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March 12, 2010, Volume 17 Nr. 6, Issue 257
    
In a word...(or a phrase....or five paragraphs) #3

Peter Schoffstall

Beware. (Short for be wary.) (You should be forewarned of the following. A person who I am closest to knowing, having known all my life, tells a brief anecdote about the multi-purpose, mostly supplemental, medical insurance company which played havoc with his dying wife. At 72, dying of colon cancer, she was denied verge of death hospital health care purchased through United Health in her AARP policy. United Health said she had not paid her immediate past monthly premium. My friend had written them. Next he received a letter with a $141 check enclosed and asked to sign a waiver against the situation since they had discovered that she had made her final and previous payment for the month she died in. A newish AARP ploy for United Health is “SecureHorizons.” /p The letters and the checks and the plea have continued to my friend, but he has not cashed any other of the checks and is contemplating his legal avenues. His wife died in 2008.

The Daily Kos, a blog on the Internet, says of this: “...let me dwell on the track record of an individual insurance company, specifically United Health Plans. United Health Group is America’s largest health insurance company.  According to their 2008 annual report United  has  75,000 employees, insure 29.1 million Americans directly and cover up to 78 million people, contract with 650,000 doctors and 5200 hospitals. Their insurance programs include:  a government subsidized Medicare Advantage program called Secure Horizons, a Medicare Part D prescription program called Prescription Solutions, and they have an exclusive arrangement with AARP to offer a Medicare supplement. The company has a  subsidiary, Ingenix   (remember this name) which provides "actuarial data, claims management services, and health intelligence in 56 countries and in the USA to 6000 hospitals, 240,000 Md's, 1500 health plans, and 250 government agencies.”
  
“In 2008 United Health had total revenues of approximately $81.2 billion ($75.9 billion from health insurance and $1.6 billion from Ingenix) and their 2008 net revenue was $5.2 billion from health insurance.  (This profit was in essence moneys diverted from health insurance premiums paid by government, individuals and employees to obtain medical care even after the company’s huge administrative costs are deducted.) They had an additional $229 million profit from Ingenix. According to SEC filings during our current economic and health care crisis their (my heavy leading) 2009 first quarter total revenue went up 8% to $22 billion and their net profit was $984 million. According to the company’s own report they have a medical loss ratio of about 80 per cent - that is, of collected premiums  they spend only about 80 %  on actual medical care, that is we lose 20 per cent of the  money we pay  them to their overhead and profit.”

“Some recent corporate history with you will demonstrate how far their corporate culture is from taking care of the sick and disabled. In 2006 The Wall Street Journal reported that company executives were back dating their stock options. Because of the ensuing scandal in October 15, 2006 company President and CEO William McGuire, who usually made between $60 and $120 million a year was forced to resign but he took with him the largest golden parachute ever paid, a compensation package estimated to be $1.1 billion. He was subsequently forced to pay back to the SEC $468 million in refunds and $7 million in penalties. In 2008 the net realized profit of the United Health Care Group fell 36 per cent from 2007 – from $4.65 billion in 2007 to $2.98 billion in 2008 due to legal costs.  In 2008, an investigation by New York State Attorney General Andrew M. Cuomo found that Ingenix and its parent United Health Group  defrauded consumers and providers by manipulating its database used to quantify reasonable and customary medical care provider rates to make them remarkably lower than the actual cost of typical medical expense.  This provided health insurance companies over the past 15 years the means to inappropriately lower payment of provider claims, thereby increasing the insurance companies’ profits and often leaving patients to pay the difference. The company paid a $50 million fine and set another $50 million aside to revamp its data system as an external organization under non-profit public supervision. In 2008 United Health paid another $895 million in legal and settlement costs in two other class action law suits, the major one brought by CALPERS retirement fund over the stock option deception. In addition, on January 15, 2009, United Health Group announced a $350 million settlement of three class action lawsuits filed in Federal court by the American Medical Association and others for not paying claims for out of network medical services to their patients. Anyone can easily see that the management of this company has no sense of public fiduciary responsibility and has focused major resources on making profit and manipulating the financing of health care. It is a real stretch to imagine that the same board of directors and top officials, so caught up in these huge illegal money grabs would really be interested in paying attention to my patients’, and your family’s, and our neighbors’ sickness and pain or in any remediation of our health care system’s problems.1

1 The Daily Kos, Sun Jun 07, 2009 at 08:08:22 AM PST. The Daily Kos is a daily internet commentary, carefully researched and presented, which elsewhere has documented the purpose and performance of United Health Care' the largest health care business in the United States. The Kos is famous for its documentation of tracking United.

2010 Peter Shepherd

The writer is a retired English teacher whose compulsion to write every day leads him to comment on a variety of things.

The author requests comments on this article.  Click HERE to send.

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