WellPoint Routinely Cancels Coverage of Breast Cancer Patients

April 23rd, 2010

So, let me understand this: Obamacare is going to require people to pay for insurance that can be canceled as soon as they come down with a serious illness? Get the state to hold a gun at people’s heads to pay into a scam. That sounds like a pretty good gig for those diabolical corporations. This is is pure fascism.

Man oh man, what a country.

That said, should the people responsible for this situation below be charged with manslaughter, or murder?

Via: Reuters:

Shortly after they were diagnosed with breast cancer, each of the women learned that her health insurance had been canceled. There was Yenny Hsu, who lived and worked in Los Angeles. And there was Patricia Reilling, a successful art gallery owner and interior designer from Louisville, Kentucky.

Neither of these women knew about the other. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders — more than any other health insurance company in the United States.

The women paid their premiums on time. Before they fell ill, neither had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

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.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women’s specific cases without a signed waiver from them, citing privacy laws.

That tens of thousands of Americans lost their health insurance shortly after being diagnosed with life-threatening, expensive medical conditions has been well documented by law enforcement agencies, state regulators and a congressional committee. Insurance companies have used the practice, known as “rescission,” for years. And a congressional committee last year said WellPoint was one of the worst offenders.

In his push for the health care bill, President Barack Obama said the legislation would end such industry practices.

But many critics worry the new law will not lead to an end of these practices. Some state and federal regulators — as well as investigators, congressional staffers and academic experts — say the health care legislation lacks teeth, at least in terms of enforcement or regulatory powers to either stop or even substantially reduce rescission.

“People have this idea that someone is going to flip a switch and rescission and other bad insurance practices are going to end,” says Peter Harbage, a former health care adviser to the Clinton administration. “Insurers will find ways to undermine the protections in the new law, just as they did with the old law. Enforcement is the key.”

3 Responses to “WellPoint Routinely Cancels Coverage of Breast Cancer Patients”

  1. Druff Says:

    And let us not forget that the “reform” legislation was written by a former Wellpoint VP:

    http://emptywheel.firedoglake......lers-plan/

  2. tochigi Says:

    if daily kosians catch you dissing Health Carrrrrre Reforrrrrm, you are in BIG trouble!

  3. Peregrino Says:

    Algorithm? You don’t need an algorithm to identify recent diagnoses, just a simple query. An algorithm would make more sense if fraud detection was the objective, as suggested by the article. Which begs the question: should an insured with a legitimate claim be denied coverage due to evidence of fraud? Contracts of all kinds include a clause that voids the contract if the contract is not made in good faith. Which is probably why these women were denied coverage. The last thing an insurance company wants is a lawsuit. Defense attorney fees usually cost more to an insurance company than paying a fraudulent claim. If WellPoint denied coverage to these women, you can be sure WellPoint has an ironclad case. Do I respect WellPoint? Hell no. Anybody with class would say, well, you defrauded us, but you’re sick now, so we’ll help you out of pure human decency. But who every accused an American corporation of pure human decency? In contrast Obamacare attempts to create a context where no one has to consider committing fraud to obtain health care. Scream about it all you want, but it is just a pragmatist attempting to drag the U.S. into the 21st century universal health care model as defined by many other countries around the world whose health care systems make health care in America look like the dinosaur swamp that it is.

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