Six of [California's] largest insurers rejected 45.7 million claims for medical care, or 22% of all claims, from 2002 to June 30, 2009, according to the California Nurses Assn.’s analysis of data submitted to regulators by the companies.
The rejection rates ranged from a high of 39.6% for PacifiCare to 6.5% for Aetna for the first half of 2009. Cigna denied 33%, and Health Net 30%. Anthem Blue Cross, the state’s largest for-profit health plan, and Kaiser, the state’s largest nonprofit plan, each rejected 28% of claims.”
Source: HMO claims-rejection rates trigger state investigation, LA Times, September 4th, 2009.
The saying, “if you’re not outraged, you’re not paying attention”, has never been truer. This is the system that the Democrats in Congress, and Obama, want to force us to participate in. One in which we’ll be forced to pay $13,500 a year to private sector health insurance companies, plus deductibles, co-pays, and uninsured ancillaries, for the right to be randomly screwed over and financially devastated (if we live through the process) when we place a claim for coverage.
We’re being played, folks – the debate over inclusion of a “public option” is a classic diversionary maneuver by the powers that be: get all of us radicals and progressives and liberals worked into a lather over defending and demanding that they follow through on some bullshit half-assed compromise which they’ve arbitrarily defined as being within the realm of political feasibility, and keep us off the street and from demanding what we really want, and NEED – Canadian style SINGLE PAYER healthcare.
This article emerges out of a number I tossed out in a posting on Facebook a day or two ago, suggesting that the average American would need to consume something on the order of 5% of the resources they presently consume (collectively) if their standard of living were to be equalized with the rest of the world’s population without destroying the planet’s ecosystem (i.e., how much less would we need to consume for the rest of the world to be able to consume an amount equal to what we do).
A friend asked me where I got that number from, and I’m somewhat embarassed to admit (since I’m such a data driven person) that I can’t actually recall at this point – I did the math in my head a while ago. I did some research for real numbers, mostly searches and reading on ecological footprint figures, as I vaguely recall basing the calculation on something along those lines; at this point, while the 5% number may actually have been based on some other metric entirely, the footprint metric seems the most reasonable one to use for the purpose of discussion.
California Budget Bites has a more detailed rundown of who is most impacted by the tax increases included in the recently passed California state budget… and guess what? The less money you make, the bigger the additional piece of flesh your state government now demands of you. In fact, the bottom fifth wind up paying twice as much of their income as the top 1%. Twice as much.
“The Health-Care Crisis Hits Home”
In the article above, a columnist for Time chronicles the trials and tribulations she and her family have gone through in an attempt to keep her brother, whose kidneys are failing, alive. He earns $9/hr. Lives in Texas, where the rules for how little you need to earn to qualify for Medicaid are absurd, and 25% of the population is uninsured. Has Asperger’s syndrome (high functioning autism). Purchased “temporary” insurance from a company with a record of “post-claims underwriting” (going back after the fact when a claim is filed and looking for reasons to justify excluding the claim based on prior history), who only paid up after the state dept. of insurance started looking into the situation.
The only sane reaction, after you’ve read this story, is to be utterly enraged and disgusted. I had to walk away from the computer, halfway through the story, because it upset me so much. It is very clear that the guy would probably be dead by now if he didn’t have a super-empowered sister who has covered these issues for 15 years and even moderated a presidential candidates forum on them. Even with that, he’s not having an easy time of it. What about all the people who aren’t equipped to advocate for themselves, or don’t have a champion like her? They suffer, and then they die. That’s it. Pure and simple. What else can someone making $9/hr. do? Where is someone like that supposed to come up with thousands of dollars for deductibles, excluded and uncovered expenses, copays, etc.?
Apple’s web site has a feature on how a Canadian health care clinic was able to benefit its patients by converting to a paperless office (running Macs, of course).
Notice what is, and is not talked about, in the article: not one word here about automating health insurance claims, reimbursement paperwork, tracking approvals from insurance companies and appeals of denied claims, optomizing the reimbursement “coding” process, or automating the bill collections process. Instead, it is all about being able to more efficiently serve the patient’s medical needs, and automating the paperwork associated with keeping a patient’s medical records up to date and usable.
If you want an idea of what’s wrong with the budget we’ve just passed here in California, then head on over to the California Budget Project’s “Budget Bites” blog (where they post ongoing updates on various budget related issues). Here’s a sample: What’s Wrong With This Picture?
The new owners of the Tribune Co., which publishes the L.A. Times and the Chicago Tribune (among other papers), are going to be making widespread changes to their 12 publications, including massive layoffs, and balancing content and advertising in a 50/50 ratio on news pages, according to the New York Times, in an article entitled: Tribune Co. Plans Sharp Cutbacks at Papers.
Here’s the “logic” they’re using:
…the struggling company has looked at the column inches of news produced by each reporter, and by each paper’s news staff. Finding wide variation, they said, they have concluded that it could do without a large number of news employees and not lose much content.
This makes about as much sense as measuring computer programmers by how many lines of code they produce. In other words, none at all. Based on what I read in the article, you can kiss goodbye to serious journalism at any of these newspapers.
I wrote the letter below, in response to this fairly revealing article, The Chicken Doves, in Rolling Stone magazine – about “How the Democrats Screwed The Anti-War Movement”. All about how the Democratic Party establishment sold out the anti-war movement (and the people of Iraq) for political gain. Note: Links not included in original letter.
… or, at least, I do on Facebook.
Notice the purpose to which I put my ownership.
The graph on the Political Compass web site, which analyzes the positions on the political compass of the various candidates for President in the primary elections, demonstrates why many many Americans like myself feel so disenfranchised by the current political process and the “choice” it has given them. Every single candidate of significance in both parties falls into the upper right hand quadrant: Authoritarian/Right – the Democrats just fall closer to the lower left-hand corner of that quadrant, the Republicans, the upper right hand corner.
Me? I fall into the extreme lower left-hand corner of the lower left quadrant: Left/Libertarian… my views on social and economic issues are almost diametrically opposite that of every single candidate. And exactly in the same quadrant as my political party: the Green Party (globally and in the U.S.)… although that party is much closer to the center than I am, amusingly enough.
PNHP’s Senior Health Policy Fellow Don McCanne, M.D. writes a daily health policy update, taking an excerpt or quote from a health care news story or analysis on the Internet and commenting on its significance to the single-payer health care reform movement. My mother forwarded me his posting for June 29th, 2007 (not yet up on the site as of this writing), discussing a paper produced by Health Access on the topic of high deductible insurance plans.
The money quote:
…the high deductible plans would only add more stress to the thin
financial resources of middle-income families and do little to
protect families from significant medical debts of thousands of
dollars. An individual mandate for a high-deductible plan would have
a perverse result of bringing a middle-income family closer to
bankruptcy, not protecting it.
The 800 pound gorilla of software development has moved forcefully into New York State, supported by voting machine vendors using Microsoft Windows in their touch screen voting machines and other systems. Over the last two months Microsoft and a cadre of high paid lobbyists have been working a full-court press in Albany in an attempt to bring about a serious weakening of New York State election law. This back door effort by private corporations to weaken public protections is about to bear fruit.)