"...They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators."
(By Murray Waas updated 10:14 a.m. CT, Thurs., April 22, 2010, msnbc.com) See full story link below.
I have said it before and I will say it again - This is just one example of things insurance companies have done over the decades to avoid taking care of the beneficiaries and line their stockholder's pockets. I have worked at an insurance company and have seen the lengths they will go to prevent paying a claim for covered services! All those who have opposed the healthcare reform - I hope you never get sick without insurance. It is a painful way to die. We have seen that hospitals and other practitioners want to avoid taking care of patients when they have no insurance or even the "wrong" insurance so why be surprised about Wellpoint? The insurance companies have a list of people they will not insure, under any circumstances. Are you on that list? If you have employer based insurance and you are on the list, you may be OK (unless you work for a small business). If you are unemployed and want to buy insurance - they won't sell it to you - at any cost. I have a great education, lots of student loans, but no job, and no insurance. And I pray everyday I don't get sick.
Until we start with ACCOUNTABILITY for making a bonehead (though profitable) decision and PUT THEM IN JAIL - this kind of CORPORATE issue will happen. Make this a company mandate - cost one their life - be criminally charged and suffer the necessary FATE!
JAIL.
JAIL.
JAIL.
No insurance + CANCER = LITTLE to NO Treatment = DEATH
Sounds like fraud (nah - MURDER) to me. Many knew what their decisions would mean - so, lets make them explain - to a jury.
Did I mention - JAIL.
:angel:
Tell it to a jury, sure. But a judge might very well explain the law to the jurors in a way that makes them think they must acquit. Possibly.
I vote for burning in hellfire for all eternity. People who put money before people are truly evil. Unfortunately, they are everywhere.
Perhaps there's a little thief in everybody. We all fall short of perfection. Some of us are just worse than others by degree. :mad: I wish severe suffering, both here and in the hereafter, on those who cruelly throw others away for the buck.
Perfect example of why we need guarenteed healthcare not insurance. Profit has become more important than human suffering or human lives. Horribly cynical isn't it?
The basic business model of health insurers is to exclude the sick from coverage. It's central to what they are. As long as you have a system in which for-profit insurers compete with each other, finding ways not to cover the sick is going to be part of their business plan. The new health insurance law is supposed to ban that practice, but my money is on the insurers to find some way around that law. And in a model where collecting premiums is the source of revenue and providing care is considered a "loss" - that's the term they use - we will have new and better strategies to avoid providing care.
And who can blame them for doing what they are set up to do - make profit at the expense of their policy holders? It's like blaming a lion for killing deer. We wouldn't be dumb enought to let a lion loose on the school playground, but we let these insurers control our access to care.
Exactly -- for-profit corporations in this country (regardless of what business they're in) have a fiduciary responsibility, BY LAW, to make the highest profits they (legally) can for their shareholders. If they don't (if they operate in ways that don't maximize their profits), they can be sued by the shareholders. The way health insurance companies do this is by taking in all the premiums they can, and paying out as little as possible for actual healthcare for their policy holders. Why are we surprised that this is what we get, when this is the model we've had in place for decades?
Unfortunately, I agree that I'm confident the insurance companies will find a way around the new restrictions and regulations put into the healthcare "reform" bill, which was mostly a give-away to the insurance companies instead of real, meaningful reform.
And I hope that some of the many people who were so upset and opposed to even the mild "reforms" that were proposed and eventually passed will see the reporting on this and rethink their position.
Exactly -- for-profit corporations in this country (regardless of what business they're in) have a fiduciary responsibility, BY LAW, to make the highest profits they (legally) can for their shareholders. If they don't (if they operate in ways that don't maximize their profits), they can be sued by the shareholders. The way health insurance companies do this is by taking in all the premiums they can, and paying out as little as possible for actual healthcare for their policy holders. Why are we surprised that this is what we get, when this is the model we've had in place for decades?
Unfortunately, I agree that I'm confident the insurance companies will find a way around the new restrictions and regulations put into the healthcare "reform" bill, which was mostly a give-away to the insurance companies instead of real, meaningful reform.
And I hope that some of the many people who were so upset and opposed to even the mild "reforms" that were proposed and eventually passed will see the reporting on this and rethink their position.
yup, this is what happened when it (insurance) went "for profit" the idea behind "group risk" (i am sure there is a better term) was to spread the cost out over a large group, some of which would never need any coverage, most of which would need little thereby having enough to cover the few who would need a lot.....with minimal left over for administrative costs.....but as elk has pointed out, when it becomes "for profit" the need to make money becomes prime......
this reason alone, is enough reason for obama care.
"Obama care" doesn't go nearly far enough. It not only preserves the present, private-for-profit insurance system -- it hand over millions of new customers to the for-profit insurance companies and gives them billions of taxpayer dollars for them to pocket as profit.
I have said it before and I will say it again - This is just one example of things insurance companies have done over the decades to avoid taking care of the beneficiaries and line their stockholder's pockets. I have worked at an insurance company and have seen the lengths they will go to prevent paying a claim for 
People who put money before people are truly evil. 
Unfortunately, they are everywhere. 
:mad: I wish severe suffering, both here and in the hereafter, on those who cruelly throw others away for the buck.
Not_A_Hat_Person, RN
2,900 Posts
Yet another argument for national health care. Medicare and the VA don't automatically drop breast-cancer patients.