Yanking Health Coverage Wins A Bonus

The Skinny: California Lawsuit Shines Light On Little-Known Health Insurance Practice

(CBS)  The Skinny is Keach Hagey's take on the top news of the day and the best of the Internet.

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It's the kind of story that makes Europeans look at the American health care system and shake their heads.

The Los Angeles Times reports that one of California's largest health insurers set goals and paid bonuses based in part on how many individual policy holders were dropped and how much money was saved.

Times reporter Lisa Girion writes that Health Net Inc. avoided paying $35 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid the senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies.

The Times had to get its lawyers involved to pry the documents backing up these claims out of Health Net's clutches, even though the company had to produce them for a law suit brought by one of those dumped policy holders.

Health Net tried to keep them secret, arguing that they would embarrass the company. (Perhaps they should have thought of that before complimenting their analyst for her "banner year" in 2003 when she exceeded her performance goal and helped the company avoid "$6 million in unnecessary health care expenses.") But in the end, the newspaper won, and so was able to show, for the first time, how an insurer linked cancellations to employee performance goals and to its bottom line.

The suit was brought by Pasty Bates, a 51-year-old hairdresser whose coverage was rescinded by Health Net in the middle of chemotherapy treatments for breast cancer, leaving her with $200,000 in medical bills.

Three years later, she still has a catheter embedded in her chest where the chemo was pumped in and is unable to afford tests to determine whether the cancer is gone.

Health Net contended that Bates failed to disclose heart problems and shaved 35 pounds off her weight on her application.

Bates' lawyer, William Shernoff, claims that the analyst's performance goals show that Health Net was bent on finding any excuse to cancel the coverage of people like Bates to save money.

"I haven't seen this kind of thing for years," Shernoff said. "It doesn't get much worse."

Bush The Elder Defends Bush 43

USAToday reporter Susan Page scored a rare interview with Bush the Elder yesterday, and used it to needle the 83-year-old former president about his son's Iraq policy.

"Do they want to bring back Saddam Hussein, these critics?" the elder Bush said. "Do they want to go back to the status quo ante? I don't know what they are talking about here. Do they think life would be better in the Middle East if Saddam were still there?"

Bush was interviewed in a replica of the White House Situation Room at his remodeled presidential library in Texas, where visitors can play a new interactive computer game that allows them to consider options Bush 41 weighed during the Gulf War.

The program calls the idea of going to Baghdad "very tempting" but says it "would have been a disastrous decision," splintering the international coalition and leaving U.S. and possibly British troops on their own in Iraq."

Bush 41 "reacted testily" when asked about criticism of Bush 43, and said that questions like those raised by USA Today are one reason he generally eschews the press.

Witches Open A School In The Heartland

A business calling itself the Witch School recently opened on the main drag of Rossville, Ill. - pop. 1,200 - and the local churches are spooked, USA Today reports.

The school, which calls itself a "pagan colony" and claims to have more than 190,000 registered members online, offers seances, initiations and rituals six days a week.

The town's major is fine with it, as the school pays property taxes, collects sales tax and uses city-owned water and gas systems, in addition to filling an empty building in a town that already has plenty of vacant storefronts.

When two people showed up at a City Council meeting to object to the school, he told them, "I don't remember voting on you coming to town."

But the local churches are up in arms. Church leaders have put up a billboard that reads "Worship the Creator, not creation" - a reference to the Wiccan belief that elements of natures are deities.

"Our ultimate goal would be to convert them to Christianity," said youth pastor Andy Thomas. "If that doesn't happen, I don't know what will be next."

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[ninerman168]

Love George Bush wish Ann Coulter was running for President

[xlib]

How about we all DEMAND the same health care coverage our noble leaders have. I want, no, DEMAND to have the same coverage as nance, hill and the rest of them.
Our system does need revamping but I maintain that if it is put in the hands of the government we will be in worse shape.

[brianbwb-2009]

"Do they want to bring back Saddam Hussein, these critics?" the elder Bush said."

Can''t, you and you son had him lynched, remember, dummy?...

"Do they want to go back to the status quo ante? I don''t know what they are talking about here. Do they think life would be better in the Middle East if Saddam were still there?"

You mean better than now? Lets see, 4,000 fewer American dead, and probably a quarter of a million fewer innocent Iraqi dead, a quarter of a trillion dollars of our future embezzled to the pockets of your (and his) friends, hmm...

I''d say yes.

As for the insurance scam, this is what Bush and the rest of the fascists think about you and your health.

This is why private companies should not be in the health care business. The time has come for socialize medicine. These modern day carpet baggers have price themselves into the stratosphere. The greed of Big Pharma is spreading.

[rudy654-2009]

And don''t forget that they also publish that 80% of Americans like the health care system as it is. It makes you wonder how the poll was taken and by whom? Anyone with the health insurance knows the headache it can be just to get those people to pay. I have gone to the doctor, and thought everything is paid for no problem. Great insurance!! Several months later, claim denied for XY and Z reasons and now I have a bill to pay. Oh, but the insurance company sends me a form just in case I don''t agree. By the time they address it, I will be in collections if I don''t pay the doctor.

[rudy654-2009]

Oh but where are they the limbites, Hannitites, and the Ingrahamites? The best health care in the world? What a joke! And then, just about two weeks ago, CBS publishes a trash and blatantly false article about the English Health care system being a torture chamber. Except one problem, all of what the articles said was really about the US health care system. People from England posted here that it was blatantly false, and that they had a very good system. But of course, many of us knew that it was promoted with an agenda by somebody we will never know.

[biscuitmom]

Apparently Health Net was happy to keep her on as long as she was paying premiums and not filing claims.

[ewestmor]

I am one of HealthNet''s victims, but I was informed there was nothing I could do about it. I suffer disk degenerative disease and chronic pain syndrome. Along with that some permanent nerve damage. I was on Health Net HMO at one time. Every treatment or test that my primary care suggested for me, Health would not approve, stating it was experiemental and there was no guarantee that it would not help me. As I watched myself getting sicker, I had to change over to a more expensive PPO. But even though it is too late to repair the problems at least I am now getting the proper treatment. It is my strong belief that if Health Net had approved some some the test and treatments, I would not be forced to live as I do now in constant wrenchng pain.

[mrassekh]

"Do they want to bring back Saddam Hussein, these critics?" the elder Bush said. "Do they want to go back to the status quo ante? I don''t know what they are talking about here. Do they think life would be better in the Middle East if Saddam were still there?"

What business is it of ours how life is in the Middle East?

[dana12475]

I am a retired registered nurse. My last professional job lasted 2 mo - case manager at Blue Cross Blue Shield Texas. The month of March is bonus time for denying treatment, and God help you, if you had an HMO policy. My Ethics in Nursing gave me an excuse to retire early. BC/BS Texas profits huge and bonuses to nurses & doctors are very large. This is in every insurance company.

[toolmangler-2009]

AND WE HAVE THE AUDACITY TO CALL OURSELVES A CHRISTIAN NATION. What is Christian about treating the poor, the weak, and our veterans like yesterday''''''''''''''''s trash???

Posted by ttinsly at 04:05 PM : Nov 09, 2007


Just proves to me that real ''Christians'' are not in power in Washington.

[andor3]

someone said: "Welcome to liberal health care in a liberal state."

Oops! you meant conservative-valued corporation-controlled health care--that is what is at work here. They got busted by a liberal state. *** liberals always looking out for folks and interfering with corporations trying to make a buck by exploiting kids and families.

What is this country coming to when the people have the power and nerve to rein in a corporation trying to take their money and harm their families? Dern liberals anyway...

[eskieville1]

After reading a variety of commentary the last few days--it is becoming more obvious that our lives are worth nothing to our "leaders". Only rich people have any value to them. Get ready for riots and revolution. How depressing and sad!

[denn034]

Welcome to liberal health care in a liberal state. Let''s hope they don''t install that deficit exploding *** in the rest of America.

[bill1fj]

We need a health care system based on whatever the congress gives itself should be available to all legal citizens, at the same cost.
That would be fair for all.

[hypnotoad72]

Re: Bush''s bit in what could have been a separate article, why didn''t #41 take out Saddam when the world was with him? (Plus, wasn''t there a youtube video of VP Cheney telling everyone, circa 1994, essentially why we didn''t go in at the time?)

http://www.youtube.com/results?search_query=cheney+iraq&search=Search

Don''t get me wrong. I am in support of the war, am glad Saddam is dead (he was a real pile), know Clinton and Gore spoke of Saddam''s intentions should he get WMDs and so on, but why couldn''t Hussein be taken out back then?

[likeabllunch]

'' .. war rapes babys & what u did was assaulting an officet, u get a medal of honor & u are henceforth an officet: u get to to visit 1 sick bed at up to 33 villages each night spread across 3 or 6 countys so to cut & paste your blooms & other inventorys for up to 33 dollars each night, hold hands & weave bouquets, recycle garbage & garden to educational props accents dances jingles arts crafts knicks knacks, shopgift grass dirt for cures cancer other margaritas margaritas other cures cancer, shift shapes, toggle virtual & realtime, travel eternitys at speed of thought, hikenswim nerfbus bumpcar camp & nap, dance get well feed world get sick tax world hike naked dance dressed porn songs rallyd round billions sick beds that swimm & drift tens millions spore bloom weed dragon trail fickle first aid lunch farm cottage studio trail crossing yseedsberry trail groups dotted wit homed sheltets, speckled with drip compost fertilizet & drip water irrigatet, dcorated with folk playing zero resistance free form tai chi aikido yogaerobic inkblot sport & puzzle for life & lunch the musical epic quest to cure the common death & the wondet supet flora poet ballot ballet bowl & lusty forge your own epic karaoke feed worlds with free food medicine for each & all forever & evermore & infinite wishes come true .. if any ask which came first, eternity or earth? earth & eternity came together, so any answer is logical .. ''

[standlee5]

These companies want to make millions with no regulations. The elected officials have forgotten that their job is not to promote big business but to REGULATE it. We all pay the price for deregulation when congress is in bed with big biz.

[standlee5]

Why isn''t the insurance commissioner for the state of Ca. shutting this company down. They should be fined and required to cease operations. That''s why we have insurance commissioners to oversee these scumbag companies. Our state has a hard azz insurance commissioner and the insurance industry tries to make the argument that our premiums are higher than any other state. Well, so what. What the h3ll good are low premiums if the frigging insurance company takes all your money then cancels you.

[andor3]

Funny how people (usually people who have something to gain/lose) will try to tell ghost stories about how bad single payer health insurance *might* be.

But they seem to ignore how obviously broken the current system is. Insurance companies make health care decisions based on maximizing profit, which translates very directly into providing the least care and charging the most money they can get away with. It is hard to imagine a worse system than what we have now--the current system is designed to fail.