Showing posts with label private insurance. Show all posts
Showing posts with label private insurance. Show all posts

Wednesday, January 20, 2016

Criminalizing the Sick

As Hillary Clinton cynically vows to incrementally build upon the "successes" of the Affordable Care Act, the Obama administration keeps chipping away at them.

The latest chip punishes people who desperately sign up for expensive private health insurance when they get sick or hurt. Such behavior is a rude slap in the face to the free market predators, who are then forced to dip into their obscene profits and pay a portion of your hospital and doctor bills. 

Of course, the way the insurance companies spin it, it's those conniving sick people who are to blame for driving up everybody else's premiums. It's the same old Divide and Conquer ploy that the ruling class has used since time immemorial in an attempt to hide their own greed and malfeasance.

As Barack Obama might explain it, if you "game the system" by waiting until you're at death's door to use your rent and grocery money to pay hefty insurance premiums, you're going to have to pay the piper. You'll have to wait until the next open enrollment period to have your bursting appendix removed.  You might even have to die as prematurely as you would have in those awful days before the health care sweepstakes were instituted. You can't buy a lottery ticket after the drawing, people! You can't put a flat screen TV on your credit card just to watch the Super Bowl, and then expect a full refund when you return it the next day, all full of smudges and fingermarks. 

As the New York Times explains it,
The administration, which had created more than 30 “special enrollment” periods, sent emails to millions of Americans last year urging them to see if they might be eligible to sign up after the annual open enrollment deadline. But, insurers and state officials said, the federal government did little to verify whether late arrivals were eligible.Kevin J. Counihan, the chief executive of the federal insurance marketplace, said Tuesday that special enrollment periods “are not allowed for people who choose to remain uninsured and then decide they need health insurance when they get sick.”
Since the Neoliberal Project has deemed your body to be a commodity which you only partially own, you are expected to behave like a responsible consumer. If you seize up your engine because you didn't oil the capitalistic machinery as directed, don't come crying to Obama when you stall out. If you don't pay through the nose for the pricey undercoating deal, tough luck if your bod gets rusty. Keep yourself polished and gassed up, and pledge your financial allegiance to the underwriters instead of to the undertaker. Above all, keep up those monthly extortion payments, lest you get an unpleasant visit from the WellCare repo man. 
Mr. Counihan said the administration would eliminate six of the special enrollment periods, including two for certain lawfully present noncitizens who experienced “system errors” and “processing delays” when they used HealthCare.gov. In addition, he said the government would clarify eligibility standards and step up enforcement to prevent abuse of special enrollment periods.
The actions appeared to have several purposes: to motivate consumers to sign up by the Jan. 31 deadline; to prevent an influx of large numbers of sick people into the market in the middle of the year; to persuade insurers to enter or stay in the public insurance marketplace; and to minimize rate increases in 2017 and later.
Medical care cuts both ways, said Counihan. The right of protection racketeers to get rich hinges upon the fear cooperation of regular people, who must pay for Medical Care Product in advance. You see, in the most exceptional nation the world has ever known, health care is still not a basic human right. It is a privilege for only the select few with a high enough credit score and bank account balance to qualify for survival.

The new rules mean that not only will people have to go shopping every year for a new insurance plan, they will now have to prove they have a permanent address. People who temporarily move in with relatives (maybe because they lost their job when they got sick) won't qualify for coverage outside the narrow enrollment period. People who get sick or hurt outside their home states will have to jump through hoops to prove that they're not trying to cheat the system. All citizens shall be considered suspects until and unless they can prove their financial and medical innocence:
In a blog post on Tuesday, Mr. Counihan said, “Our program integrity team will pull samples of consumer records nationally and may request additional information from some consumers or take other steps to validate that consumers properly qualified for these special enrollment periods.”
In addition, he said, officials will emphasize to consumers that “they may be subject to penalties under federal law if they intentionally provide false or untrue information.
These are the same pathocratic clowns who profess to be so amazed that Bernie Sanders' Medicare for All campaign is so popular. They seem to be honestly baffled that people aren't in love with Obamacare. Who, except lefty unicorn believers, wouldn't rather pay high premiums and co-pays and deductibles to the for-profit insurance racket and then get treated like a criminal if they show up in the emergency room?

The architects of the Affordable Care Act and the private insurers they serve are now criminalizing and intimidating the sick. Before you know it, newspapers and websites will be adding photo galleries of Obamacare Cheats to supplement their regular poor-shaming features on Food Stamp Grifters and Welfare Queens.

So use your Obamacare card at your own risk. And keep up those monthly payments to Blue Cross. Stay close to the phone in case a government official, acting on behalf of United Healthcare, decides to call you in for an audit. A hospital-to-prison pipeline could be in your future if you don't get sick responsibly.




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.