Tuesday, July 21, 2015

Insurance Company Executioners

If a stoned vigilante security guard can't quite succeed in killing a young black man with a shot to the back of the neck, then the predatory insurance cartel will be only too happy to finish the job.

They might as well take out the "protection" part of the Patient Protection and Affordable Care Act (PPACA). Because if you get sick or hurt in the commission, or vicinity, of what the government-subsidized Predatory Insurance Cartel (PIC, as in nit-picky) deems to be "illegal activity," it can and will deny payment of your medical bills. And it's all perfectly legal. PIC is judge, jury and executioner.

Private insurance subscribers can die, for all PIC cares.  If you happen to be employed at a no/low-benefit job, you're black, or you live in a state ( like Oklahoma) that has denied Medicaid expansion for the working poor, it seems like they're basically praying that you die, and die quickly.

The "illegal activity"of Monroe Bird III entailed making out with his girlfriend in the parking lot of his own Tulsa apartment complex last February. When security guard Ricky Leroy Stone approached the couple and demanded ID, the victim allegedly locked the doors and started to back out.  Stone claimed he shot Bird in self-defense through the rear window of the vehicle as the victim was backing up. Bird himself, rendered a quadriplegic from the shooting, had no memory of what occurred, but insisted he'd done nothing wrong.

Stone was never charged, claiming the standard "stand your ground" privileges of white guys who want to shoot black people.  Tulsa District Attorney Steve Kunzweiler, in blaming the victim, said “Mr. Bird might have made choices that might have gone a different way if he had listened to the security guard and obeyed his instructions."

Never mind that blood tests later revealed pseudo-cop Stone to be stoned on marijuana, and that he was not actually a sworn police officer, and that Bird was under no obligation to obey him.  In Oklahoma, apparently, failure to obey a parking lot attendant can get you shot when you're legally parked while black. You made the "wrong choice" of living in an apartment complex guarded by a George Zimmerman clone. Too bad, so sad.

Of course, the story gets even worse
Three months later, as he lay in the hospital hooked to a ventilator, Mr. Bird’s insurance company declined to cover his medical bills. The reason? His injuries resulted from “illegal activity.”
Yet Mr. Bird was not convicted of any crime in connection with the incident. He was not even charged.
Without insurance, Mr. Bird’s family could not move him to a rehabilitation center specializing in spinal cord injuries. He was discharged from the hospital and died at home last month from a preventable complication often seen in paralyzed patients.
The complication was a pulmonary thromboembolism caused by a blood clot in his leg. Blood clots in the extremities are a common condition in paraplegics and quadriplegics. They can be avoided through physical therapy and skilled nursing, either in a rehab facility or through intensive in-home care. Bird was deemed to be deserving of neither. His care was left to his mother and grandmother.

Bird supposedly benefited from the much-touted PPACA clause which allows young people to stay on their parents' insurance plans until age 28. Even so, his family is now left with more than $1 million in unpaid bills. Bird's insurance was through the plan of his stepfather, an employee of the elite and exclusive Southern Hills Country Club, where the application process alone costs members $40,000. You can just imagine how many black people (besides Tiger Woods) play golf there, and how many black people wait on white people there.

According to the New York Times, there are no statistics on how many Americans are denied insurance coverage based on the "illegal activity" clause in many policies. 
Insurers have long relied on allegations of illegal activity to deny coverage to patients injured in a variety of contexts, from traffic infractions to gun accidents. The judicial rationale is that “we don’t want to reward illegal activity,” she said.
In one court case, a union health plan denied the claims of a worker’s son who was injured while allegedly building a pipe bomb, Ms. Patterson (Crystal Patterson of the American Bar Association) noted. In another, an insurer declined to cover the medical expenses of a man who lost control of an uninsured, unregistered car while trying to pass another driver in a no-passing zone.
Courts have upheld the denials even when there were no convictions for illegal activity. The administrator of the policy can deny claims even when no criminal charges are filed, Ms. Patterson said.
Despite the alleged "protections" against denial of care based on pre-existing conditions, the PPACA affords no protections against any and all other forms of predation. You can still be denied coverage if you get sick, should some unelected, unaccountable, anonymous claims adjustor decide you are morally not entitled to it. You can have an insurance card and still be condemned to an unnecessary painful death. 

Black lives matter. Repeal the Stand Your Ground laws. And let's keep pushing for Single Payer health care.


Jay–Ottawa said...

The Monroe Bird case reminds me of a line from “The Lion in Winter,” a smart film from the Sixties. Eleanor of Aquitaine (Catherine Hepburn), sassy as ever, recalls the mortal sin that was the young Henry. There was passion. They took off on a binge, she says without apology, wherein they shattered all God’s commandments at once––or words to that effect.

Back to the Bird case. Look how many commandments of decency have been violated all at once in a land that once was capable of so much more.

There’s America’s special affection for guns in play here. Guns are so plentiful and powerful it’s a wonder anything gets done because they're going off all the time in the hands of the authorized and not-so-authorized to pull the trigger. Got a problem? No problem. Get a gun. The Second Amendment supports your right to something or other, remember that.

The trigger puller in this case was white and the guy who took the hit was black. Where have we seen that before?

Then the drugs, marijuana in the veins of the authority figure this time, not the downtrodden. That’s a little bit of a twist in the War on Drugs, which will only end when both sides run out of drugs and/or bullets.

Next, of course, and the central feature of Karen’s essay: the intricacies of Obamacare, a thicket so dense and twisted, it keeps the poor and the near poor and the about-to-become near poor from reaching medical care in time and in sufficient measure. What wise people, we Americans, to appoint as boss the profit making insurance man over the medical worker.

Here's another side effect of the bitter ACA pill: the extended family of the victim is now in the hole of bankruptcy. Their sobs won’t be as audible down there.

Oh wait, our fine courts will set the whole thing right. Look again. The blindfolded lady holding the scales of justice before the hall of justice? Money kicks her in the ass one more time. There are probably more crimes of injustice committed by our legal system than by the people dragged before the bench of justice.

On closer inspection the Bird case, as a microcosm of America’s ills, might expose still more hypocrisies to the light, but we have enough already to overload a good citizen’s agenda.

Tommybones said...

This is so incredibly disgusting I am at a loss for words. Sorry I can’t add anything more insightful but I just had to express my sorrow that this poor guy had to lose his life for nothing but the insurance industry’s profits. And this is OK with the people who run this country. Ain’t capitalism great!