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HMO Pays Staffers to Drop Sick People

Virtually all the Democrats running for president have endorsed health care proposals that maintain a major role for private insurance companies. Much of their rhetoric suggests that if we could just get everyone health insurance, then all will be well. But the debate continues to ignore the horror stories like the one reported in the L.A. Times Friday.

A private insurer paid $20,000 in bonuses to an underwriter for dropping coverage for sick people, including a hairdresser who was half way through chemo treatments for cancer. She was left with $200,000 in medical bills as a result. Meanwhile, the company, Health Net, saved $35 million by cutting off 1,600 people who had made a major medical claim. Built into the system were performance bonuses for employees who dropped the most and the sickest patients. The widespread practice suggests that Americans need a lot more than an insurance card to guarantee access to medical care when they most need it.

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Posted by Stephanie Mencimer on 11/12/07 at 7:10 AM | E-mail | Print | Digg | de.licio.us | Reddit | Newsvine | Yahoo! MyWeb | StumbleUpon | Netscape | Google |



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Not ALL the Democratic candidates: Dennis Kucinish is advocating Universal Health Insurance, NOT based on insurance companies.

Posted by: SUZANNE MILLER on 11/12/07 at 8:58 AM  Respond

HMO/PPO's s/b abolished. They provide no services. Doctors and other health care providers could easily submit claims via computer to one central health care payment computer, just like an income tax return. The central computer could reimburse the filer within seconds directly to bank accounts. Post-audits could be made by computer, then, selectively, by human auditors. Cheating health care providers would be maximally punished. The one payer would negotiate how much it will pay for Rx's. Today's system is fraught with politics, begs for scams, and has almost nothing to do with our national health.

Posted by: rod ruger on 11/12/07 at 9:01 AM  Respond

So what is new? This has been going on since the inception of insurance. And they only want to insure the healthy and young.
Many of us in healthcare, have seen the results of this on both ourselves & our pts.
Yet most of Americans just want to scream about socialized medicine.
That is, until it happens to them.

Health care even when you have it, is a laugh. My last job went from an 80/20 plan to 60/40. That is not care of any kind. Its what private equity firms do to a company. That was before the layoff.
Universal health care cannot include the hmo's and ppo's of today and it must include dental also. You can tell a person is part of the working poor by their teeth!

Posted by: Cherry Crum on 11/12/07 at 3:33 PM  Respond

Healthscam healthscare healthcare, gimme your wallet...

Posted by: Bert on 11/12/07 at 7:00 PM  Respond

We might as well give up on the Democrats and have our own new revolution. We know who our enemies are: The top 1% mostly, but also as far down as the top 19%. The opulent, greedy swine who use their money to get more money while the rest of us suffer. The unaccountable multinational corporations with more influence in the world than God.
They need to be stopped. They have the money, but we have the power if only we wake up and realize it.

Posted by: James on 11/12/07 at 11:33 PM  Respond

And the REALLY EVIL thing? Those same companies are very actively "consulting" China and India to adopt their "obviously superior" healthcare model.

Posted by: Egalitare on 11/13/07 at 5:27 AM  Respond

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This article has been made possible by the Foundation for National Progress, the Investigative Fund of Mother Jones, and gifts from generous readers like you.

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