Archive for big insurance

Blue Cross Blue Shield health care disaster: Man with brain tumor needs care STAT, not a death panel.

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Lolly Jean Twitter profile health care

One of my longtime Twitter pals, @Lolly_Jean, is desperately trying to raise the profile of what health care insurance companies are doing in the employer provided field; maybe shaming Blue Cross into allowing her husband to continue the care they have already approved, the care her husband was receiving until he became sick, will help.

She has tried tweeting to news and cable outlets to no avail. Any suggestions anyone might have to help her raise the profile of this devastating issue--for her husband and the others in employer-provided health care policies that will likely follow-- would be greatly appreciated.

Here is her story in her own words (bolding is mine):

My husband has a brain tumor and has been under care of Memorial Sloan Kettering in Manhattan, and receives his radiation treatment from Memorial Sloan Kettering in Commack, Long Island, New York. He became ill from side effects, was taken to our local hospital on January 28th, where he remains today.

We have been fighting Empire Blue Cross Blue Shield for the past 2.5 weeks, as they refuse to allow him to be transferred to Memorial Sloan in Manhattan (MSK) for acute care and resumption of his remaining radiation treatments to the brain. We receive our insurance through my husband's employer, and we pay an additionally for Direct Point of Service care, which allows us choice of doctors and facilities. To note, my husband has been under the care of Memorial Sloan Kettering for the prior 4 years.

Blue Cross, at first, wanted to transfer my husband to a hospice facility with a standing DNR (do not resuscitate) order. My husband is not in end stages of his illness.

They fought us for a precious week of treatment time until they agreed that my husband did not warrant end of life care. They still refuse to allow us to take him to MSK, where his doctors know him, have knowledge of the rare form of tumor he has, and where until 5 weeks ago, he was receiving his treatment.

As I mentioned, this is employer-provided health care. My husband's employer is advocating he be moved to MSK for the remainder of his treatment, and has been very helpful in contacting Blue Cross in advocacy of his case.

MSK is 'in network' on our plan. They accept the negotiated payment as per their contract with Empire Blue Cross Blue Shield. And as I stated, we do have a Direct POS plan which allows us to go outside of network, should we choose.

To force us to change our doctors at this stage is unconscionable, immoral and dangerous.

To force us to go to a facility that cannot provide the same level of cancer care would not allow for the outcome that MSK feels my husband's condition should have.

And the more time we fight Blue Cross, my husband becomes weaker. This truly is a death panel, one run by the actuaries in Empire Blue Cross.

Please, help us by lending your voice by advocating for my husband.

By the way, here's the @AskAnthem Twitter profile. Notice the link they provide at the bottom:

Anthem on Twitter health care

Here's what you see when you follow the "customer support" link they provide, because, you know, they CARE:

anthem support health care under maintenance

I'm sure Anthem's "improving your online experience" and apologizing for "any inconvenience" are a huge comfort to Lolly Jean and her ailing husband.

You can get the ball rolling by tweeting this post to @empirebcbs (Sally Kweskin, their PR director in New York) and @askAnthem.

I don't know about you, but I'm not letting up until we get more action than a pleasant, solicitous response.

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"Gosh, one might conclude that maybe #Obamacare isn’t the cluster**** we’ve been told it is."

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obamacare insurance companies

The facts just keep rolling in. Here's a short clip:

Visit NBCNews.com for breaking news, world news, and news about the economy

Commenter at Scrutiny Hooligans:

theotherbarry says:

November 5, 2013 at 11:20 am

I just got back from a business trip in Virginia, and I heard similar stories from folks from all over the US.

On my way back I stopped in to see a distributor in Clemmons NC – he says that he & his daughter both got the letters from their insurance companies – she for herself, he for him & his employees.

He says that they got onto healthcare.gov & found better coverage for less than they had been paying. With subsidies, she will actually wind up paying next to nothing, and that he with his small business tax credit, will wind up with a better policy for less.

Gosh, one might conclude that maybe this isn’t the cluster**** we’ve been told it is.

All In with Chris Hayes takes it from there. Here is the entire segment:

Visit NBCNews.com for breaking news, world news, and news about the economy

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Insurance giant WellPoint, key player in #Obamacare rollout, is upbeat about exchanges

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ermahgerd good news

Republicans aren't going to like this story. The Los Angeles Times is reporting that WellPoint is feeling mighty good about the Affordable Care Act, despite the glitches that are being doomsdayed all over the media.

Insurance giant WellPoint Inc., a key player in the rollout of the Affordable Care Act, said it remains optimistic about the healthcare expansion despite the rocky start of a federal insurance exchange.

WellPoint's CEO Joseph Swedish, other executives, and White House officials are putting their noggins together to brainstorm about how to fix the website issues. Fixing problems. What a concept. Maybe Republicans can try it sometime.

On a conference call with analysts and investors, Swedish said public interest in the health overhaul has been strong and the call volume at the company's service center doubled during the first week of enrollment... "We remain optimistic about the long-term membership growth opportunities on the exchanges," Swedish said on the conference call, "but given that we are just three weeks into the open enrollment period, it is really too early to draw any definitive conclusions."

How thoughtless of him to throw a wrench into the GOP smear machine. Who does he think he is, a major wealthy Big Insurance player who Republicans might actually respect? The nerve.

i hate good news

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The Obama administration has been busy

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newsy news smaller

I'm about to run out the door, but I wanted to get a couple of newsy, good news/bad news items out there for you. First, via an email alert from the New York Times, the good news:

Justice Dept. Files Lawsuit to Block US Airways-American Merger

The Justice Department, along with the attorneys general of six states, filed a lawsuit on Tuesday seeking to block the proposed merger of American Airlines and US Airways.

The $11 billion deal, announced in February, took American out of bankruptcy. It would create the nation’s biggest airline, a company with the size and breadth to compete against United Airlines and Delta Air Lines, which have grown through mergers of their own in recent years and are currently the biggest domestic carriers.

But in the complaint filed Tuesday in Federal District Court in the District of Columbia, the Justice Department said that the merger “will leave three very similar legacy airlines — Delta, United and the new American — that past experience shows increasingly prefer tacit coordination over full-throated competition.”

And the bad news, via The Hill. Surprisingly, this has been the Labor Department's site since February, but nobody said a peep about it. Republicans will. It feeds right into their talking points:

Administration delays ObamaCare caps on out-of-pocket costs

The Obama administration has delayed a main provision in President Obama's healthcare reform law that would limit out-of-pocket insurance costs for consumers until 2015.

The cap, which includes deductibles and co-payments, was supposed to limit consumer costs to $6,350 for an individual and $12,700 for a family. But administration officials have quietly delayed the requirement for some insurers, allowing them to set their own limits starting in 2014. [...]

An administration official said the health law would “protect consumers from the worst insurance company abuses, by banning discrimination based on a pre-existing health conditions [sic], ending lifetime and annual limits on what an insurance company will cover, and capping out-of pocket spending to protect Americans and their families.”

A-a-nd the GOP takes full advantage and ups their Obama/Obamacare bashing in 5...4...3...2...

heavy sigh

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What I will not write about today

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frustrated15Sometimes I get so frustrated and/or disheartened and/or annoyed by some of the news stories of the day that I can’t bring myself to write about them. Here are a few recent reports that made my blood pressure hit the roof. I am avoiding delving into them at length out of concern for my physical and mental health.

See what I mean? So who’s up for a couple of Margs or a trough of wine?

drunk flamingos

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"One day a single-payer system will provide better care at less cost and aggravation."

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sign single payer health care smaller

Today's L.A. Times letter to the editor, because our voices matter:

Re "Another surgery — while knee-deep in the red tape," Column, Jan. 6

Steve Lopez asks, "Can't we switch to a healthcare system instead of a paper-shuffling, profit-driven, CEO-bonus-building system?" Great question.

There are dozens of for-profit health insurance companies astride the U.S. healthcare "system." Besides profits for their owners, their premiums must pay for exorbitant executive salaries and benefits, lobbyists in Washington, political contributions, marketing programs, lawyers and lawsuits, redundant computer systems and staffs trained to deny claims. These parasitical organizations contribute nothing to actual healthcare.

One day a single-payer system will provide better care at less cost and aggravation. As Winston Churchill said, "Count on Americans to do the right thing — after they've tried everything else."

Ed Carstens

Santa Clarita

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Insurance giant Humana sues after backlash over ads on Rush Limbaugh show

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Humana is getting a whole lot of negative feedback on the Twitter Machine, and they are not thrilled. And guess who is at the root of their mammoth problem. Go ahead.

Here's a hint: It rhymes with Mush Mimbaugh.

Via The Hill:

Insurance giant Humana is suing a Maine company to stop it from using the name "Concentra" to sell memory pills after suffering a backlash over advertising on Rush Limbaugh's show this week.

Humana, the parent company of Concentra Health Systems, filed an injunction on Thursday demanding that Maine's Preval Group stop using that name, the Associated Press reports. [...]

"We are not affiliated with this company or this product in any way," Concentra says on its web site. "We apologize for any confusion created by this event, but assure you that this advertising is not from our company."

Rush-ing away as fast as they can.

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