Andrew Cuomo, health care, Health Insurers, Healthcare Coverage, Medical Costs, PacifiCare, Rigged Health Insurance Rates, rocky delgadillo, Steve Poizner
Andrew Cuomo, health care, Health Insurers, Healthcare Coverage, Medical Costs, PacifiCare, Rigged Health Insurance Rates, rocky delgadillo, Steve Poizner

Heat Is On Health Insurers

Los Angeles Times   |  Lisa Girion   |   February 14, 2008 08:19 AM


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With medical costs rising, record numbers of people losing their coverage and healthcare at the top of the domestic agenda, health insurers found themselves Wednesday in the cross-hairs of regulators, elected officials and law enforcement in California and across the nation.

New York Atty. Gen. Andrew Cuomo said the nation's largest health insurers have rigged rates they pay for physician visits, leaving patients with higher medical bills.

In Los Angeles, City Atty. Rocky Delgadillo has assembled a team of investigators and prosecutors to probe industry practices such as canceling patients' coverage after they get sick. Today he is set to unveil a first-of-its-kind website to solicit information about insurance cancellations and delays and denials of treatment.

The announcements follow a yearlong string of fines and citations against insurers in California. Just last month, amid widening state probes, state Insurance Commissioner Steve Poizner decided to seek as much as $1.3 billion in penalties from Cypress-based PacifiCare as a result of widespread claim problems.

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With employer-provided health care, you cannot sue the insurer in state court if your benefits are wrongly denied. You cannot get punitive damages. Why? Because of ERISA. The Pension Reform Act of 1974 otherwise known as the Employee Income Security Act.

You folks got screwed back in 1974 and didn't even know it. That's what's wrong with politics today. Everyone is worried about "God" and not about health insurance for their children.

The reason for the immunity against bad faith lawsuits is that the employers need to have "collective bargaining" on behalf of their employees to ghet them coverage. The insurers rake off 30% of the top in order to "screen" for per-existing conditions. This is called "underwriting."

A single payer system is needed to give every American coverage as a right. If you want fancy doctors, just pay for it out of your pocket as you do for your cosmetic surgeries.

Cut insurers out of the deal and you save 30%. Physicians who accept the single payer plan would have qualified immunity from lawsuits - that's the very thing that they don't want because then they couldn't blame the attorneys.

In summary - if your insurer doesn't pay you cannot sue for punitive damages if the plan is employer-provided. This means that if you die of cancer because they would not approve a bone-marrow transplant because it is "experimental," you have no remedy. This is what John Edwards tried to tell you. You don't hear Hillary or Obama saying such things! Oh, no.

    Favorite    Flag as abusive Posted 12:06 PM on 02/15/2008

We can't use taxpayer money to benefit taxpayers- that would be big bad SOCIALISM! So you get cancer and you could lose your house. That is criminal with all the tax payer money squandered around the globe. Meanwhile the vast majority of Americans want us out of Iraq- and we are ignored. We've got to keep the military industrial industry in business forever and the health insurance business too. Just keep on scaring people with phrases "islamic fascism" and 'socialized medicine". I think people are wising up and that is why Hillary is tanking.

    Favorite    Flag as abusive Posted 06:22 PM on 02/14/2008

The French actually have one of the best healthcare systems in the world.

But say the word French and people cover their ears and yell: FREEDOM FRIES!

FREEDOM FRIES!

FREEDOM FRIES!



Maybe we could thin the herd by taking stupid people's health insurance away.

Sorry CONS, no more health insurance!

    Favorite    Flag as abusive Posted 05:32 PM on 02/14/2008
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You know the freedom fry episode was one of the most embarrassing moments of my life with respect to the Bush administration.

It was a time when men were acting like boys and the President led that parade. People were buying french wine and pouring them out on the streets.

It was at about the same time the FOOLS were reminded that the liberty tower had been given by the French. I guess that got them to settle down. We love lady liberty too much to give her away.

I couldn't be heard, but I screamed several times Mr Bush you have no cloths on and ought to be ashamed of yourself. Freedom fries my butt. It is a trade mark of Republicans.

    Favorite    Flag as abusive Posted 12:20 AM on 02/16/2008

We could save one trillion dollars a years to have a single payer system like Germany or Switzerland, and have a healthier population at the same time with a longer life span. Our medical system is now bankrupting every company in the entire country So why do we not do this? Because the big insurance companies and the doctors are now getting this one trillion extra dollars each year, why would they ever give this huge amount of money up? We are basically screwed forever.

    Favorite    Flag as abusive Posted 04:29 PM on 02/14/2008

Mostly true.

But the doctors are getting less of the pie all the time.

    Favorite    Flag as abusive Posted 05:23 PM on 02/14/2008

Thanks for reminding readers that doctors benefit from privatized healthcare. It's all about promoting scarcity, and maximizing profits. How else are we going to attract physicians to the profession? I mean, really. Helping others, learning, intangible rewards from contributing to the health and well-being of society. We've got to fight. The new motto of the medical profession.

    Favorite    Flag as abusive Posted 06:11 PM on 02/14/2008

The Republicans and conservatives always scream that regulations hamper progress, but in some situations, the opposite is true.

Health insurance companies and medical expenses are not regulated and this is one of the forces which is plunging this country into a situation where we cannot compete with the world and shall become a third world country with powerful, special interest groups which are the only ones to prosper.

At some time, and soon, the United States is going to have to make some very serious decisions, as to whether we rope in health care, by going to a single payer system, and taking away huge expenditures at inflated prices to some of the system, while strangling others, and whether permitting the insurance companies, the pharmaceutical companies, the deregulated energy companies, and the oil companies prosper, at the collapse of the country is how we are going to fall, or if we are going to make the tough decisions, and help this country provide care for its' people, and reign in the tremendous greed and corruption in this country.

    Favorite    Flag as abusive Posted 01:51 PM on 02/14/2008

If we still haven't learned from the subprime and the healthcare crisis that unregulated and free-for-all capitalistic market system is not only counter-productive but destructive to society, we deserved to be a third world country someday.

    Favorite    Flag as abusive Posted 01:00 PM on 02/14/2008
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Dear America,

decide if you want a single-payer system such as in Canada or other European nations. Or, keep the one you have. Stop being afraid.


You blame the corporations for failing to provide healthcare. Yet, you are unwilling to accept the alternative due to fear of socialism. The corporations have you.


The Soviet Union is dead. The healthcare and politicians are arrayed against you. Do something or shut up. Your choice.

    Favorite    Flag as abusive Posted 12:38 PM on 02/14/2008

I wonder why the Health Insurance Co. Lobbyists give Hillary Clinton more money than ALL other politicians (repubs or dems)?

Oh that's right she wants to force all Americans to poney up to the insurance companies whether they can afford to or not. The insurance companies must be tickled pink.

    Favorite    Flag as abusive Posted 11:39 AM on 02/14/2008

As a society, we would not tolerate watching a person get hit by a truck and then have some weasel come along while they are down and steal their wallet. But that is exactly what the insurance companies do. Why do we put up with it? Let put these bastards behind us. No profit medical coverage is the only civilized option we have.

    Favorite    Flag as abusive Posted 11:35 AM on 02/14/2008

The heat is on insurance companies? Tell that to someone who has lost coverage and has a sick loved one, the people are on fire all due to greed

    Favorite    Flag as abusive Posted 11:20 AM on 02/14/2008

My premium just went up to $1400 per month (2 young kids, my wife , myself). That was with a $4000 deductible, no dental and various copays. My wife worked in the insurance industry for 13 years, so she knows the ropes. We almost decided to go without insurance, but instead went with a $9800 deductible at over $600 per month.

That $1,000,000,000,000 and counting spent in Iraq
to capture ONE MAN really friggin' pisses me off.

    Favorite    Flag as abusive Posted 10:16 AM on 02/14/2008

Doesn't really matter if you have insurance because if you try to use it they will either deeny your claim or the co-pays will still bankrupt you. Why bother to pay for it?

    Favorite    Flag as abusive Posted 10:21 AM on 02/14/2008

We are in the same boat with a large deductible $6000, $700 a month in premiums, a dwindling savings account and no guarantee that anything will be covered. Try $220 out of pocket for one fifteen minute doctor's visit that included a listen with the stethoscope, a weigh in and a prescription. If we don't get this mess straightened out and regulated this country is screwed.

    Favorite    Flag as abusive Posted 02:41 PM on 02/14/2008
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Insurance companies are passe, anyway. The minute the government began to legislate that insurance is mandatory in so many facets of our lives, the government became a part of the insurance industry.

We should just do away with the insurance companies - cut out the parasitical "middle man", as it were - and go to a national insurance pool for any form of mandatory insurance to include health care insurance.

This time, however, we should avoid the mistake we made with Social Security and ensure that the funds so obtained are firewalled off from Congressional access.

"Surpluses" are temporary, not a "petty cash" drawer to fund the purchase of candy by Congress.

    Favorite    Flag as abusive Posted 09:55 AM on 02/14/2008

Pretty good post. But I'd add that what we need is a Democratic candidate who would be willing to actually fight for real "single payor" universal health care analogous to every other Western nation. Short of a single payor system that eliminates limited pools to determine rates and a health care system that is driven by arcane medicine oriented on saving every life regardless of cost, or resources necessary to achieve that end, we will remain with a screwed up incredibly expensive industry.

    Favorite    Flag as abusive Posted 11:52 AM on 02/14/2008

Why are those who benefit the most from our capitalist economic society doing the most to destroy our democratic society.Picture them gleefully burning the house down and restraining the fireman from putting the fire out. They have gone greedily MAD. This is not intelligent greed, this is STUPID GREED!

    Favorite    Flag as abusive Posted 09:41 AM on 02/14/2008

The U.S. must nationalize health care and drive these ass holes out of business. Problem is, the same ass holes own the federal government. So pin prick attacks from state and local government is the best we can do for now, barring pitchforks and torches of course.

    Favorite    Flag as abusive Posted 09:20 AM on 02/14/2008

Being an insurance company is the next best thing to being an oil company. Take the premiums and then when you file a claim cancel the policy. The best run healthcare in the country is Medicare. Get rid of the insurance companies. If we stopped spending money on wars maybe we could spend some of it on the citizens of this country. If you ever checked yourself out of a hospital because you couldn't pay the bill you'd understand why this is so outrageous.

    Favorite    Flag as abusive Posted 09:02 AM on 02/14/2008

It's really not even a matter of war spending. If we just spent a part of what we now give insurance companies on asingle payer system we could save billions by simply cutting out the profit. Where in the world did we get the idea that desease and suffering are something to profit off of? Unbelievable!

    Favorite    Flag as abusive Posted 10:14 AM on 02/14/2008

European,Canadian health care is just around the corner

    Favorite    Flag as abusive Posted 12:54 PM on 02/14/2008
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The religion of capitalism is where we got it.

    Favorite    Flag as abusive Posted 04:58 PM on 02/14/2008

The war in Iraq is an example of "externalizing costs" for oil companies who want to secure control of the "access" to oil. Our government uses military force to secure that control. While you don't pay at the pump for the war, your taxes go to prop up the system.

    Favorite    Flag as abusive Posted 12:09 PM on 02/15/2008

I really wish there was some legal way to hang these clowns...

Where the heck is the ACLU when you need them?

    Favorite    Flag as abusive Posted 12:12 AM on 02/15/2008

An insurance company is simply a Ponzi scheme with a computer.

    Favorite    Flag as abusive Posted 12:07 PM on 02/15/2008
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