Cigna is also the company that denied a 17 year old girl a liver transplant and she died. AT 17 !!!!

Yep – Nataline Sarkisian

It’s also where whistleblower Wendell Potter used to work.

Capitalism is, by and large, a zero sum game, folks. One makes. One loses. If you don’t like it, think about its replacement and how you might help change happen.

It appears it is time to revolt. After all, we have had to live with the revolting crime that is insurance. Our representatives have mandated that we have insurance for so many things. They were paid to do this by the insurers. They took bribes to make this happen.
Would you ever trust a representative of your government again?

I think that’s what makes me the most angry – that we can’t trust our gov’t about anything. We certainly always knew that there were things going on that we might not approve of, but this stuff is out-and-out corruption right in our faces. And they expect to get away with it and they do. Americans will probably never feel the same about their gov’t or their country.
How sad.

So the Democratic Congress and progressive hero, President Obama have a plan for this dire situation:

mandate everyone pay CIGNA and others like it, and in exchange CIGNA will have to be a tiny bit more slippery in maintaining their profit margins by denying claims.

what a great plan! Thanks Democrats! good thing we don’t ‘vote against our interests’ when voting for you, like those other stupid buffoons on the (R) side.

though ponder for a moment – a President McCain could never get an abomination like this ‘reform’ passed, because then Democrats in Congress would find it politically expedient to oppose it, and ehrm, so would the Progressive Netroots.

stacie ritter was on democracy now! this morning. interview is here:

http://www.democracynow.org/20…..ance_giant

i think it’s important to note, since jason didn’t mention it (and it’s possible that i have this wrong and would like to be corrected if that is the case), that single payer (hr 676 expanded and improved medicare for all) would prevent this type of abuse — but the public option, as defined by hcan and jason (or any of the bills currently under consideration) would NOT.

the fight for a public option is NOT the fight to end this. single payer IS.

again, please correct me if i have this wrong.

CIGNA dumped me after I lost my job and COBRA benefits. No apologies. Luckily, I was able to buy other shitty insurance.

Personally, I want their heads. I want to see the complete destruction of not only CIGNA, but every other health insurance corporation.

You eff around with millions of people like me, and you make enemies for life.

This is great now hopefully we can get her on the News KO and rachel should be fighting to interview her!

Its for people like her, its for America, that we blog and comment People never doubt why we fight or that we can do some good.
To not fight as best we can even if its only with words to just give up and let people like Stacie and her daughters suffer would be the greater crime.
The crime of silence in the face of wrong.

Thank you Jason. People need to hear these things in the media.

Health Net has a great big office in Rancho Cordova. Perhaps there are other health (not) insurance companies here. Perhaps I will make a little sign and walk up and down in front of one of their buildings. It could say something like “Stop the Murder by Spreadsheet”. I also have the names of local reporters who have been calling about our divorce. Anyone else want to come with me?

Good teacher, what must I do to inherit eternal life?”
19“Why do you call me good?” Jesus answered. “No one is good—except God alone. 20You know the commandments: ‘Do not commit adultery, do not murder, do not steal, do not give false testimony, honor your father and mother.’b”
21“All these I have kept since I was a boy,” he said.
22When Jesus heard this, he said to him, “You still lack one thing. Sell everything you have and give to the poor, and you will have treasure in heaven. Then come, follow me.”

Frackin Tea Baggers not one of them has read the Bible with an open heart not one of them has heard the Word with an open heart, Not a one of them has been saved even if they say they have been Born Again.
Judge a man by his deeds not his words.

If I lived there I would come with you. I detest Health Net – had their crappy insurance for awhile. And talk to those reporters. Show them this story and demand that they investigate the health care stories around the country.

How about a sign that says “Death Panel – Room 406″

Judge a man corporation by his deeds not his words.

It is, after all, considered a person under the “law”.

Definitely wrong. A combination of outlawing denials of care like this and a public option for people to use if they wanted to would allow people like Stacie to get this care covered.

I think that the way the public option is being written now it is for people who have no insurance. You cannot move from private insurance to the public option. Perhaps this has been changed recently. Selise would know the answer to that.

And by the way why do those shots cost $440?

Why not $880? Oh, yeah mother might not be able to pay and Drug company loses a customer. Charge as much as they might be able to pay but not too much or customer dies. What a business plan.

Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? 38When did we see you a stranger and invite you in, or needing clothes and clothe you? 39When did we see you sick or in prison and go to visit you?’
40″The King will reply, ‘I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’
41″Then he will say to those on his left, ‘Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. 42For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, 43I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.’
44″They also will answer, ‘Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’
45″He will reply, ‘I tell you the truth, whatever you did not do for one of the least of these, you did not do for me.’

The Least of your Sisters is at your door Ed Hanway will you not open it?
Save her daughters and save your own Immortal Soul! If you will not do it for compassion then look younder at the Lake of Fire that awaits you.

Good one Mary!

That’s why capitalism can’t be used for something like healthcare. Nothing wrong with capitalism, but it’s wrong to make money (or more money) off other people’s suffering.

I don’t think they lose too much sleep worrying about their clients dying. They really have it made – they don’t have to worry about doctors making a mistake, they don’t have to be concerned about hospitals screwing up, etc. They just sit back and the money rolls in.

Everybody has to worry about doctors making mistakes. Even fancy, dancy doctors.

All of these fat cats have skeletons in their closets. What are they and how public can we make them? If they don’t, their wives do. Or their kids. Or their families, friends, people who owe them money, etcetera.

The time for dirty tactics is here because they ask us to go there.

Action Alert, Firepups!!! Apparently, Dancin’ Nancy Pelosi is tryin’ ta pull a Pete Stark on Alan Grayson and has told ‘im to shut the fuck up! Citizen Knocksville has a link on the last thread to the old witch’s web site to leave your support for Grayson and tell her where to put her party discipline.

Tell Me brothers and sisters who has fought for the Poor to be Fed and Clothed?
Who has fought for Prisoners and Against the Death Penalty (I think after the Crucification we can guess JC’s views on that issue)

Who now fights to help the sick!

And ask yourself who stands against us? Not a one of whom has a better chance than a camel of going through the eye of a needle.
This is a battle between Good and Evil make no mistake about it we might fail but I am proud to stand with you all and on my dyin day say we tried and enjoy my eternal rest no matter what happens later! We are trying our best in this struggle and that is all God can ask from us.

I meant that if a doctor makes a mistake, the insurance company won’t be sued, the doctor will. It’s amazing when you think about it; the insurance companies really don’t have to do anything except sell you the crap they are pushing. Then it’s smooth sailing without lifting another finger – except an often repeated “NO”.

Already sent her an e-mail. Said “We’re tired of this and we’re not taking it any more.” Suggested to her that instead of telling Grayson to be quiet that she should be booking speaking engagements for him around the country to get our message out.

I would join you too Mary if I lived where you do!

You go girl! Keep those reporters in your loop even if you cannot give them everything they want. You have some power now.

How in heaven’s name can ANY treatment be refused by anyone who is not a doctor????? Who could possibly think that should be part of the “business plan.” But it is. What a mess.

The system as it is currently configured is simply NOT sustainable without these horrors. Mandates and a jiggered public option are only going to contribute to increased costs for everyone.

I believe that insurance coverage is directly responsible for the increase in prices across the board. People would never pay what is paid for them by insurance, and then the premiums go up for everyone. What a mess.

Reform would outlaw all insurance from denying care like this for pre-existing conditions, not just those who are currently uninsured.

OT (but not really)
New VR Campaign To Stop The Incitement Of Domestic Terror By Extremist Media, Politicians And Religious Leaders: Attorney General Urged To Enforce Laws Stop Domestic Terror

http://www.velvetrevolution.us/stop_terror/

’bout time.

Citizen mardam:

“Nothing wrong with capitalism but it’s wrong to make money (or more money) off others people’s suffering.”

Wrong on all counts there Citizen, the entire premis of capitalism is to profit from the suffering of others and to maximize the profit by maximizing the suffering. There is EVERYTHING wrong with capitalism and the political debate over healthcare is beginning to expose that truth!

What she wants to censor him or something after all the crazy birther, death panel, Obama is brainwashing kids, setting up concentration camp lies Rep Michelle Bachmann has said?
Show me one lie Alan has said! I can’t count all the lies the GOP has said but Alan gets punished for speaking the truth?
Did not the Devil the Prince of Lies promise Jesus the world if only Jesus would bow down to him?
Stay strong Alan stay strong.

I know all I needed to know about CIGNA in CA, when a young woman I knew who had little morals or ethics rhapsodized about how she got to approve/deny services to patients. She also spent a lot of time campaigning for the thoroughly crooked Chuck Quackenbush (remember him?), both on company time, and whenever I saw her socially. I’m polite to her (never have to see her often), but I consider her scum to this day. It’s in the blood at CIGNA.

Hi selise, I think you are probably right, but it’s hard to say since, in the end, we don’t know what kind of PO HCAN will end up supporting. However, the worst thing about the PO is that the moral outrage aroused by cases like Tracie Ritter’s and also by statistics like the recent finding that 45,000 people per year are dying from lack of insurance, can’t be easily maintained and channeled into support of any PO bill that is as weak as the current ones or will not take effect until 2013.

I’ve felt this for some time, but it was really brought home to me yesterday at the MadAsHellDoctors meeting in Lafayette Park yesterday. The motivation present at that meeting was palpable. It was reminiscent of the civil rights and anti-Vietnam War demonstrations of the 1960s in their early days. There was laughter, there were plenty of tears and cheers, there was anger, and there was determination, extending even to civil disobedience, if necessary, to get Medicare for All Done. I’ll be blogging on this later, as, I’m sure will ralphbon, and montanamaven.

One thing you can count on, however. Whatever the outcome of the present shenanigans in Congress and however much money is forthcoming from the insurance companies to protect their position, we won’t quit. There is a mass movement coming, and it will end with Medicare for All. And next year there will be a nationwide network to get this done, and there will be demonstrations calling on Congress to take up reform again and pass a real reform bill, election year or not.

Medicare for All is our solution to the human right of universal health care in this country. It is a moral issue. Everybody in; Nobody Out. Soon you’ll be hearing and seeing the white ribbon of hope flying all across this land.

Definitely wrong. A combination of outlawing denials of care like this and a public option for people to use if they wanted to would allow people like Stacie to get this care covered.

1. where is “outlawing” denial of care in your requirements or in any of the bills?

2. stacie’s insurance was via an employer. if she even had access to a public option, the costs including premiums would have had to be born by the family (which at something like $14,000/year would have probably cost more than the cost of the denied care).

Citizen Twain:

I also sent a response but I wasn’t as cavalier or diplomatic about the stupidity of disciplining her party regulars when they start makin’ connections with and money from the body politic…Nancy Pelsoi and Harry Reid are beginnin’ to look a lot like the leaders of the Wiemar government and Reichstag in 1932-33.

Reform would outlaw all insurance from denying care like this for pre-existing conditions, not just those who are currently uninsured.

no.

this is about denial of care based on medical necessity (the insurance company thinks it gets to decide that and not the family’s docs).

that is something completely different than the issue of pre-existing conditions. i think you have the two confused.

Actually, the $5,883/hour assumes 52 40-hour weeks. (Slightly off for calculation method.) However, since Ed Hanway is such a hard worker, we have to assume he needs a little bit of time off during the year. Let’s say 4 weeks? That brings his hourly take up to $6,354. So now we’re up to about 14 treatments/hour.

It’s rough all over, ain’t it Hanway?

How do these sonsabitches sleep at night?

Neither Nancy nor the Dems OR THE R’s who voted AGAINST censuring Wilson have ANY leg to stand on.

It’s too much: she didn’t want anything done about Wilson and now she wants to go all batshit crazy on Grayson?

Donnez-moi un break, s’il vous plait!

Did her face move? If so, that means she’s really pissed.

Nancy and Harry need to retire and let the Grown Ups have a shot at it…

I was just pricing the cost of a shingles vaccine, and discovered that–without insurance–it’s $215 to $240 here where I live in the US. I could walk a health center in Canada and receive it for $150, without being covered by a Canadian policy.

It’s manufactured by Merck, with corporate headquarters in New Jersey. I see exactly the same thing with another drug I take–made in the US, cheaper in Canada, even without insurance coverage. Why?????

Fortunately, Medicare does cover this vaccine, except for a copay of around $50, but why is the underlying cost so high here? And does that mean that Merck is soaking the government, which has no bargaining power under Medicare part D???

Something is very wrong here!

we already know what hcan and jason said was required for their support. here’s my link (from my first comment above):

http://seminal.firedoglake.com/diary/6416

the rest of your comment i either agree with completely or am inspired to hear. white ribbons!

am looking forward to reading about yesterday. thanks again for going and representing so many who could only be there in spirit.

Citizen reader:

I think One hung Harry Reid and Dancin’ Nancy Pelosi are beginnin to experience the fear of impending political doom…both of them are gunna be out of leadership after this healthcare fight and Reid may very well be outta the Senate.

We need to replace Nancy and Harry.

Everyone is “concerned” about Alan’s use of the word holocaust. But what is it when 45,000 people are murdered every year? And how many are just maimed? I understand the word holocaust finds its origins in the Jewish faith and I respect that. The numbers of people dying and suffering by the hand of a passive/aggressive industry and government is only going to grow. Could someone give me a better word to use? I am not being sarcastic.

How many years has this been going on?

20 years x 45,000 = almost 1 million!
40 years would be 2 million?

… by today’s standards. Have death rates increased or decreased? Who knows.

Unless our general standards are going to go way up for what the R’s have been spewing, then LEAVE GRAYSON ALONE. I want to hear more from GRAYSON!!!

“What we have here is a…..”; so goes an old line from a vintage movie.

But what we have HERE…in the U.S. of A. in 2009 is….pure and simple…a system of ORGANIZED BRIBERY!

Can you imagine for one moment allowing a judge who is hearing a case to accept a “contribution” from one of the litigants? Such a thought is as if to totally destroy the judge’s integrity as well as the “contributor’s” reputation.

But now, fast forward to the United States Congresss and….Voila…such a “contribution” is welcomed and blessed.

Not so, however, the integrity of that Congress. Even though a few honest lawmakers are able to rise above the temptation…at least on THIS occasion…the INTEGRITY of the body which makes our laws is steadily descending, spinning toward the Eighth…or perhaps the Ninth…Circle of Hell wherein reside the Traitors…those who abuse their sacred trust. On an almost daily basis their decisions are subjected to, and often colored by, MONEY…and lots of it.

The total legislative process is held hostage by…MONEY; and the best interests of the people of the U.S. are compromised by and disregarded because of….sure, you got it…..MONEY!

Where is the court action calling into account the humongous conflict of interest proceeding unabated, despite the obviousness of the situation? Where are the enraged citizens (hopefully with pitchforks) DEMANDING an end to such abuse? And where are the guardians of the public trust marching “as to war”??

Until we have answers to these questions, the United States of America will remain

Jane has a cross-post up and already in progress on the front page: “Is The White House Drafting Secret Bill Without a Public Option?”

From your lips directly to the democractic process Norske!

You are delusional… Capitalism is not a zero sum game… actually government is a zero sum game…

In our principles of reform we support it clearly states:

A standard for health benefits that covers what people need to keep healthy and to be treated when they are ill. Health care benefits should cover all necessary care including preventative services and treatment needed by those with serious and chronic diseases and conditions.

So Stacie would indeed fit that rubric.

I hope there is a mass movement coming … I think you are right. The pols want to get the out of the way for the elections, but it will only intensify by then. If only because the general public will be hopelessly confused by then and totally unmanageable in terms of political messaging!

Sounds good to me!

If you don’t want to pay for insurance… don’t get it. There are very few things that insurance is required… And the things are required are typically required to protect the lender. Would you lend money to somebody for a house and not require them to insure it? If it burns down the lender is SOL because you know damn well the person who borrowed the money would never pay it back. Or… if you went and paid cash for a brand new car would you drive it with out insurance even if the state did not require you to carry liability or comp/col? I think not… and the reason is you are protecting your investment (not to say that cars are ever an “investment”; becasue they are not but you get my point).

first, cigna claimed the treatments were not necessary. that is one of the key points re denial of care — that private for profit insurance companies get to have any say in this.

second, i referred (and linked) to your recent statement in defense of hr 3200 for the moving line in the sand. a defense which most certainly did not include the original principles including universal access to the po. or additionally, preventing denial of care.

finally, once again, does hr 3200 “outlaw” this kind of denial of care?

Spew Alert.

We know there are many horrific stories of unnecessary and avoidable human suffering and unconscionable economic destruction like this one caused by private for-profit insurance companies and Big PhRMA. I firmly believe that the only way to overcome our bought-and-paid-for President, his Chief of Staff, and the senators and representatives who never give a second thought to spending $83 billion per month fighting undeclared wars in Iraq and Afghanistan is to keep telling these horror stories until they are too ashamed to vote against urgent and necessary health care reform. We need a single-payer system. This cobbled together mix of provisions under consideration in Congress is a shameful disgrace of barbaric proportions because it is focused on protecting the financial interests of shareholders and corporate profits, a system that kills 45,000 people per year and leaves 50 million people uninsured without reasonable and necessary health care. WTF is up with that? I feel such anger as Jesus must have felt when he overturned tables scattering money all over the floor and threw the money changers out of the temple. This is BULLSHIT!

Thank-you, Jason, for placing the focus on people, where it always should be, because they are the story. People need to realize that what is happening to the victims of our current predatory system will happen to them unless we refocus the dialogue on people and enact a single-payer system.

The public option is an inadequate compromise solution, IMO, and I think it’s disgraceful to settle for it. But, if that’s the best these compromised and insensitive jerks can come up with, no one should vote for a bill without it.

There is a simple answer for those who want to whine about costs. End the Goddamn Wars and stop spending $83 billion per month killing innocent people and stealing their natural resources.

Reframe the debate on people like Stacie and her twin daughters.

You’re focusing on the wrong part of that principle:

A standard for health benefits that covers what people need to keep healthy and to be treated when they are ill. Health care benefits should cover all necessary care including preventative services and treatment needed by those with serious and chronic diseases and conditions.

HR 3200 puts the decision of “medically necessary” back in the hands of your doctor and not the insurance industry.

It also guarantees coverage of chronic conditions in the Exchange, which would do two things for Stacie. First, the Exchange plans would become the de-facto industry standard for benefits in the country. Business purchasing insurance outside of the Exchange would find it much easier to negotiate for the “standard benefits package” and insurance companies would be more willing to provide it. Second, if your employer didn’t offer the standard, you can always opt out of our employer based insurance and enter the Exchange as individuals, meaning Stacie would get the benefits she needed even if competitive pressure didn’t work.

Senators Rockefeller, Schumer, Stabenow and Widen of the Senate Finance Committee Sub-committee on Health, did a great job of pointing out that the Medical Industrial Complex’s contribution to Health Care Reform, according to the Congressional Budget Office (CBO) is $20 BILLION and in return they will get $500 BILLION in TAX-PAYER FUNDED SUBSIDIES. Democratic Senators baucus, conrad, carper, lincoln and nelson voted with the republicans to kill the public option 09-09-29.

Criminally corrupt politicians are the reason the U.S. is ranked near the bottom of every catagory when ranked next to other modern, industrialized nations. Time for publically funded elections.

lieberman $12.6M, mcconnell $7.8M, baucus $7.7M, cornyn $6.7M,
kyl $5.6M, grassley $5.4M, ensign $5.2M, conrad $5.1M, cantor $4.9M,
nelson $4.9M, burr $4.8M, boehner $4.4M, hatch $4.4M, lincoln $4.1M,
vitter $3.9M, carper $3.6M were paid by the Medical Industrial Complex to kill Health Care Reform. (Source: OpenSecrets.org, Aug. 09)

Follow the Money: Link

Call Congress and demand, Single-Payer Health Care for All!

(Toll Free # House and Senate)
1-866-338-1015 _____ 1-866-220-0044
1-800-473-6711 _____ 1-866-311-3405

Sign Single-Payer Petitions: Link Link

Don’t let the Medical Industrial Complex steal your Health Care from you and your family by donating huge sums of money to Crooked Politicians in order to maintain the Status Quo. Keep up the good fight.

SEMPER FI!

first, the insurance company claims the treatment is not needed.

HR 3200 puts the decision of “medically necessary” back in the hands of your doctor and not the insurance industry.

again, where’s the bill’s language for this? i am happy to be corrected, but you’ve got provide the evidence.

second, the ritter children did get the medication they needed but the cost contributed to bankrupting the family. access to the po, which the family would have to pay for, does not necessarily change that.

…..

i’m really interested in the first point. which of the bills now in play actually have language preventing (”outlawing”) the insurance companies from participating in decisions on what is medically necessary and leaving it up to the family’s doctors. it’s not the po that matters for this issue, so long as there are private insurance companies involved, it’s the regulation. if that regulation is in the bills, it would be a very good thing and i’d be happy to know it.

I’ll see if I can find the language, it’s a long bill! :)

second, the ritter children did get the medication they needed but the cost contributed to bankrupting the family. access to the po, which the family would have to pay for, does not necessarily change that.

That’s not exactly how it happened. CIGNA refused to cover the medication because it “wasn’t medically necessary,” so the only way for them to get it was to pay for it themselves. Yes, they got the medication, by paying for it themselves. Anyone can get any care they want if they pay for it themselves. When insurers deny care, you can still go buy it if you want. It’s just that this cost is impossible for families to bear.

Access to the PO would change that, because chronic conditions would be covered by the PO and by all plans in the Exchange.

But Jason, doesn’t that depend on what restrictions there are on the use of the PO. Under what conditions would Tracie Ritter’s family be eligible and which current bill allows such eligibility?

There’s something wrong with capitalism when there’s no free market. The health insurance industry has managed to escape the free market. That’s why capitalism can provide no coherent justification for its continued existence/

See the quote from my above comment:

It also guarantees coverage of chronic conditions in the Exchange, which would do two things for Stacie. First, the Exchange plans would become the de-facto industry standard for benefits in the country. Business purchasing insurance outside of the Exchange would find it much easier to negotiate for the “standard benefits package” and insurance companies would be more willing to provide it. Second, if your employer didn’t offer the standard, you can always opt out of our employer based insurance and enter the Exchange as individuals, meaning Stacie would get the benefits she needed even if competitive pressure didn’t work.

I’ll see if I can find the language, it’s a long bill! :)

thank you. please take your time, i understand re the length (and complexity) of the bill. much appreciated.

Anyone can get any care they want if they pay for it themselves. When insurers deny care, you can still go buy it if you want. It’s just that this cost is impossible for families to bear.

right. my point is only that even if they have access to the exchange, if the cost of the po is more than (or similar to) the cost of the meds, it wouldn’t necessarily change the outcome, which in this case was bankruptcy.

Sorry Jason, Are you sure you answered Mary’s question?

see my comment @39, i think jason was confused between denial of insurance due to pre-existing conditions and denial of care due to the insurance company claiming it wasn’t medically necessary (or some other rational they like to dream up).

Thanks, selise.

I remember that post of Alank’s quite well. In fact, I made the first comment on it. However, we still don’t know where, in the end, HCAN will come out because I think it’s already demonstrated that it believes in the idea that “consistency is the hobgoblin of small minds.” So I wouldn’t expect it to hew to what it said previously if Rahm asks it to move.

I agree, Mary. When we get up to 45,000 per year and then ask how many have died since the failure of the Clinton reform in 1993, we may be talking about more than 500,000 fatalities since that time. That doesn’t compare with the WWII holocaust in Europe, nevertheless, it is quite a mass killing and the word “holocaust,” or at least the idea of “mass murder by spreadsheet,” seems to fit well enough.

Well, perhaps. But you’d be getting an entire insurance plan for that cost, not just these meds, and your expenses would be capped, so I’m pretty sure it would work out in your favor.

Still, it’s a great point, if things aren’t affordable all the way around, the PO doesn’t mean much. Which is why affordability is another one of our principles…

Sorry, yes, all insurance would no longer be able to deny care for pre-existing conditions, or charge you more if you’re sick or a woman or that kind of thing.

Well…seeing as Rahm already pressured and we didn’t move, perhaps you may be wrong.

Jason, there’s nothing wrong with HCAN’s principles; but how about the legislation (HR 3200) you’re supporting? Is it consistent with your principles?

Jason, I’ll await the language you’re referring to with great interest. One great thing about HR is that it’s easy to find critical language in a document that’s only 30 pp. in length.

Jason, where is the language in HR 3200 that says they can’t charge you more?

Perhaps. I hope so. But I continue to wonder about that for two reasons. First, HCAN’s support for HR 3200 is already a retreat from its principles and second, your reply including the word “perhaps” suggests that you’re not sure yourself that further movement by HCAN won’t occur.

Don’t know the language in the bill, but the fact sheet on the bill is pretty clear:

http://edlabor.house.gov/docum…..071409.pdf

That, of course, is your opinion. We disagree.

As for the wording, I was being cute.

Just another CIGNA story (among millions, I’m sure). My son, who graduated college but doesn’t earn enough to move out yet, has sleep apnea. Last year his doctor sent him to a sleep lab where he was fitted with a CPAP machine at the low, low cost of $700 deductible. In the past year, he has lost over 40 pounds, started exercising, quit smoking, and now needs his CPAP machine settings adjusted. CIGNA will pay for the doctor’s visit (after co-pay, of course) but not the sleep lab ($2500) that determines what the new settings should be. How messed up is that?? I thought the insurance company would WANT him healthy — I was wrong, they only want his premiums…

Enjoy your new house, Mr. Hanway. I hope your next one is in Hell — you’ve certainly earned it.

Selise is right; Jason is wrong.

1. This was a medical-necessity denial, not a preexisting condition denial.

2. The Ritters had private employer-based insurance. Under HR 3200, unless the employer was very small, they would have been compelled to keep that insurance at least until 2015.

3. Under HR 3200, a private insurer would have the same right to challenge the medical necessity of a prescribed treatment that CIGNA has now. The family could appeal. As now. HR 3200 scopes out appeal structures; it does not state that private insurers have to fund all treatments a doctor calls necessary.

4. According to the Democracy Now interview with Stacy Ritter, CIGNA’s endocrinologists said that lab tests did not show definitive evidence of growth hormone deficiency. None of us here knows if they were wrong. I wouldn’t cavalierly call them liars without evidence. The Ritters’ endocrinologist withheld the hormone treatment until he saw evidence of delayed growth. That’s a clinical judgment call, not hard science. Moreover, and possibly more importantly, the FDA labeling for human growth hormone warns that using it following cancer treatment could hasten or exacerbate cancer recurrence.

5. So we’re not talking about clear-cut chronic condition that HR 3200 would have compelled an insurer to cover. This ain’t type 1 diabetes. CIGNA had at least a plausible argument. Possibly even the right one.

6. We in fact have no way of knowing whether a public plan – whether under HR 3200, SCHIP, or even my beloved HR 676 – would have covered this treatment either.

7. And Jason, unless you can cite actual evidence to the contrary, I do not believe that the caps on out-of-pocket expenses under HR 3200 apply to treatments adjudicated as unnecessary.

8. The difference is that a private plan, even under HR 3200, experiences fiduciary pressure to seek out medical-necessity reasons to deny. So we have reason to suspect, but cannot prove without more evidence, that CIGNA had its thumb on the scales in the Ritter case. Competition from a public option plan, by the way, could conceivably even worsen such pressure, by compelling the private plans on the Exchange to look even harder for plausible medical-necessity rationales to preserve profits from their reduced premiums.

9. The only kind of system we can trust to make the fairest possible judgment in a case like this is one where the profit motive has been expunged. Australian, Swiss, German, Singaporean, Danish, Japanese…pick your flavor. But not the American system as it exists now, nor a hybrid system where the profit motive persists.

I disagree. There’s something very wrong with capitalism. It rewards our basest impulses and competition is much less efficient than cooperation. The idea that one of us can by accumulation of money prove himself “better” is insane. We die which makes all of us human. The standards by which we judge ourselves, we make ourselves and they are stupid.

The problem with that is this -

1) You are targeting the low paid employees with your signage and while that can be effective, you can also be told to leave and arrested for trespassing, not that it should stop you.

2) The real target as just with the illegal drug trade is go directly to the top. Targeting the insurance companies and making them the villains works best I believe. Nobody really likes “Greed” not at the expense of others anyway.

One way we could really make the movement heard is to cancel your health insurance even if its provided by you employer, you can refuse it.

This is the same as if your really upset about fuel prices, don’t drive for a week, two weeks or month, take public transportation, but see those types of “radical” things never happen because we are generally selfish and we then personalize actions that should be taken.

Big Business only feels the bite of loosing money, otherwise they just don’t care. Why do you think when bad pub hits them, they reverse ship? That is potential money lost with the imagine of “wrong doing”. Stacy Ritter with going public with her story might get coverage from Cigna.

Is that the solution to our problem?

We shouldn’t have to shine light on shady business dealings for them to do the right thing. They clearly aren’t going to do the right thing, you have to force them to do it.

But since up to this point our Government is not interested in forcing the insurance companies to do what they are SUPPOSE to do (and also Banks by the way) you have to take the legs from under them and force the Government to give us Universal Care. TR said and I vaguely remembered “ArnoldCare”, from the Republican Govenator. The insurance companies even shot that down.

So what choices do we have?

You really want to put the hurt to the insurance industry, then just STOP PAYING THEM, PERIOD.

I’m not paying; I can’t afford it for one thing and my company offers it. The system isn’t far and isn’t just, this is apart of pulling this country kicking and screaming into doing the social justice we should have FINISHED 50 years ago.

It is pretty clear, but we both know that the devil is in the details here. Wonder why the fact sheet on the bill doesn’t have references to sections to help us find our way through this nearly 1100 page bill.

Why are you protecting the Insurance Companies? How many instances of FRAUD happen that they catch?

I’m pretty sure they turn down more people for coverage because its too expensive or they filled out the wrong form or some other stupid reason than people trying to make fraudulent claims.

The Ritters seem like a normal middle, middle class family with sick children they don’t qualify for S-Chip otherwise they wouldn’t be protesting…

I guess your saying Stacy Ritter is a shill for the HR676/Public Option movement?

HR3200 – A bill for the people 1100 pages long

The Bailout of the Financial Services Industry, not to mention the FDIC’s takeover of over 900 banks since the “almost crash” – 3 pages and no questions…

So just who runs this country? I think the answer is pretty clear…

So was I. :-)

cheewizz, are you telling Mr. Hanway to “drop dead?” Perhaps you should apologize on the floor of Congress? -:)

You can probably get that from the section by section summary, but I haven’t checked myself.

thanks for the clarification and explanation. profit motive is expect to be a thumb on the scale. so any system without profit motive (single payer, utility level regulation with non profit insurance) is expected to be the fairer than what we have now (and fairer than proposed hybrid).

Hi Ralph, it was great meeting you yesterday. Hope you had a good trip home. mm, Bonnie and I missed you at Dinner last night.

Thanks for a great comment on this exchange. Why do you think HR 676 wouldn’t cover the treatment?

lol! djfourmoney, ralphbon is a supporter of hr 676. he/she wants to get rid of health insurance companies. we were just doing some innocent policy analysis. that is all.

djfourmoney, I recommend you read some of ralphbon’s blogs. He’s one of our best Medicare for All folks, and he’s in no way protecting the insurance companies in this comment.

Me too. And it ain’t us. We need to take back America.

Not only that. Ralph drove 10 hours yesterday for the privilege of joining in the Mad As Hell Doctors Event here in DC. One of the speakers was Dennis Kucinich.

Btw, here’s a diary attempting to compile a list of Firedog Lake participants who support Medicare for All. If it’s OK, I’ll put you on the next version of the list.

Great pleasure meeting and rallying with you, Bonnie, and montanamaven. I’ve held off blogging about the rally because I think MM got better pix, plus some video. But it was a great demo and fun yelling at the White House with the Mad-as-Hell docs.

Thanks selise, and I think I’m out of the closet as a he.

Hi. In case I wasn’t clear enough, I consider the Ritter case an argument for single payer precisely because this appears to be a gray-area medical decision about a costly and controversial treatment.

If an insurer challenges the medical necessity of such a treatment, you want to make sure that challenge is not influenced by the profit motive. The only way you can do that is with a public or truly nonprofit insurance plan.

That said, it’s very possible that if all the facts were fairly assessed, a public insurance plan might reach the same conclusion as CIGNA. Growth hormone treatment is a pricey non-life-saving therapy that many experts believe is overprescribed. And using it to counteract pituitary damage from radiation treatment requires particular caution and judgment, to ensure that the hormone is not increasing the risk of cancer relapse.

Growth hormone therapy is precisely the kind of medical expense that we need any health care financing system to review critically. Jason exaggerates the degree to which HR 3200 would shield that review from the profit motive.

Hi, Joe. Re your question, see my comment at 98.