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It Took Public Shaming Via Twitter to Get Big Insurer to Cover Grad Student's Cancer Care

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opednews.com Headlined to H2 8/6/12

reprinted from the Center for Public Integrity's IWatch News

Aetna's had a lot to say lately about how  business is good. The company disclosed last week that it made $458 million in profits this spring, and said it expected to make more money this year than executives previously thought possible. The firm also signaled it set aside three quarters of a billion dollars from policyholders to buy back shares of its own stock instead of paying more claims. But a few days before that, Aetna's CEO got a real-world understanding of just how inadequate some of the company's policies are.

And thanks to Twitter, the rest of us got a better understanding of how U.S. health insurers are able to profit so handsomely from the inadequate policies they sell, especially to students.

A significant part of Aetna's revenues come from its student health plan business. The company contracts with many colleges across the country to provide coverage to students. Trouble is, those policies typically have low annual and lifetime limits -- as was discovered recently by Arijit Guha, a 31-year-old graduate student at Arizona State University who's been diagnosed with colon cancer. Guha was paying $400 a month for a policy that had a $300,000 lifetime limit. It didn't take long for his care, including surgery and chemotherapy, to quickly exceed that.

Facing a growing mountain of bills and the very real possibility of having to file for bankruptcy, Guha and his friends decided to set up a provocatively named website -- poopstrong.org -- and to use Twitter and other social media to raise money to pay the claims Aetna was denying.  

Tweeting as Poop Strong, Guha soon drew the attention of a customer service representative at Aetna and, ultimately, the big guy himself, CEO Mark Bertolini.


Here's an abridged version of how it went down:

Poop Strong: @Aetna's 4th qtr profit up 73%: "it continued to benefit from low use of health care." Helps they can ensure low use.

Aetna: @Poop Strong We care about our members. We want you to be empowered to be healthy and make informed decisions"Please know we're here to answer your questions and discuss your concerns.

Poop Strong: @AetnaHelp @Aetna That's so sweet you want me to be empowered. Does [Mark Bertolini] care to empower me by paying my $118k and counting in bills?...The thing is, I've needed you for the last 6 mos. Not for "support" and "to discuss concerns" but to pay my bills.

Another thread by some of Poop Strong's friends drew out Bertolini:

Bag of Moons: @mtbert You, sir, have blood on your hands. Man up & pay for @Poop_Strong's treatment, & for others like him. You don't need the $, they do

ItsLerama: My bud @poopstrong, a PhD student w Stage 4, was shamefully kicked off his insurance. @Aetna. Btw congrats on the $10.6M CEO salary @mtbert!

Mark T. Bertolini: @Its Lerama @ aetna We did not kick @poopstrong off his insurance. We are on the phone with him now to find a solution to his financial issue.

Nhojelttil: @mtbert @ItsLerema @Aetna @Poopstrong You did, in fact, do just that. Glad if you're fixing it now. A little bad PR goes a long way, huh?

Mark T. Bertolini: @nhojelttil That's not the case. His benefits did not cover anything. We paid hundreds of thousands in $ already. A call is all it takes.

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for 20 years, Wendell Potter worked as a senior executive at health insurance companies, and saw how they confuse their customers and dump the sick -- all so they can satisfy their Wall Street investors.
Wendell Potter is an Analyst at the Center for Public Integrity; Former insurance company executive; Author of Deadly (more...)
 

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