Tag Archives: Health Insurance

Mass Unemployment and COVID-19: What It Means for Health Insurance

Steffie Woolhandler, M.D. and David Himmelstein, M.D. wrote yesterday in the Annals of Internal Medicine that many of those who lose, or already lost their jobs due to the coronavirus pandemic have a lack of health insurance. Many did not have insurance before the outbreak, and now that they are unemployed, their employer-based insurance will end as well.

Here is the article in full:

Annals of Internal Medicine

April 7, 2020

Intersecting U.S. Epidemics: COVID-19 and Lack of Health Insurance

By Steffie Woolhandler, MD, MPH; David U. Himmelstein, MD

During the final week of March 2020, the U.S. Department of Labor reported that a record number of workers—6.648 million—filed new claims for unemployment benefits. That beat the previous record of 3.307 million filings, which was set the week before, bringing the 2-week total to 9.955 million. This is just the beginning of the surge in joblessness due to the coronavirus disease 2019 (COVID-19) pandemic. A Federal Reserve Bank economist estimated that the ranks of unemployed persons will swell by 47.05 million by the end of June.

For many, job loss will carry the added sting of losing health insurance. Congress has moved to cover severe acute respiratory syndrome coronavirus 2 testing for uninsured persons, but did not include provisions to cover treatment of COVID-19 (or other illnesses). The recent $2 trillion bailout bill offered no new health insurance subsidies or coverage.

Estimating Coverage Losses

We estimated the likely effects of current job losses on the number of uninsured persons by using data from the U.S. Census Bureau’s March 2019 Current Population Survey on health insurance coverage rates among persons who lost or left a job. The uninsurance rate among unemployed persons who had lost or left a job was 26.3% versus 10.7% among those with jobs. Applying the 15.6–percentage point difference to the 9.955 million who filed new unemployment claims last week, we estimate that 1.553 million newly unemployed persons will lose health coverage. This figure excludes family members who will become uninsured because a breadwinner lost coverage and self-employed persons who may lose coverage because their businesses were shuttered, but are ineligible for unemployment benefits. If, as the Federal Reserve economist projects, an additional 47.05 million people become unemployed, 7.3 million workers (along with several million family members) are likely to join the ranks of the U.S. uninsured population.

Coverage losses are likely to be steepest in states that have turned down the Patient Protection and Affordable Care Act’s Medicaid expansion. In expansion states, the share of persons who have lost or left a job who lacked coverage was 22.1% versus 8.3% for employed persons—a difference of 13.8 percentage points. In nonexpansion states, the uninsurance rate among such unemployed persons was 38.4% versus 15.8% for employed persons—a difference of 22.6 percentage points. In other words, nearly 1 in 4 newly unemployed workers in nonexpansion states are likely to lose coverage, bringing their overall uninsurance rate to nearly 40%.

Our projections are based on differences in coverage rates for employed and unemployed persons in 2019, but there is little reason to believe that the predicament of unemployed workers has improved since then. Although many who lose their jobs are likely to be eligible for Medicaid or subsidized Affordable Care Act coverage, and some will purchase continuing coverage under COBRA (Consolidated Omnibus Budget Reconciliation Act), the same was true in 2019. Indeed, the situation may be worse today because some laid-off workers probably gained coverage through an employed spouse in 2019, an option less likely to be available in the face of the impending massive layoffs.

Urgent Policy Needs and Longer-Term Solutions

With jobs and health insurance coverage disappearing as the COVID-19 pandemic rages, states that have declined to expand Medicaid should urgently reconsider. Yet, the high uninsurance rate among unemployed persons in Medicaid expansion states underlines the need for action in Washington. Tax revenues are plunging, and all states except Vermont are required to balance their budgets annually. Hence, only the federal government has the wherewithal to address the impending crisis.

Thus far, neither Congress nor the administration has offered plans to expand coverage. Some have suggested that the federal government cover COVID-19–related care for uninsured persons through Medicaid, but some states would probably decline such a Medicaid expansion, leaving many newly jobless persons—and the 28 million who were uninsured before the pandemic—without coverage. Instead, we advocate for passage of an emergency measure authorizing Medicare coverage for all persons eligible for unemployment benefits.

Although the COVID-19 crisis demands urgent action, it also exposes the imprudence of tying health insurance to employment, and the need for more thoroughgoing reform. A trickle of families facing the dual disaster of job loss and health insurance loss can remain under Washington’s radar. However, the current tsunami of job and coverage losses along with a heightened risk for severe illness demands action. A decade ago, Victor Fuchs forecasted that “National health insurance will probably come to the United States after a major change in the political climate—the kind of change that often accompanies a war, a depression, or large-scale civil unrest.” Such a major change may be upon us.

https://annals.org/aim/fullarticle/2764415/intersecting-u-s-epidemics-covid-19-lack-health-insurance

COVID-19 and America’s Social Safety Net

Friday’s HuffPost published an article by Emily Peck on the Coronavirus (COVID-19) and its impact on the country’s broken social safety net.

The article indicates that millions of working Americans do not get paid sick days. It also states that a stunning 70% of low-wage workers and one of three workers in the private sector, have no access to paid sick time.

According to Ms. Peck, the US is one of the few countries in the world without a national paid sick leave policy. In addition, she adds, millions of Americans do not have health insurance, or their policies are designed to keep them away from doctors with high co-payments and deductibles.

Both these issues, Ms. Peck writes, highlights how coronavirus, or COVID-19, could test the US’ uniquely weak social safety net.

Kristin Rowe-Finkbeiner, the executive director of MomsRising, a nonprofit advocating for paid leave is quoted in the article, “Right now we’re looking at a situation where we have a lack of policies that most other countries take for granted that protect their public health.”

This isn’t just a “coronavirus” problem, Ms. Peck says. Even though the CDC warned Americans earlier in the week, so far there have been very few case reported in the US. (Note: As of this writing,  there have been 74 reported cases in the US, and two men have died in Washington State, and one case was recently reported in Rhode Island, and one in Manhattan)

Yet, fears of an outbreak has put a spotlight on the public health system. With cuts to many agencies by Trump, many experts fear that we will be unable to deal with the crisis, especially since the Trump called it a hoax at a recent political rally.

He also appointed his evolution-denying Vice President, Mike Pence to coordinate the Administration’s response after gagging several Administration personnel from appearing on the Sunday talk shows. It was mentioned after the announcement that Pence did not believe that smoking causes cancer when he was Governor of Indiana.

For the Democrats, says Ms. Peck, coronavirus makes the case for policies like universal health care and paid sick and family leave.

Some key points to consider:

First, flu rates are higher without sick leave. What about coronavirus?

In the US, the article reports, just 10 states, 20 cities and three counties have some kind of paid sick leave. This is compared with the rest of the world, where more than 145 countries have this benefit. People who live in those places, research shows, are less likely to get sick, Ms. Peck reports.

And lack of paid sick leave is certainly a “risk factor”, according to Nicolas Ziebarth, associate professor in health economics at Cornell. Professor Ziebarth’s 2019 paper in the Journal of Public Economics, looked at Google data on flu rates, compared cities with leave policies with those without, and found that flu rates were 5% lower in places with sick leave.

An upcoming paper of Professor Ziebarth’s, based on CDC data, has found that the rates are actually 11% lower.

For those workers in low-wage jobs, if they get sick, they cannot afford to take time off of work because they are barely getting by. So, they end up going to work, and they get their co-workers sick.

Working from home isn’t an option.

Many companies are telling employees to work from home with the threat from coronavirus. However, for low-wage hourly workers, says Ms. Peck, this just isn’t an option. Many work in industries that have contact with the community — such as food servers, people who care for children, clean offices and homes.

As stated above, it is not just sick leave, The US also lacks any kind of comprehensive paid family leave policy, according to Ms. Peck, which would enable workers to take time off to care for a close family member’s health issues. This issue first came to light in 1993 when Bill Clinton signed into law, the Family and Medical Leave Act, which required covered employers to provide employees with job-protected and unpaid leave for qualified medical and family reasons.

An example of just how needed is paid family leave, comes from the experience of Ericka Farrell, a mother of three in Maryland, who lost her temp job in the early 2000s because she had to take so much time off to care for her young son. She did not regret staying home, but now works with MomsRising to advocate for paid leave herself, writes Ms. Peck.

Millions are uninsured. Many more have terrible insurance.

According to Ms. Peck, even if you take time off when you are sick, you might not be able to afford to see the doctor. Slightly more than 10% of Americans. she mentions, or about 30 million people, don’t have health insurance. This is because their employers do not offer it, or it is too expensive.

Things to consider regarding the uninsured:

  • Far less likely to go to the doctor
  • Americans with insurance face obstacles to getting care due to high co-payments
  • Then there are the deductibles, which have been going up for decades
  • Most people haven’t come near clearing those deductibles at the beginning of the year

John Graves, associate professor of health policy at Vanderbilt University Medical Center was quoted as saying, “If we as a society are going to face a spreading infectious disease, the worse time of the year is the beginning of the year.”

Graves added that the US health care system is simply not designed to deal with a potential pandemic.

First, he says, the US relies on employment-based insurance. If people are thrown out of work due to an economic downturn, they lose coverage.

Second, insurance is designed to encourage people not to see the doctor through so-called “cost-sharing.”  Co-payments and deductibles exist to discourage people from visiting the doctor or going to the hospital for every “cough and sniffle.” Graves said.

Lastly, in 2018, the Administration made it easier for people to buy insurance plans with less generous coverage, and don’t always cover expenses stemming from preexisting conditions, the article says. Experts have said that these plans they consider junk policies, have even higher out-of-pocket costs.

So what does this all mean?

It means that cuts to the social safety net guarantees that should the coronavirus get out of hand, the US is not prepared to deal with it effectively, and many more people will probably die who shouldn’t because of politics and ideology.

Hospital closings in rural areas, the firing of hundreds of health care personnel at the federal level, silencing the experts in infectious diseases, and the appointment of a man who rejects evolution and says smoking does not cause cancer to coordinate the Administration’s response, is a recipe for a catastrophe of unimanigable proportions. Calling it a hoax in front of your ardent supporters who believe everything you say, will only lead to more confusion and more deaths.

But this crisis also proves that it is high time those on social media sites like LinkedIn who are part of the health care industry, whether they are physicians, in the pharmaceutical industry, work in hospitals, are device manufacturers, or are consultants and researchers, accept the fact that single payer, universal health care (Medicare for All) is not just an economic necessity, but a public health necessity as well.

Is your big, fat five or six figure incomes more important than human health? It’s your call.

The Trump Administration Cracked Down on Medicaid. Kids Lost Insurance. — ProPublica

In case you think Medicare for All is a pipe dream, here is an article from ProPublica that reports that even children are vulnerable to losing their medical coverage when they need critical surgery and other life-saving treatments.

If you don’t care if adult Americans cannot get adequate medical care, then perhaps you should care that children do. After all, it could be your kid who needs it. Would you really sacrifice your kids to the almighty dollar and profit?

One salient point to mention, the Petersen’s are from northern Idaho. Idaho is a Red state and voted for Trump. While there is no way to tell if Mrs. Petersen voted for Trump, it can be assumed that she probably did. So much for making America great again. Your kid dies because the President hates Medicaid.

Here is the article link:

Weeks before 4-year-old Paul Petersen’s surgery to close a hole in his stomach, he lost coverage. The administration’s latest enforcement of the Affordable Care Act burdened many Idaho Medicaid recipients, as a million kids nationwide lost coverage.

Source: The Trump Administration Cracked Down on Medicaid. Kids Lost Insurance. — ProPublica

Majority of Americans Would Switch From Employer-based Health Care

Common Dreams and Business Insider both reported last week on polling that counters the right-wing narrative, and what some Democratic primary candidates are defending, that says that Americans like their employer-provided health care.

The survey, they wrote, showed that 59 percent of respondents who have employer-provided insurance “said they would support switching their employer-based health insurance to a government plan under Medicare for All” as long as quality of coverage would remain the same or improve.

The poll also found that Americans on government-run healthcare plans such as Medicare and Medicaid are more satisfied with their coverage than those on employer-sponsored plans, which have soared in cost over the past two decades.

According to BI, this is how the polling was broken down:

  • 44% of people said they were on an employer-based plan. Of them, 41% love their plan, 20% don’t like their plan, and 39% would be fine if it changed as long as they kept coverage.
  • 28% were on Medicare, Medicaid or military coverage. Of them, 57% love their plan, 14% don’t like their plan, and 29% would be fine if it changed as long as they kept coverage.
  • 12% directly purchased health insurance. 39% love their plan, 22% don’t like their plan, and 39% would be fine if it changed as long as they kept coverage.
  • 7% said they did not have health insurance.
  • 9% didn’t know or had some other type of coverage.

As reported in BI, the results highlight the fact that although a majority of Americans are fairly satisfied with their employer-based health coverage — which supports other polling on the subject — mainly people just like being covered in general, bearing little loyalty to a specific insurer.

Therefore, If the system provides equal or more comprehensive benefits, then broad swaths of Americans are likely to support it.

Medicare for All is not likely to pass anytime soon, but as more people come to see the benefits of such a program, compared to the rising cost of employer-based health insurance, that majority will only grow larger.

Those who advocate for Medicare for All need to keep pounding away at educating the public, and to make sure that coverage under Medicare for All is better than employer-based health care.

Surveys Say Health Care More Expensive for US Workers

A post on LinkedIn by Jaimy Lee, Health Care Editor at LinkedIn, reported Thursday that a pair of surveys indicated that health care is getting more expensive for many workers in the US.

Ms. Lee states that,

“Of the roughly 50% of Americans who get their health insurance from their employer, the cost of the average single premium rose 3% and the average family premium jumped 5% from 2017 to 2018, according to the Kaiser Family Foundation. That means premium rate increases are rising faster than inflation, which rose 2.5% during the same period.”

In addition, the Kaiser survey reported that:

  • The average annual premium last year for one person was $6,896 and $19,616 for a family in 2018. (Workers have to pay for, on average, between 18% and 29% of their premium.)
  • The average deductible amount for single coverage in 2018 was $1,573. That’s similar to 2017.

And that a separate survey stated that, 45% of Americans between the ages of 19 and 64 years old were underinsured — meaning they have health insurance but their out-of-pocket costs exceed at least 10% of their household income — in 2018. [Emphasis added]

And, in a blow to those who would like to keep the current employer-based system and not move towards an improved and expanded Medicare-for-All system, a growing number of the underinsured are people who get their health benefits through their employers. That’s up 20% over the last four years. (Traditionally the underinsured are adults who buy insurance on the individual market.)

Ms. Lee closes her post on employer-based health care underinsured workers with the following from Vox:

“In a great historical irony, the evident faults of employer-sponsored insurance are helping fuel a new appetite for Medicare-for-all, a single-payer system where everybody gets health coverage from the government,” writes journalist Dylan Scott. “Shifting 160 million people from the coverage they currently get through their jobs to a new government plan is a lot of disruption — and disruption, especially in health care, has historically made a lot of Americans nervous.”

They may be nervous at first, but it would be much better to be fully insured and nervous for a short time, than to be uninsured and nervous worrying about how they will afford ever increasing costs of insurance.

Medicare-for-All is the only way to provide such piece of mind.

Immigrants Pay More In Private Insurance Premiums Than They Receive In Benefits | Health Affairs

A press release from Dr. Carol Paris of the Physicians for a National Health Program (PNHP) reported the following article from yesterday’s Health Affairs journal.

Two of the authors of the study, Steffie Woolhandler and David U. Himmelstein are regular contributors to many articles appearing in Health Affairs, and you may remember them from my review of the book they published along with Howard Waitzkin and others, Health Care Under the Knife: Moving Beyond Capitalism for Our Health.

Here is the press release in full:

FOR IMMEDIATE RELEASE:

Despite recent claims that immigrants are a drain on the American economy and health system, a study published yesterday in Health Affairs shows that immigrants make a net contribution to private health insurance plans. The research team, which included several PNHP members, found that as a group, immigrants paid $88.7 billion in private insurance premiums but used only $64.0 billion in insurer-paid health care, generating a surplus of $24.7 billion in 2014.

In “Immigrants Pay More in Private Insurance Premiums Than They Receive in Benefits,” researchers Leah Zallman, M.D., M.P.H., Steffie Woolhandler, M.D., M.P.H., Sharon Touw, M.P.H., David Himmelstein, M.D., and Karen Finnegan, Ph.D. found that between 2008 and 2014, immigrants generated a cumulative surplus of $174.4 billion for private insurers, heavily subsidizing the the benefits of U.S.-born enrollees and boosting the profits of insurance companies. On a per-enrollee basis, immigrants provided an average premium-over-payout surplus of $1,123 each, while U.S.-born Americans incurred an average deficit of $163 each. Undocumented immigrants, who generally use little medical care, generated the largest surplus at $1,445 per enrollee.

While recent studies have examined the financial impact of immigrants on public health programs like Medicare, this project was the first to look specifically at immigrants’ role in financing private health insurance. Since undocumented immigrants or those residing legally in the U.S. for fewer than five years are not eligible for Medicaid and Medicare, private insurance is often immigrants’ only coverage option. Even so, many immigrants are afraid to use the coverage that they earn and pay for.

“Almost every day I see immigrant patients who avoid seeking the care they need to stay healthy,” said lead author Dr. Leah Zallman, who is director of research at the Institute for Community Health, physician at Cambridge Health Alliance, and assistant professor of medicine at Harvard Medical School. “Political leaders have created a climate of fear by blaming immigrants for driving up health care costs. However, this study and our prior research shows that by paying more into the system than they receive, immigrants actually subsidize both private insurance and Medicare for U.S.-born citizens.”

Don McCanne added the following on his post this afternoon about immigrants and private health insurance premiums.

From the Discussion

Immigrants contributed far more in premiums for private coverage in 2014 than their insurers paid out for their care, with undocumented immigrants generating the largest per enrollee surplus. This net surplus offset a deficit incurred by US natives and exceeded total insurance industry profits by about $10 billion that year. Our 2014 findings were not anomalous: Immigrants made large net contributions in every year in the period 2008–14, with little change over time.

While immigrants’ premiums were similar to those for US natives, immigrants incurred much lower expenditures—a disparity that was present in analyses limited to working-age adults. Among immigrants, expenditures increased with duration of time in the US, a phenomenon documented previously. This may reflect worsening health habits related to acculturation, increased care-seeking behaviors, and increased educational standing with time in the US. However, because premium contributions also increased with time in the US, immigrants made a net contribution to private health insurance regardless of their length of residence in the US.

Our findings contradict assertions that people born in the US are systematically subsidizing the medical care of immigrants, particularly those who are undocumented. On the contrary, immigrants subsidize US natives in the private health insurance market, just as they are propping up the Medicare Trust Funds.

Immigrants’ subsidies to private insurance and Medicare likely reflect their relative youth and good health, as well as the reluctance of many to seek care. Policies that curtail the flow of immigration to the US are likely to result in a declining number of such “actuarially desirable” persons, which could worsen the private insurance risk pool.

Source: Immigrants Pay More In Private Insurance Premiums Than They Receive In Benefits | Health Affairs

Americans Are Skipping Health Insurance

Bloomberg on Monday published an article by John Tozzi that reported that some Americans are taking a risk and skipping health insurance because of the cost.

In the article, “Why Some Americans Are Risking It and Skipping Health Insurance”, Bloomberg interviews three families; the Buchanans of Marion, North Carolina, the Owenses of Harahan, Louisiana, and the Bobbies in a suburb of Phoenix, Arizona.

The Buchanans decided that paying $1,800 a month was too much for health insurance and decided to go without it for the first time in their lives.

Doubling insurance premiums convinced the Owenses to do so as well, and Mimi Owens said that, “We’re not poor people but we can’t afford health insurance.”

Saving money to pay for their nine-year-old daughter Sophia, who was born with five heart defects, forced the Bobbies to go uninsured for themselves and their son Joey.

These three families are but a small part of the dozen other families Bloomberg is following to understand the trade-offs when a dollar spent on health insurance cannot be spent on something else. Some are comfortable financially, others are just scrapping by.

According to Tozzi, the share of Americans without insurance is near historic lows, the current administration is rolling back parts of the ACA. At the same time, Tozzi reports, the cost for many people to buy a plan is higher than ever.

In the case of the Buchanans, wife Dianna, 51, survived a bout with cancer 15 years ago, her husband, Keith has high blood pressure and takes testosterone. Both make more than $127,000 a year from an IT business and her job as a physical therapy assistant. They have additional income from properties they own.

However, their premium last year was $1,691, triple their mortgage payment, and was going up to $1,813 this year. A deductible of $5,000 per-person meant that having and using coverage would cost more than $30,000.

What made the Buchanans take this step was when Blue Cross and Blue Shield of North Carolina and the major hospital system in Asheville, could not reach an agreement, putting the hospital out of network. Keith Buchanan said, “It was just two greed monsters fighting over money.” He also said, “They’re both doing well, and the patients are the ones that come up short.”

The Buchanans are now members of a local doctors’ practice, for which they pay $198 a month. They also signed up for a Christian group that pools members’ money to help pay for medical costs. For this membership, it costs the Buchanans $450 a month, and includes a $150 surcharge based on their blood pressure and weight.

After dropping their coverage with Blue Cross and Blue Shield, Keith injured his knee, went to an urgent care center and was charged $511 for the visit and an X-ray. “If we can control our health-care costs for a couple of years, the difference that makes on our household income is phenomenal,” Keith said.

There is evidence, Tozzi writes, that having insurance is a good thing. People with insurance spend less out of pocket, are less likely to go bankrupt, see the doctor more often, get more preventive care, are less depressed and have told researchers they feel healthier.

Yet, some 27.5 million Americans under age 65 were uninsured in 2016 (myself included), about 10 percent of the population, according to the Kaiser Family Foundation.

The most common reason cited by KFF was that the cost was too high. A Gallup poll suggested that despite declining for years, the percentage of adults without coverage has increased slightly since the end of 2016.

However, other data, Tozzi writes, showed no significant change.

The following chart outlines the household income and health insurance status of people under 65 who qualify for government help with having insurance.

For the Bobbie family, the current administration’s proposal to make it easier for Americans to buy cheaper health plans could open options for the rest of the Bobbie family, but with over $1 million in medical costs for Sophia, these less-expensive choices would lack some of the protection created by the ACA that allowed her to get coverage.

The tax scam that became law in December will lift the ACA’s requirement that every American have coverage or pay a fine.

Some states are trying out the new rules, offering plans that don’t adhere to ACA requirements. This is the case in Idaho where the state’s Blue Cross insurer attempted to offer a so-called “Freedom Plan” that had annual limits on care and questionnaires that would allow them to charge higher premiums to sick people or those likely to become sick.

The current administration judged reluctantly that this plan violated ACA rules.

The Owenses decided to do something like what the Buchanans did. They tried a Christian health-sharing ministry for a few months, but joined a direct-primary care group, which Mimi Owens called, “the best care we’ve ever had.”

The three American families are by no means not alone in having to decide whether to have insurance or to take the risk and forgo paying huge premiums to save money or to use it for another family member with more pressing medical issues.

Two of these families are not low-income, as they both earn over $100,000 a year and could afford to buy health coverage if it was affordable. But the reality is that premiums have risen and will continue to rise and will price them out of the market.

Except for the Bobbies, no one in the other two families have serious medical issues that are exceedingly expensive, and they have found lower cost alternatives, but for many other families in the U.S., that may not be an option.

The only real solution is universal health care. Then the Buchanans, Owenses, and Bobbies of America will not have to worry about how they are going to pay for medical bills if some serious medical condition arises. We can and should be better than this.

Fallout of the End of ACA Subsidies

Joe Paduda today gave a very succinct and clear-minded assessment of the fallout of the ending of the ACA subsidies, also known as Cost-Sharing Reimbursement (CSR) payments.

Here is Joe’s article.

It makes perfect sense that what the Orange man said yesterday will do more damage to health care than his false and misleading pronouncements of the past year that the ACA is failing and doing harm.

It is you, sir, who are doing harm. To the poor, to minorities like those in Puerto Rico despite your morning mea culpa, to African-Americans and Latinos,  to women, to international agreements and organizations,  and to our credibility with our allies and adversaries.

 

Hey, Hey, Ho, Ho…HMO’s Have Got to Go: InHumana, cont’d.

Dear Readers: I beg your indulgence one more time, so that I can finish the narrative of my previous post, “InHumana”.

After spending untold hours yelling and screaming, complaining and pressuring the folks at InHumana, my mother was transferred to another facility late yesterday afternoon.

My day began by contacting InHumana’s Customer Service department, and after speaking to one woman, I asked her to transfer me to a supervisor. I told both the CSR and her supervisor that the facility my mother was in was a dump and a roach motel.

I criticized the company for limiting the choices of facilities in my county, and as I said in my previous post, that was like wanting to buy a car, and your auto insurance company limits your choices to x number of dealers, and an even smaller number of models to choose from, which corresponds to number of “InHumana beds” available in each contracted facility.

While the supervisor escalated the issue to the Access to Care team, I contacted InHumana’s CEO and President, Bruce D. Broussard’s assistant. She transferred me to their Expedited Resolution team, and spoke to two women.

I had previously sent my article, “InHumana” to Mr. Broussard on Sunday evening after I wrote it, and informed all four women I spoke to. I also tweeted Mr. Broussard throughout the day.

I gave InHumana an alternate choice, and was informed some time later that they did not have any “InHumana beds” available at that facility. I told the women that I did not care if they were contracted or not contracted with a better facility, I wanted my mother taken out of there by end of business day.

I told them that as a $41 billion dollar company, that is about to be sold to Aetna, they can afford to spend a little more to put my mother in a better facility. They informed me that because she was in their Medicaid HMO, she was limited to certain facilities.

In the meantime, I called that dump, and spoke to the Case Manager there and informed her that I was upset with the quality of the facility, and that I wanted to have my mother removed from there. She also said I was limited because of her insurance, and said the same thing to her that I said to InHumana.

I threatened to call our attorney if InHumana or the roach motel did not get her out of there, and spoke to his assistant, who had returned my previous call from the previous Friday.

Later in the afternoon, I received a phone call from a woman from InHumana who said she was the representative for this area of Florida. She was contacted to assist, and was having my mother’s case reviewed by their medical director.

After doing some more yelling and screaming at the Expedited Resolution team member to get my mother out of that roach motel, I received a call from the Admissions person at the first facility we contacted on Sunday. She told me that they had a patient go home and that there was a bed available, and that they were going to make arrangements to have my mother transferred.

So it wasn’t due to InHumana’s efforts that my mother got out of that roach motel, but rather serendipity that a patient went home, thus opening up a bed.

But it did not have to be that way. This could have ended early on in the process if InHumana was more interested in the medical care of the patient, instead of protecting their bottom-line, and their shareholder’s value, not to mention the compensation Mr. Broussard must be getting, which would probably cover my mother’s stay in this new facility for quite a long time.

Today I informed by the Admissions office that InHumana only pays for TWENTY DAYS of rehab, and since she spent one day in that roach motel, we already used one day, so we have nineteen more days for them to pay.

After that, it becomes our responsibility, at $150 a day. I don’t know how long she is going to be there, but we don’t have that kind of money, so I will contact our lawyer for his advice,

This is why, along with the aggravation they put me through yesterday, I called this article, “Hey, Hey, Ho, Ho…HMO’s Have Got to Go”.

THEY ARE CHEAP BASTARDS.

InHumana

The following post is personal. In fact, it is very personal, so if you think that personal issues should not be aired on this blog, I beg your indulgence, and hope that after reading this that you will overlook this indiscretion. Also, it is somewhat off-topic, but when has that ever stopped me?

Early Friday morning, my mother fell in her bedroom. When her home health aide and I found her after unlocking her door, she was on the floor near the foot of her bed.

I called 911, and when they arrived, they attempted to pick her up, but she complained of pain, so they transported her to the nearest hospital for x-rays.

She was admitted to Bethesda Hospital West, a relatively new hospital in my area. In 2013, my father was taken to this hospital when he fell in the house, so we were familiar with the hospital and liked it.

Sunday morning, I was informed that she was going to be discharged and that the hospital was trying to get her into a skilled nursing and rehab center near the parent hospital of Bethesda West, Bethesda East.

The day before, the Case Manager for the hospital gave me a list of twelve centers that my mother’s insurance company, Humana, has contracted with.

Out of the twelve rehab centers, only three of them were less than ten miles from my house. The Case Manager contacted the Admission person for the center near Bethesda East, but when I tried to reach this woman, I had to leave voice messages for the woman who handles admissions during the week.

Every other center the Case Manager called did not have any Humana beds, and when I tried to call Humana’s Customer Service number from my house, their automated system informed me that they were closed. Yet, the Monthly statement they sent us says that you can call Customer Service on Saturday and Sunday.

The other rehab centers on the list are either too far away from my house, or too far for my mother’s aide to go to, so would have required us to get a new aide who would be unfamiliar with my mother, and who my mother would be unfamiliar with.

The orthopedic surgeon who consulted on my mother’s case recommended a place to my brother, who is also a physician, but he did not write down the name of the center.

When it was time to transport my mother to the rehab center that did accept her, I went ahead, and when I got there, I saw that the place was a dump.

The décor was ugly and outdated, the staff was just as ugly and looked very unprofessional. The place smelled, and the room was too small. The family of her roommate were too loud and looked like refugees. The staff had to ask them to go to another room because they were too upsetting to me and my mother.

If one was to compare the atmosphere and ambiance of Bethesda West to a five-star hotel, being transported to this rehab center was comparable to being in a roach motel.

I expressed my displeasure to the head nurse at this facility, and she understood my feelings. I told her that I was not taking this out on her, but rather Humana for the way my mother and I had been treated in getting her transferred to a rehab center.

This episode demonstrates that Humana’s only concern is with saving money, protecting their bottom-line profits, and being more concerned with their shareholder’s value, rather than the value such treatment would have on the patient and the patient’s family members.

Humana’s lack of sufficient, nearby alternative rehab centers, when there are plenty of other places in the area, their failure to accept where the hospital or the orthopedist recommended my mother to receive physical therapy, is example of how bad our health care system treats elderly patients and their families.

Therefore, I have called this article, “InHumana”, because they are inhumane, and quite frankly, suck. And now they are going to be bought by Aetna. So now, they are going to get bigger, more profitable, and probably cutback on services and facilities, instead of allowing patients to go wherever they want to go, or wherever a doctor recommends them to go.

It’s like this: say you want to buy a car, but your auto insurance limits you to only twelve dealers, and most of them are too far for you to travel to, and when you contact these dealers, they don’t have the kind of car you want. This is what InHumana is doing to us. They have limited the rehab centers we can choose from, and the ones we wanted don’t have any “Humana” beds available on a Sunday afternoon.

This is not only insane, it is also insulting to the families that they do not have a say in where they want their loved one to receive care. I guess the g-damn bottom-line is more important to InHumana than patient’s well-being and that of their caregiver family members. In a word, InHumana is cheap.