By their words shall ye know them
Thursday June 18th 2009, 10:37 pm
Filed under: Politics

I’ve been debating writing this all day.  It would be far more fun to talk about how cool Karin’s yarn is starting to look in my new project. And I do try not to go on and on on such things.

But I think this is compelling, and I think it’s terribly important. I read this article today, thanks to Lene: about the executives at the nation’s major health insurers admitting Tuesday before incredulous members of Congress of both parties that yes, it is true: there is a list of about 1,000 expensive medical conditions which, if you have, and if you have private coverage (ie, you’re not protected by the laws governing HMOs about pre-existing conditions) they will scour your medical records as far back as 20 years looking for a reason to drop you. Something, anything, you didn’t disclose on your application.  And they will find one.  Some have whole departments set up for this and give bonuses and positive performance reviews to their employees who drop expensive patients.

One person’s doctor had once noted that he had gallstones but didn’t mention it to his patient. When the guy later found out he had cancer, his insurer canceled him for fraud for not disclosing what he didn’t know.

This was not an isolated case; this is simply how they conduct their business and they freely said so. They told the congressmen that it had saved them $300 million over five years.

I recommend that these lovely individuals put a Bob Marley cd on and go read Charles Dickens: “Business? Business! MANKIND was my business!”

Note that in California the insurance commissioner proposed fining one of the Blue Cross companies $12.6 million. And then did not do so.

There is a case underway, finally, in which the insurance company did not notify a couple they were considering them for rescission during the period during which the wife could have switched their insurance to her employer’s; then, after her husband was in a car accident, which, as I read the article, the company apparently knew about, they continued to collect premiums from them.

Until the husband submitted medical bills that were more than that monthly payment.  And then they dropped the couple and refused to pay a dime.

All three executives said they would continue their policy of rescission regardless of whether the insured had knowingly lied in filling out the application or not. They said it keeps their costs down.

You got a problem with that?

26 Comments so far
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Wow. Speechless. Though we know it was so, hearing it admitted and so offhandedly justified is just shocking. Will. Anything. Be. Done? This cannot be ignored!

Comment by Cathy (catsandyarn on ravelry) 06.18.09 @ 11:00 pm

That is right, business as usual. Who are we to interfere with they’re profits. Immoral? So, who will make them be otherwise? But believe me Medicaid is not better.

Comment by Henya 06.19.09 @ 12:01 am

I have a potentially expensive “rare” condition but so far my insurance is covering me (through Hubby’s work).However I am watching my bills very carefully as I am not sure for how long. The I some of the blog she referenced yesterday and was incenssed, can you believe what the Canadian medical system is putting her though? And thats the type of system our Government wants to go to?

Comment by Danielle from SW MO 06.19.09 @ 4:27 am

Oh, this is a avery sensitive issue with me though I do not have a chronic medical condition. I have become aware that my doctor often tells me that we do not have to perform that routine test this year because it was okay last year. That is how I ended up with severe anemia and had bleeding ulcers that took took four months to figure out and then ended up needing an endocopy and colonoscopy which cost a lot more than an initial test….and it goes on and on and on.

Car insurance companies do the same. I interviewed for a job with a company about 10 years ago and was told a condition of my employment would be to agree to cut back on payments to injury folks as much as possible. Did I have a problem with that?

Then there was the job interview with an attorney that told me I had the job only if I felt comfortable lieing on their behalf.

I didn’t accept either position though they pay considerable more than what I currently earn.

Hopefully, President Obama will put a stop to some of these ridiculous insurance practices.

Comment by Joansie 06.19.09 @ 4:48 am

I am speechless! Not surprised, just speechless! I don’t wish ill on anyone but I wonder what these decision makers would say if the shoe was on the other foot.

Comment by Jody M 06.19.09 @ 5:18 am

Unethical is the only word fit to print that comes to mind. How do those folks sleep at night?!

Comment by Channon 06.19.09 @ 5:48 am

Do not get me started on insurance!! I could go on for days. I would love for one of those executives to sit down with my seven year old son and his rare heart defect and then tell me to my face that they won’t cover him.

Comment by Momo Fali 06.19.09 @ 5:49 am

Why, yes, I DO have a problem with that!

The way I understood it, Obama initially wanted everyone who wanted/needed health coverage be given the opportunity to have what the Congress and Senate have, I don’t see any of those folks complaining about their coverage,eh? So.. what happened to that plan?
Hopefully these hearings will get us closer to that plan.
btw? As far as I know, they’ve never looked at the health coverage system/program in Canada as an option/model.
It’s going to take a huge attitude adjustment in our country regarding everything and everyone in the healthcare system, and the banking system, and our consumerism and and and.
They’re supposed to be in those fields to help, to be of service, and not to be withholding and acting like gods, and raking in the money.
I should stop now.
I’ve also really been loving all the posts about the falcons :^)

Comment by marianne 06.19.09 @ 6:20 am

Do I have a problem with that? Aaaaaccrrkkkk.
Pardon me while I choke to death! These are not insurance companies — they are money making mills!
Don’t get me started!

I need to calm down. Take a deep breath. Again.
Once more. Okay, now I can give you a joke:


A young couple at the beach noticed a lady with a bag over her shoulder going from group to group on the sand. They noticed that the lady would stop and talk to the people, and occasionally reach into her bag, give something to the people, and receive money in return. The couple wondered if she was selling drugs. Then they noticed that the lady only stopped where the group had a boom box, and since the young couple did not have such, the lady did not visit them. After a bit the young man said to his wife, “I’m going to find out what she is doing,” and he moved farther down the beach. A while later he came back, grinning. “I know what she is doing — She’s selling batteries for the boom boxes. She sells C cells by the seashore.”

Comment by Don Meyer 06.19.09 @ 6:27 am

It’s not just insurance compnaies (although it’s bad with them becasue we are talking about people’s health). It’s all big businesses. Nortel here in Canada is under the gun for denying all severance pay to 1,000’s of laid off workers, while giving out 45 million in bonuses to top executives. Reason? In order to keep them on board so they’ll do a good job. Whatever happened to doing a good job because that’s WHAT’S EXPECTED OF YOU?

Comment by Sandra 06.19.09 @ 6:30 am

YES! I have a big problem with it, and it is the reason why the health insurance that I pay for is basically crap.

About 4 years ago I applied for an insurance policy. Whatever was in the doctor’s records based on one blood test and that I was never told about made them deny me coverage.

Once one insurance company does that, you simply can not get any decent coverage because every application asks if you’ve ever been denied — catch 22 there — if you say yes, they turn you down, if you say no and they find out, they turn you down

and I might add that the shillyshallying going on in Washington D.C. about not having a public option is making me pretty hot!

Comment by Bev 06.19.09 @ 7:17 am

That is simply appalling! There are people in this world that I just don’t know how they sleep at night.

Comment by TripletMom 06.19.09 @ 7:39 am

So, the next question is “What do we do about this?” I’m thinking of opting out of the health insurance ripoff entirely and buying whatever I need myself. Which does mean that if I have a heart attack or stroke, I will not call an ambulance or my husband or son, but will just die quietly there. That’s what people used to do. I’m that mad. Can we start a knitters’ (needleworkers’ ?) health insurance company? Guess it needs to be auto and home, too. I think competition is part of the answer, but when everything is covered from octomom (don’t know if she was but I do know fertility treatments are often covered) to facelifts and tummy tucks, we have problems. Such a tangled skein.

Comment by Judy 06.19.09 @ 8:00 am

Amen to the outrage! What galls me is the pitiful coverage offered to small businesses. My friend has been battling breast cancer for 10 years, which is bad enough but the continuous battles with the insurance company are worse than the medical issues. The worst part is, she knew she had a problem 10 years ago, asked for a mammogram and was refused by her primary care physician because she was “too young” (only 42 at the time)and the insurance wouldn’t cover a baseline mammogram until she was 45. She was treated for asthma and allergies for a couple of years while she argued with the insurance company and finally went out of the system and had the mammogram out of network (i.e. paid for out of her own pocket). Surprise, surprise, by then it was stage 4 metastatic breast cancer and the insurance company tried to drop coverage. I’ve forgotten most of the details now, but lawyers were involved, so she still has coverage, but since her husband works for a family owned business, the coverage everyone in the business gets now is more expensive and less extensive. It makes me so angry thinking about it, that I have tears typing this. Every day this woman continues to live is a gift and not one from the insurance company believe me! Her life is an act of God, although not exactly the kind the insurance companies mean in their policy descriptions! Sorry, I didn’t mean to rant so much, but this one hit close to home. I think it’s time to go knit something to calm down!

Comment by shadylady1216 06.19.09 @ 8:33 am

I think the purpose of human beings is Tikkun Olam, the repairing of the world. Clearly these insurance companies do not follow that purpose. Yes I understand the bottom line, but what they have done is simply immoral.

Comment by ruth 06.19.09 @ 8:41 am

I am not surprised in the slightest. I AM surprised they openly admitted it. However, I would like to note that in Canada, we have universal health care. However, medicine is not included in that. Neither is dental. So, you can go to the doctor for free (govt pays) or go to the hospital (although unless you have private coverage you are unlikely to get a private room) for free, but your medication is NOT covered under the universal health care. Many Americans don’t know that. They assume drugs are part of hte coverage. They are not.

Comment by Carol 06.19.09 @ 9:49 am

Oy. I’m glad I’m about to move to Canada! I really hope, as Ruth mentioned, that the folks in Congress believe in Tikkun Olam (fixing the world.) It’s our job. I’m not sure what the insurance guys thought was their job, but it’s not saving lives!

–one other aside. One of your commenters equated fertility treatments with tummy tucks and face lifts. (I think only people who haven’t had any fertility-related health problems must think this.) Yes, there will be people who abuse every system, but it shouldn’t cut out the rest of us from having kids.

Comment by Joanne 06.19.09 @ 1:10 pm

The second article you cited about the couple sueing after their insurance was cancelled was resolved but not in the way you’d like to know. Follow up article:,0,7742489.story

I’m getting fed up with the status quo, even though I have great insurance through my job, but we all know how scary that is these days, right? Especially for a single 51 year old on medication for high blood pressure and high cholesterol (both well controlled by the meds).

I’ve done a little looking about the fabulous health care benefits that members of congress get. Basically they are Federal employees who have a menu of available plans to choose from, with probably 80% of the costs covered by the gov’t and the rest of the premium up to the individual. The list includes a mix of PPOs, HMOs, etc. So you’re still dependent on the insurance company. BUT the big benefit of insurance through a large company is that they can’t cancel you and in many companies (mine included) their contracts with the insurance plans on offer stipulate that they must cover pre-existing conditions.

I really had to laugh at one of last year’s Presidential debates when McCain said he opposed government-run health care because people’s medical decisions shoudn’t be made between them and the gov’t but should be made between them and their doctor. Hello, decisions aren’t made between them and their doctor; they’re made between them and their insurance company!

Comment by Debby 06.19.09 @ 2:44 pm

Outraged but not surprised.

Comment by Eileen 06.19.09 @ 3:58 pm

This absolutely frosts me. I know it happens, but it still shocks me every time. This does seem like a very good reason why things like health care should perhaps (imagine) not operate with profit as the bottom line, but under some other kind of system. Capitalism just doesn’t work for everything. (Again, imagine.)

Comment by Jocelyn 06.19.09 @ 6:47 pm

Of course they are only admitting the tip of the iceberg, but it is surprising that they’ve been honest to even that degree.

There are so many awful incidents and stories within my family about the active harm caused by insurance companies or lack of coverage at all. It’s appalling and I won’t go into it all because it’s just too much. I recently joined a task force through my church to look into ways of helping with health care reform, seeking ways that all people can be covered, no matter what their economic status is, whatever their ethnic backgrounds or age or pre-existing conditions. I don’t know if this one little step on my part will do any actual good at all, but at least it feels like an active step for me in reaching out for a good, positive solution rather than just continuing to ‘take it’.

One of the things we’ve been doing is educating ourselves about health care in other countries. And it’s fascinating; at best, the US insurance system treats people as ‘customers’ rather than ‘patients’; if you can’t pay, out you go. At worst it’s really evil. France is especially interesting because the people actively demand good care and expect it and get it, evenly, fairly. The doctors get to decide the treatments needed in reasonable countries like France and Britain and Denmark; there is nobody second-guessing them and saying, ‘no, you can’t get that expensive treatment, go away and die’.

It’s a disaster, it’s criminal, what these insurance companies do, and people die because of their greed and lack of caring for their fellow man. They need to learn basic human decency, and that we are all in the same boat; if we can’t care for each other as our brothers and sisters we are all lost. I don’t know if that’s even possible, but by god I wish those insurance companies would be taken out of power.

Aw well, I didn’t mean to get going so much on it all. You’ve touched on a raw nerve with this one.

Comment by Beckett 06.19.09 @ 11:21 pm

I once worked for a good ol’ boy who’d been born and raised in the south eastern US. He had a saying about insurance (always pronounced in a laconic drawl):

“Insurance. When you buy it, it covers everthang. When you try to use it, it don’t cover nothin’.”

Which I think about covers it.

Comment by wunx~ 06.20.09 @ 12:53 am

I am speechless, have been for quite awhile about insurance policies. That said, we have Kaiser for health and Allstate for homeowners and car. Both have always been great to deal with. But I have definitely seen the other side with friends.

Comment by Linda W 06.20.09 @ 7:06 am

Kaiser is an HMO, and therefore is subject to laws about accepting pre-existing conditions (as the private insurers should be.) Kaiser’s newsletter actually has a link to the LA Times article, I imagine because it sure makes them look good by comparison.

Comment by AlisonH 06.20.09 @ 11:08 am

This is why I have come to believe that ‘insurance’ is simply the wrong model for healthcare. As one of the op-ed pieces in the NYT put it recently, there’s a lot of crying about how a public healthcare plan would ‘ration’ healthcare- but we *already* ration healthcare- we provide it for healthy employed upper and middle-class people and not for sick or poor ones. What’s more, we spend more money for worse care than practically anyone. The choice isn’t between rationing and not rationing. It’s between rationing sensibly or rationing stupidly.

Comment by RobinH 06.22.09 @ 11:40 am

I can’t stand this. I don’t understand how someone could do such immoral work… I realize salary’s talk, but really? WOW.

Comment by Alicia 06.23.09 @ 1:54 pm

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