Tag Archives: insurers

Injured Worker Arrested When Employer Could Not Cut WC Benefits

The Charlotte Observer today reported on the case of an injured worker who suffered a brain injury after a fall in 2003 at his employer’s workplace. And because they could not cut off his benefits, they had him arrested.

In case you find this incredible, here is the link to the article:

https://www.charlotteobserver.com/news/local/article217808590.html

Is this what it has come to today in Workers’ Comp? That insurance companies refuse to continue lifelong payments to injured workers because they believe he is faking his injuries, so they and his employer have him arrested?

This is more than harsh; this is despicable.

 

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This election is about your pre-existing medical condition – Managed Care Matters

Fellow blogger, Joe Paduda, summed up what is at stake for millions of Americans, your humble blogger included, if the GOP holds onto the House and Senate after the Midterm election thirteen days from today.

At the bottom of Joe’s post is a link to a Blue Cross/Blue Shield website. Scroll down to the part labeled “Medical Condition Rejection List.” It covers every conceivable illness and condition that human beings may suffer from, and included on that list is peritoneal dialysis, which I am undergoing, and hemodialysis also.

If the Republicans get their way, the only people who will have health insurance are perfect specimens, and we all know that there is no such thing as a perfectly healthy human being. We are all born with, or have the potential to get, some form of illness or disease at some time in our lives. It’s in our genes.

Unless of course, you are Superman/Superwoman.

Here is Joe’s post:

Will you be able to afford health insurance, and will that insurance cover your pre-existing medical conditions? For most, that’s the biggest issue in the upcoming election. Congressional Republicans are planning to pass legislation that allows insurers to: a) stop … Continue reading This election is about your pre-existing medical condition

Source: This election is about your pre-existing medical condition – Managed Care Matters

Follow-up to CVS to Buy Aetna

As I reported last month, and in today’s New York Times and Wall Street Journal, CVS has agreed to buy Aetna for $69 billion, reshaping the US health care industry, according to the Times article.

The transaction, the article said, is one of the largest of the year, and would combine the drugstore giant with one of the biggest health insurers in the US. It would blur the lines between traditionally separate spheres of the health care industry.

This move by CVS is response to moves by Amazon, which has quietly laid the groundwork for an entry into the United States’ pharmacy business.

According to the Wall Street Journal article, Aetna stockholders will receive $207 a share, $145 in cash and 0.8378 of a CVS share, or $62 in stock.

 

CVS to Buy Aetna

This should wake you up before your morning coffee.

Reuters is reporting that pharmacy operator, CVS Health Corp. is making a bid for Aetna Insurance.

Bid is more than $66 Billion.

Here is the article from Reuters.

Do we really think a pharmacy should own an insurer? What ever happened to the idea of competition is good?

One day, we will live in a world like that of the movie, Rollerball (the one with James Caan), where corporations run the world, and your wife can be taken anytime by a corporate executive.

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.

 

ACA Subsidies to End

Here is the New York Times article tonight which will appear in tomorrow’s paper.

The Orangutan is blowing up the health care law, and with it, the health care system.

Cutting off subsidies to cover low-income individuals and signing an Executive Order that will create chaos and uncertainty is dangerous, reckless, and despicable.

Not even Gru is that mean-spirited and inhumane.

The Roman Senator Cato the Elder ended his speeches by declaring that “Carthago delenda est”. which means Carthage must be destroyed.

We need a modern Senator to declare that “Trump sit remotus”, means Trump must be removed.

Single Payer Supported by Majority of Physicians

A shout-out to Dr. Don McCanne for posting the following article from Merritt Hawkins.

Merritt Hawkins
August 14, 2017
Survey: 42% of Physicians Strongly Support a Single Payer Healthcare System, 35% are Strongly Opposed
By Phillip Miller
A plurality of physicians strongly support a single payer healthcare system, according to a new survey by Merritt Hawkins.
The survey of 1,033 physicians indicates that 42 percent strongly support a single payer health care system while 14 percent are somewhat supportive. Over one-third (35 percent) strongly oppose a single payer system while six percent are somewhat against it. The remaining three percent neither support nor oppose single payer.
The results contrast with a national survey of physicians Merritt Hawkins conducted in 2008, which indicated that 58 percent of physicians opposed single payer at that time while 42 percent supported it.
In Merritt Hawkins’ experience, there are four reasons why a growing number of physicians are in favor of single payer. First, they are seeking clarity and stability. The fits and starts of health reform and the growing complexity of our current hybrid system are a daily strain on most doctors. Many of them believe that a single payer healthcare system will reduce the distractions and allow them to focus on what they have paid a high price to do: care for patients.
Second, it’s a generational issue. The various surveys that Merritt Hawkins has conducted for The Physicians Foundation in the past show that younger doctors are more accepting of Obamacare, ACOs, EHR, and change in general than are older physicians As the new generation of physicians comes up, there is less resistance among doctors to single payer.
Third, there is a feeling of resignation rather than enthusiasm among some physicians about single payer. These physicians believe we are drifting toward single payer and would just as soon get it over with. The 14% of physicians surveyed who said they “somewhat” support single payer are probably in this group.
Fourth, there is a philosophical change among physicians that I think the public and political leaders on both sides of the aisle now share, which is that we should make an effort to cover as many people as possible.
However, while single payer has gained acceptance among some physicians, it remains strongly opposed by over one third and strongly or somewhat opposed by over 40 percent. It is still a polarizing issue among physicians and is likely to remain so for the foreseeable future.
So, if a majority of physicians support single payer, and they are the ones we should listen to when it comes to taking care of our health, and if a growing majority of Americans are coming around to this idea, then the only ones standing in the way are our politicians.
POTUS, the Secretary of Health and Human Services, Mitch McConnell, Paul Ryan, Rand Paul, and the medical-industrial complex of insurance companies, drug companies, and medical device manufacturers are all opposed and are preventing this nation from joining the rest of the developed world in providing health care to ALL its citizens.
And there is one more obstacle in our way: Wall Street investors and their clients who are funding insurance and medical companies, engaging in adverse selection and determining who lives and who dies. Who gets covered and who goes into bankruptcy.
They need to removed from the equation.