medically appropriate care" was properly awarded $200,000, a California appeals court ruled in an opinion posted December 20.

"Kaiser-Bellflower's policy was to keep patients waiting in the emergency room until they left without treatment," the appeals court said. "Between 1999 and 2006, more than 5,000 patients were sent home without receiving medical screening exams."

The problem is not that hospitals do good work, obviously. We, as a society, accept that problem do arise, and that mistakes can and do happen. But when mismanagement becomes endemic, when patient care suffers because of the bottom line, when the very system in place is the problem, then it is time to change the entire system. It is interesting to note that one of our founding fathers, Benjamin Franklin, created numerous social institutions which we still use today. I can just imagine what he must be thinking right now...

"The post office is doing okay, but I wish they would pick up the pace. Both the fire department and the police are dong the best they can, given the resources they receive. I wish the people down there would wise up and give them the funding they need! The public library is my pride and joy, I am so glad they haven't closed too many of them. But this insurance thing, I knew that was going to come back and bite me in the ass!"

There are those diehard capitalists who urge us to just stick with the system. They say that market forces are the only things needed to fix the problem, when people choose or don't choose an insurance plan they are sending a message that is heard loud and clear. I say it is clear as mud, looked at through a pair of binoculars, from the wrong side, facing the wrong direction. People don't know what they are buying. People have no way of evaluating one plan verses another. Furthermore, by making a person pick a specific plan that is supposed to "cover their needs" they are being asked to guess at what diseases or problems they might get in the future.

What we do know is this, the for-profit-health-insurance industry is not delivering what they promise.

If they don't deliver I say stop paying them. How's that for market forces?

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