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The suit was brought by Pasty Bates, a 51-year-old hairdresser whose coverage was rescinded by Health Net in the middle of chemotherapy treatments for breast cancer, leaving her with $200,000 in medical bills.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

May she catch the Clap and lose her health insurance under the No-Tramp clause.

[random_radar]

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

So its okay to lie? Isn''t that the issue here?

If Bates was truthful, then I agree that Health Net is evil. But if Bates really did lie on her application, then tough luck about being canceled.

Of course, lots of people wouldn''t agree with me. I wonder how many of them lie on their applications, resumes, and affadavits? Are we really sympathetic people or trying to cover our own sins?

[mswolfestock]

"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."

. . . . oh, heck, pastor, just burn a few of them at the stake, or maybe throw water on them and they''ll melt like the Wicked Witch in the Wizard of Oz. I think the "Christians" in Rossville need to lighten up a little bit. If they would open their minds and put their prejudices aside, they might just learn something. To the "Christians" in Rossville: this is still a free country, we are still supposed to enjoy the separation of church and state. This country was founded on the notion that EVERYBODY has the freedom to worship (or not) as they choose. If y''all got this upset about Wiccans, what would you do if a bunch of Muslims came to town and they wanted to build a Mosque?

[bwessels]

GHWB, it is worth looking at the balance sheet, because the answer is maybe not obvious. Saddam was a brutal dictator, but he was both secular and contained. Your Reagan administration saw fit to arm and aid him against Iran during the 1980s for these reasons. Radical Islamist sentiment like al Qaida was a danger from places like Iran, and later, Taliban Afghanistan.

Of course you betrayed Saddam by selling weapons to Iran as well, and he then betrayed you by invading Kuwait. You decided to punish but not remove him in 1991. Dictators are better than Ayatollahs, apparently. You left the mess for Clinton.

Meanwhile the Islamists were pretty ticked off about Americans on sacred Saudi sand, our abandonment of Iraqi Shiites to old ally Saddam, and general U.S. collusion with Middle East scumbags. 9/11 happens. Boy George links it to Saddam, which is as close to 180 degrees off course as you can get. We re-invade the secular state to ferret out those Islamic radicals, but mostly to make you proud, Dad.

Now we are in the middle of the Iraqi Civil War to create a Sunni state, an Islamic Shiite state (Iran #2), and Kurdistan. None of the factions fears the U.S. military or the Iraqi military. They all feared Saddam.

[iceman_1960]

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

Conservatives like Bush denounce "socialized medicine" but they offer nothing but Pie-in-the-Sky pablum by way of an alternative.

"We need to help move all poor kids into private insurance coverage..." blah blah blah...

Might as well wish upon a star for that to happen.

[gunnerv1]

tuckerndfw You won''t be "giving" your money to them because the Gov''t will be Taking it.

[iceman_1960]

It"s just too d*amned easy for the wealthy and the Upper Middle Class to take this "If it ain"t broke, don"t fix it" attitude to the American health care system.

Because for THEM it isn"t broke.

These are the folks who brought us child labor in textile mills and coal mines before the bleeding-heart social reformers got laws passed to prohibit those practices.

[slim1h2o]

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.

This *** has been going on for years. There should be alaw to protect policy holders from being dropped in the middle of their operation, or treatment.

Further more these Insurance Co''s should be ran out of business, when they get caught dropping their clients, in such situations.

so we shouldn''t have done anything after the highjackers did their acts? Just let the rest of the world think anyone can come into our country and destroy all those lives? I don''t think so. Stay out of Iraq maybe, but not Afganistan.....

[condumism]

Posted by tuckerndfw
Voting for Hillary is the same as voting for Bush.

Only in the fact that Hillary will continue to allow Corporations to run this American disaster. However, voting for Giuliani, McCain, Thompson, or Rommel IS EXACTLY THE SAME as voting for Bush in every way.

[dbl06]

I''m not sure an 83 yr old ex-president showing some signs of senility is fair game, but the question is fairly easy to answer. There have been a whole lot of innocent Iraqis killed that would still be alive if Saddamn were still in power(what little power he had left). I guess we should mention the nearly 4000 dead and 25,000 wounded who would be better off. Of course those are the Americans. The world would be a better place if George Bush had never been born. And George H. W. Bush wouldn''t have to alibi for him.

[slim1h2o]

Insurance companies are little more than criminal enterprises scamming people out of their money and providing nothing of value in return.

Posted by tuckerndfw at 12:41 PM : Nov 09, 2007

Agreed, However, their lobbying arm in congress ensures, nothing will be done to correct the situation. Just more Bushitt.

[missingamerica]

Hah. Iraq isn''t the only disaster of Jr. and his Republican pals.

Take the CRB CI. The crude oil segment is climbing in U.S. $ terms, but flat or declining in Canadian $s. How?

1) Republicans change bankruptcy law to make it tough for Joe or Jane Average to escape overwhelming debt & created a "Business Is a Law Unto Itself!" atmosphere.

2) Fed wants to "prove" Bush''s "trickle down" tax cut policies & hides the impact of lost manufacturing & service jobs by lowering interest rates - i.e., the illusion of "success" via money supply & consumer debt manipulation.

3) Effect? The financial industry seized the opportunity & made loan after loan they previously would not have made.

4) Consumer ability to make debt payments was finally impacted by: a) wages stagnant or declining; b) no "better" jobs to get; c) the direct & indirect effects of soaring energy costs caused by Bush''s imperialistic activities in Iraq.

5) Effect? Sub-prime market crashes. The Fed lowers interest rates to prop up the stock market.

6) Effect? The U.S. $ takes it in the teeth.

7) Effect? Oil - in U.S. $ terms - soars. The price of imports across the board soar at something like a 10.3% annual pace in the quarter

Result? It puts the inclined plane wrapped around a shaft to us.

It also primes the next Administration for a catastrophe, which probably has the Republicans rolling with laughter as they sip their expensive wines and cognacs at their posh clubs in the evenings.

[myidoncbs]

A very random thinker (random_radar) asked, "So its okay to lie? Isn''t that the issue here?

If Bates was truthful, then I agree that Health Net is evil."

The issue here is that the insurance company is the LIAR, the scammer, the blood sucking skumbag! The idea which the insurance companies sell is "pooled risk". Everybody puts money in the pot, some will get sick, the pot pays them for their healthcare. But what they REALLY do is this: "take money from as many people as possible, screening out anyone who they think might get sick, then pay nobody and pocket all the money." That is a SCAM, pure and simple. And because they prey on people''s fear of getting sick, and they have no intention of paying to help those who are truly sick, it is an EVIL SCAM.

The fact that some people lie to get insurance is directly due to the fact that the insurance companies won''t insure them if they don''t lie. I don''t condone lying, but what other option do people have?

If we had a truely universal health care system, like ALL of the other civilized countries in the world, then we would not have any of these problems.

[cathaleen]

I am not shocked. The insurance companies have been doing this for years. This is capitalism at its best.

[antoniof123]

I am amazed that some of you know to breath the air. Those of you who say Hillary''s health plan is this monster ready to eat you don''t have a clue. Read it on your own if you can read because if you can''t then don''t say something that some shock jock has stated.

It is not socialized medicine too bad because that may be the only way to save our medical environment here in this country.

But the shock jocks know everything I forgot read it you may be surprised otherwise keep quite it is getting old swift boating is so reactionary and that is well not worth the time of day.

[enriquecaliente]

Insurance Companies = A license to steal.

[eskieville1]

A universal single payer health care system is needed NOW!Capitalism and health care are a bad mix--that is now obvious to all.

[afmca]

This is why the Repub arguements against single payer universal health coverage is just a cover-up for their real reason for hating this plan - greed and lack of empathy. You could still have a robust private sector competing for business, but it is shown that a self-policing industry is a sham. I''ll bet Patsy Bates would welcome more socialized medicine if it got that tube out of her chest. Health Net and the other examples of corporate greed is another of Bush''s legacies.

[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.

[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.

[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.

[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 .. ''

[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?

[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.

[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.

[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!

[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...

[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.

[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.

[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?

[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.

[biscuitmom]

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

[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.

[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.

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.

[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.

[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.

[ninerman168]

Love George Bush wish Ann Coulter was running for President