Exactly so!
This link has been bookmarked by 3 people . It was first bookmarked on 11 Aug 2009, by KM Anderson.
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11 Aug 09
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In October 2008, Michael Napientak, a doorman from Clarendon Hills, Ill., went to the hospital for surgery to relieve agonizing back pain. His wife's employer's insurance provider, a subsidiary of UnitedHealthCare, had issued a pre-authorization for the operation. The operation went well. But in April, the insurer started sending notices that it wouldn't pay for the surgery, after all; the family, not the insurance provider, would be on the hook for the $148,000 the hospital charged for the procedure. Pre-authorization, the insurance company explained, didn't necessarily guarantee payment on a claim would be forthcoming
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Long before anyone started talking about government "death panels" or warning that Obama would have the government ration care, 17-year-old Nataline Sarkisyan, a leukemia patient from Glendale, Calif., died in December 2007, after her parents battled their insurance company, Cigna, over the surgery.
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The monthly bill for her prescription medicines -- which she says are mostly generics -- is $2,000; the doctors treating her for the MRSA infection want $280 for each appointment, now that she's lost her insurance coverage.
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First the company refused to pay for an MRI to locate the tumors, saying her family medical history didn't indicate she was likely to have cancer.
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California taxpayers, meanwhile, got stuck with the bill -- after years of paying their own premiums, the Denney family went on Medi-Cal, the state's Medicaid system.
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When they wrote back, objecting and pointing out that their annual limit was higher, the company changed its mind -- about the reason for the denial.
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just three insurance companies kicked at least 20,000 people off their rolls between 2003 and 2007 for such reasons as typos on their application paperwork, a preexisting condition or a family member's medical history.
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There is no national database of insurance claim denials, though, because private insurance companies aren't required to disclose such stats
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In June 2008, Robin Beaton, a retired nurse from Waxahachie, Texas, found out she had breast cancer and needed a double mastectomy. Two days before her surgery, her insurance company, Blue Cross, flagged her chart and told the hospital they wouldn't allow the procedure to go forward until they finished an examination of five years of her medical history -- which could take three months. It turned out that a month before the cancer diagnosis, Beaton had gone to a dermatologist for acne treatment, and Blue Cross incorrectly interpreted a word on her chart to mean that the acne was precancerous.
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once the newspaper started asking questions, the insurer suddenly decided, "based on additional information submitted," to cover the tab, after all.
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Sorry, Sarah Palin -- rationing of care? Private companies are already doing it, with sometimes fatal results
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Add Sticky NoteOpponents of reform often seem to skip right past any problems with the current system -- but it's rife with them.
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Add Sticky Noteprivate insurers are already doing what reform opponents say they want to save us from.
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The (very valid) core of the argument
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thanks to an intervention from her member of Congress
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they were able to attract the attention of a Chicago Tribune columnist before they had to figure out how to pay the six-figure bill -- once the newspaper started asking questions, the insurer suddenly decided, "based on additional information submitted," to cover the tab, after all.
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Public Stiky Notes
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