LOS ANGELES, Feb. 22, 2008
Canceled Cancer Patient Awarded $9 Million
California Insurer Will Begin Using A Review Panel Before Dropping Policies
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Hairdresser Patsy Bates owes almost $200,000 in medical bills after her insurance company, Health Net, pulled her policy in the middle of her cancer treatment. (CBS)
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Insurer Drops Policyholders
A major insurer reportedly paid one of its workers big money in bonuses based on how many policy-holders she dropped. Bill Whitaker has the story.
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Patsy Bates, 52, a hairdresser from Gardena, had been left with more than $129,000 in unpaid medical bills when Health Net Inc. canceled her policy in 2004.
Arbitration judge Sam Cianchetti ordered Health Net to repay that amount while providing $8.4 million in punitive damages and $750,000 for emotional distress.
"It's hard to imagine a situation more trying than the one Bates has had to endure," Cianchetti wrote in his findings. "The rug was pulled out from underneath, and that occurred at a time when she is diagnosed with breast cancer, one of the leading causes of death for women."
"I had cancer, my life was on the line, and these guys did not care, did not care at all," Bates told the CBS Evening News last November.
In fact, she was in the hospital getting prepped for surgery when she first learned Health Net was dropping her.
Some of the documents Health Net was forced to hand over revealed that senior analyst, Barbara Fowler, single-handedly dropped hundreds of policy holders like Bates from the rolls every year.
The shocker: the company awarded her bonuses based on how many policy holders she dropped.
The company called 2003 - the year Fowler dropped Patsy Bates - "a banner year" for her, for saving the company $6 million in what they call "unnecessary health care expenses."
"It has never affected how I performed my job duties," Fowler told CBS News, but Bates' attorney called that outrageous and illegal.
Bates, a mother of two, said she screamed when she heard about the damage award.
"I am elated," she said.
Bates' attorney William Shernoff said he wanted other insurers to take notice of the award.
"We are going to stop a put to this practice," he said.
Health Net said it was implementing a freeze on policy cancellations that would last until the company sets up a third-party review panel to scrutinize cases.
"Obviously we regret the way that this has turned out, but we are intent on fixing the processes to maintain the public trust," Health Net spokesman David Olson said.
Bates had previously been insured with another company but was persuaded to switch over to a Health Net policy after an agent suggested she could save money.
She said she had undergone surgery to remove the tumor and had received her first two chemotherapy treatments when doctors stopped treating her because her bills were going unpaid.
"I was devastated, I didn't know what was going to happen," Bates said. "It's boggling that someone can do that to you."
She went on to complete her cancer treatment through a state-funded program.
Health Net also said it would conduct a review of its practices and the way its brokers and agents are trained.
The award came a day after the Los Angeles city attorney sued Health Net, claiming it illegally canceled the coverage of about 1,600 patients. City Attorney Rocky Delgadillo also said the company illegally ran an incentive program in which it paid bonuses to an administrator for meeting targets of policy cancelations.
Health Net acknowledged that such a program existed in 2002 and 2003 but was subsequently scrapped.
In his findings, Cianchetti wrote that "it's hard to imagine a policy more reprehensible than tying bonuses to encourage the recision of health insurance that helps keep the public well and alive."
© MMVIII, CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.
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See all 192 CommentsIs there a nice rock you can go back and slither under????
What do you think insurance is for? It''s to pay the bills so we don''t have to turn to others for help. Health Net should be ashamed of themselves.
Posted by beehive21 at 07:51 PM : Feb 22, 2008
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Beehive that was a low cheap shot. If a retired judge came back and and gave that woman that much money, she deserved it. How would you like to be on your death bed and have someone tell you that your insurance says "Youre cancelled"!
Youre a loser!!
Hold on here. SHE had a policy to help her with expenses if something happened and when she asked them them to keep the promise they made when they TOOK HER MONEY, they tried to cheat her. Relate this to your car insurance. NEXT wreck you have , go pay for it yourself annd don''t ask the rest of us insured with the same company to share the expense- just the profit please.
St Pete asks the doc "Why do you belong in heaven?" The doc replies, "I spent all my life relieving people''s suffering and saving their lives."
Pete says "Hey, works for me, go on in"
Pete asks the nurse the same question and she says "I spent most of my working life standing beside the doctor trying to ease my patient''s suffering and comforting their families"
Pete says " Works for me, go on in"
When asked the crucial question, the HMO CEO says "Well, it takes a very entrepreneurial person to assume the fiduciary risks associated with with the Health care industry in the current risky financial environment."
St. Peter says ""OK. Works for me. But you can only stay three days."
Posted by beehive21
You can''t even be considered human!! Those words will come back to haunt you stupid! Cancer isn''t a selective disease.
I watched my brother die from melanoma, you better pray to God you don''t have to watch any family member suffer like that--but then, with a remark like that--you probably wouldn''t even care.
Nowhere in Europe, Japan or Canada would this treatment be possible.
If/when the US opens relations to Cuba, the US will see it''s healthcare outsourced to Havana, who have thousands of highly qualified doctors and medical staff.
When these health insurance *** find out it will cost them far more to screw their customers, they will mend their ways and start doing the righteous thing. Good for her.
"The shocker: the company awarded her bonuses based on how many policy holders she dropped."
I believe there should be a special place in hell for Barbara Fowler, and all of her superiors.
Furthermore, this is the type of BAD situation, where there ought to be criminal charges.
It is time for the state and federal governments, to act as one and pass laws that make insurance companies responsible for their errors, and stop patient dumping from happening.
Remember, these are the same insurance companies that favor limiting the amount of awards to lawyers and plaintiffs who sue for medical negligence.
More than likely, these are the same insurance companies that have been supporting Bush II, and his draconian philosophies.
Posted by exCoachKen at 10:03 PM : Feb 22, 2008
Agreed, if for no other reason but to terminate corporate greed!
One of the rules to achieve and maintain PROFIT, as stated in the Ferengi bible, The Rules of Acquisition" states that you cannot realize profit by spending money, therefore attack the causes that force you to spend money and eliminate them (in this case, cancel your customers policies and don''t pay their claims)!
Of course, by doing so, you run the risk of attracting a lot of bad publicity as well as a bad reputation through angry word of mouth advertising, but who cares, as long as there is someone out there to make a PROFIT off of!!!
SIG HEIL, BUSH!!!!
sig heil, McCain???
Well if his rant was bad, yours was pathetic. Sheeesh!
Any Regulation of corporate power and will is tantamount to treason! Filthy unworthy leeches like cancer, heart patients or any other ailments should be dumped out of the health insurance system and barred from suing these outstanding and patriotic Health Insurance Institutions!
Health insurance does not exist to share risk among our citizenry, but to enrich a select few executives and their friends. Lets not stand in the way of reasonable multibillion dollar golden parachutes and similar necessary bonuses to the only citizens that really count in America!
May God Bless those who are truly worthy!
This type of business outrage has grown virtually unabated under the Bush regime - Enron execs laugh about their new strategy at a party with Bush even before his 5 black-robed sycophants forced the coup d''etat down America''s throats....and on and on and on - deregulate and here goes the mortgage crisis - pay so much attention to the Iraq blunder that virtually any well-heeled corporate entity can simply plunder the public with relative impunity.
Universal health care is essential to the nation''s well-being and is now available in every civilized country in the world, except America. Well-connected corporate greed in the only obstacle - along with mindless followers of the neo-con wing of the GOP chanting words like "Socialized medicine" as if were some evil communist plot.
I have lived in Canada now for all of the Bush years and I can tell you first hand that even though the Canadian system, like all systems, has flaws, NO-ONE is denied life-saving treatment and NO-ONE has to stress about it. That fact alone makes it worthwhile for everyone.
Perhaps if your life-or-death medical treatment had been withheld by the company in question, you might wake up. I hope it never happens to you.
It seems to me that God has become the almighty dollar, and screw everyone else.
Posted by exCoachKen at 10:03 PM : Feb 22, 2008
Agreed, if for no other reason but to terminate corporate greed!
Posted by liberalme at 10:08 PM : Feb 22, 2008
[SIGH] don''t you people get it? The "corporate greed won''t stop" it will be just like car and home owners ins--except you won''t have a say in cancelling this policy and getting a better one more suited to your family and circumstance. On the surface this looks like it is geared to help us all--but in reality, it is a bid to ins and the health and pharm industry--to have a captive payer with a payee who is spending money that is not theirs. You guys better follow the special interest back to Hilary and who ever else is for this. When we all have this Universal care, what is to stop them from charging even more than they get now--and since it is not their own money what is to stop our government from shrugging their shoulders and requiring each and everyone of us to ante up? Monopolies are dangerous things--but especially suspect when we are told they are for our "own good".
Posted by incog-nito at 11:11 PM : Feb 22, 2008
You''ll get an up and close quick lesson in why if you or someone you love ever gets cancer and you don''t have insurance.When those 2 to 300 thousand in bills, and transplants hit you--bet you will understand why people take out insurance to help defray those costs. It''s not rocket science--if you don''t know it is because you are either too young or too self centered to realize insurance is to pad against potential bad times in health --which eventually happens to everyone.
Suddenly national healthcare doesn''t look so bad!
Just about every civilized country on earth has national health care, except the US. We say we can''t afford it, yet we spend more per-capita on health care than anyone... Unless we are totally lame, we should be able to copy sweden, canada or germany''s system and save money!
Where does the money we are spending now really go? Does it go to patient care or fat bonuses for weasels?
Let''s give national health care a try.... Pay the doctors, serve the patients and fire the weasels!
Support for this woman against this company goes ACROSS party lines. Stop demonizing people who would agree with you.
Now for a few fact-checks. Enron filed for bankruptcy in 2001, meaning that it was conducting its illegal practices during the CLINTON administration.
If Bush had 5 "sycophants" on the Supreme Court, Roe v. Wade would be overturned. Are you suggesting Sandra Day O''Connor was a Bush sycophant?
As for the Canadian system of socialized medicine, it may not be YOUR experience that anyone is denied life-saving treatment, but don''t speak for everyone. My wife had a progressing case of pneumonia that went untreated for several days because she couldn''t get IN to see the doctor in Canada. She went back to the states and got care immediately. By the time she got help, the doctors said she was only a day or two away from maybe not coming home.
So 1) stick to fact based opinions and 2) respect that your experience may not be everyones.
Cordially,
Of course there are always people who choose to this study offhand, and rely on anecdotal or hearsay evidence instead.
"The World Health Organization has carried out the first ever analysis of the world''s health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan.
The findings are published today, 21 June, in The World Health Report 2000 %u2013 Health systems: Improving performance*.
*Copies of the Report can be ordered from bookorders@who.ch.
The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th . Several small countries %u2013 San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy."
The study was published in 2000. I seriously doubt that health care in the U.S. has considered improved since then. In fact, all evidence points to the contrary.
Sigh! Don''t you get it??? What we have in this country that passes for health care is absolute KRAPP!!! If the US ranks 37 in health care that should tell you something. Government employees get non-privatized government provided health care insurance. They do not receive their coverage like the rest of us through private insurance. They do not have to worry about being canceled or having previous conditions for which they won''t be covered. We who support this goverment with our taxes should at least have the same opportunities as they do.
Sigh! Don''''t you get it??? What we have in this country that passes for health care is absolute KRAPP!!! If the US ranks 37 in health care that should tell you something. Government employees get non-privatized government provided health care insurance. They do not receive their coverage like the rest of us through private insurance. They do not have to worry about being canceled or having previous conditions for which they won''''t be covered. We who support this goverment with our taxes should at least have the same opportunities as they do.
Posted by rudy654 at 01:34 AM : Feb 23, 2008
I agree that something must be done--but before handing ourselves and tax money to this program part and parcel--we need to examine the agenda of those who want it, the loopholes they left to be exploited, and which companies are maneuvering into position to exploit them. Iraq, Bush, NAFTA and other debacles ought to teach us the folly of rushing into something or starting a process that ultimately harms us and others and is difficult to reverse.
TO say that we are "rushing" into universal health care is an extreme exaggeration. If anything, this country has been moving at a snail''s pace towards anything that even looks remotely promising. Seriously, all I ever see is opposition getting in the way. The opposition never ever has an alternative other than keeping it as miserable as it has always been.
It should have been $900 Million.
Health Insurance executives are the lowest form of life on Earth.
Someone should be going to jail.
it is also true that few systems are truly "Universal" as people think. I was born in England and have lived there and in Holland. First of all, miscarriages and pregnancies are handled at home with occasional visits by a midwife. Most colds and sore throats or infections are allowed to resolve themselves and antibiotics are rarely given. In holland, where taxes can reach as high as 70% of one''s salary, everyone is not entitled to the care that is taken out of the taxes. Those who make over (in 1993) 35K have to buy private insurance and are not allowed to avail themselves of the programs that they help to pay for. Although in Holland one can get into see a doctor pretty easily if one has private insurance, if you have the public care, you have to wait. Some procedures which are determined to be elective there, are not elective here (like bad hips and knees, or tonsilitis....migraines, allergies like hayfever) for those types of problems the wait can be measured in months or even a year or two and it may also be determined to not be necessary and a person is sent to alternative care.
NO beehive. For example, some may feel that spending money on mental cases like yourself is a waste of our money. Hitler felt that mental patients such as yourself should be gassed. I disagree. I think you are worth the money and time needed to make you healthy again.
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