I am certain, as I'm sure most of you are, that the corruption within the health insurance industry is as widespread and flagrant as what was discovered at criminal companies like Enron and Arthur Anderson.
As we know, the denial of bona fide claims is routine. The situation is do dire and so grim that essentially you file a healthcare claim fully expecting that it will be denied. Then you decide will you fight them or cave in. Many Americans simply cave in, hence the illegal denial of claims has become the business model for the insurance industry.
Everyone asks what will the Democrats do when they control the House and can madate testimony under oath--what we must demand is a thorough and wide-ranging investigation into the criminal business practices of this predatory industry.
For example, as everyone knows and I have written about extensively,
Blue Cross of California has a retroactive review department. The criminal company routinely denies the legitimate claims of its enrollees who get sick and require expensive medical care.
Wellpoint/Blue Cross is being sued by California hospitals for what appears to be a general systematic cancellation of high-cost member policies. It's very important to point out that Wellpoint/Blue Cross doesn't seem to be investigating the applications of those members who don't make expensive claims.
But in order to short circuit regulators and a more intense probe of its criminal activities Wellpoint Blue Cross is settling with some of its enrollees.
You should be shocked and outraged to read what is being reported in the Los Angeles Times this morning.
Facing the threat of punishment from regulators, Blue Cross of California has agreed to settle more than 70 lawsuits and claims filed by patients who accused the state's largest health insurer of illegally canceling their coverage after they got sick.
The settlements will allow the former policyholders to pay hefty medical bills that they were stuck with after losing their insurance.
. . .In exchange for the money, the patients agreed to drop allegations that Blue Cross had terminated their coverage to avoid paying for treatment.
The accords could be part of an effort by Blue Cross to deflect public criticism, mollify regulators and avoid courtroom showdowns, although critics say the insurer still needs to reform its practices.
. . .Blue Cross, owned by Indianapolis-based WellPoint Inc., the nation's largest provider of health benefits, maintained that it was following the law. It declined to comment on the suits, saying talks to settle them were confidential.
http://www.latimes.com/...
Just imagine the amount of money Wellpoint Blue Cross laid on these people for the lawyer representing them to say what he did. Must be a shitload. Blue Cross wants the regulators to disappear.
William Shernoff, a Claremont lawyer representing many of the plaintiffs, said his clients wouldn't have to worry about medical bills ever again.
"Every one of our clients is pleased," he said. "But that's only half the story. The other half of the story is making sure it doesn't happen again and getting the right procedures in place."
. . .It remains unclear whether the proposed settlements would lead to substantial changes in Blue Cross' business practices or state regulations. Some see the accords as a sign that the state's largest health insurer intends to reform its practices. Others view the settlements as a way for the company to sweep the matter under the rug and move on.
There is widespread criminal activity within the for-profit health insurance industry, this is why the American people are entitled to see the top executives under oath in front of a Congressional committee. State regulators have failed.
We are in a healthcare emergency meltdown in the United States. The American people deserve a full airing of all the criminal and corrupt business practices of this out-of-control industry as a first step on the road toward universal, single-payer healthcare.
One more thing, if this is not enough outrage for a Wednesday morning read this about Dr. William McGuire and the company he runs UnitedHealth.
William McGuire ran UnitedHealth Group Inc. like his personal fiefdom, allowing the former CEO and his cronies to gain tremendous wealth with few internal controls to stop them.
. . .Faced with an independent report that found widespread problems with the way UnitedHealth Group Inc. issued stock options, the nation's second-largest health insurer said its chairman and CEO will leave the company.
The company said Sunday that chairman and CEO William McGuire will leave the board immediately and leave the company no later than Dec. 1.
http://www.nytimes.com/...
McGuire was forced out not simply because he is a crook but in order for the criminal company to maintain some semblance of respectability before the Wall Street analysts who can harshly punish a company like Unitedhealth when becomes too overtly corrupt.
To deflect legal problems, however, UnitedHealth is requiring McGuire and other execs to reprice the options at annual share high prices for the years involved.
[Removing crooks like McGuire] shows that UnitedHealth's board is trying to appease prosecutors while avoiding scaring Wall Street by signaling a change in the company's successful business model, said Peter Henning, a former lawyer in the enforcement division of the SEC who is now a law professor at Wayne State University in Michigan.
''They have to make sure that it looks to the regulators that they have done a thorough job and gotten all the miscreants out, but they have to maintain their credibility with Wall Street,'' he said.
So what precisely is the UnitedHealth successful business model? To systematically and illegally deny you and me health care after pocketing our exorbitant premiums.
When will the American people realize that these insurance companies are stealing their money then denying them care?
And when will Congress shine a light on these criminals?