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.
©
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.
Return
to Homepage
|