Health Care War! THE DUMB against the SMART
(also, how to fight your HMO and WIN!)
JUST HOW DUMB ARE THE PEOPLE WHO BELIEVE THE HMO's CLAIMS,
the Bad P.R. HMO 'agents' give to socialized medicine? PRETTY DUMB!!
LOOK CAREFULLY at PICTURE BELOW!
They sure don't understand public health issues if they can't
EVEN SPELL the word 'PUBLIC'! ANTI REFORM FOLKS ARE DUMB!
YOU CAN'T FIX DUMB!
What you're witnessing in the U.S. today is not a health care debate. It's a health care WAR. Between the DUMMIES who believe the claims of the HMO's (who are raking in the bucks by sidestepping & totally avoiding your health needs while charging top buck for premiums) standing behind a GOVERNMENT that gives no healthcare to the exploited workers yet allowing it to continue TWO GENOCIDAL wars against 3rd world civilians. Note they CALL HEALTH REFORM A BAD IDEA CITING 'lines' in Canada & the UK?? Hey, when you have a huge cancerous tumor you will read a mystery and wait in a frigging line!
THESE DUMB NUTS are FIGHTING the Smarties who want excellent & affordable health care out of elitist doctors, who want up and running E.R's, superb clinics and open door hospitals as well as PREVENTITIVE CARE and nutrition thru food stamps all of which would save health system megabucks and they want it right now! They feel they deserve it as they are this nation's WORKERS and have been shafted every which way on housing loans, salaries, by licensing, fees, penalties, the cruel law against bankruptcy, joblessness, the bankster Tsunami Meltdown experience, ridiculously high tuiton at public colleges and trade techs, horrendous student loans they can never escape, parking fees outside those colleges. They want health care for everybody accomplished very simply by our GOV NOT SPENDING TEN TRILLION A YEAR ON A DUMB OIL PIRACY WAR killing civilians in third world huts!
Some reasonable, MIDDLE GROUND FOLKS (also dummies let's face it,) say that it's too soon to take sides. Only say that as they can't figure out which end is up. No rational tools. What they're admitting also is that they are people of SCANT CONVICTION, NO FEIST, no FIRE, so dumb they can't count or are they UNAWARE of how the HMO's have SNOOKERED THE AMERICAN PUBLIC? These are idiots who probably are paying a quarter of their income for SOME USURIOUS H.M.O. and whose children will never inherit a dime as Mum and Dad gave it all to THE A.M.A. and last I heard, DOCTORS don't need bailing out, they make huge salaries! Live in mansions. Drive Rolls Royces and go to EUROPE several times a year!
Funny how a handful of doctors can hold off 330 million people, huh? Neither side has defined its territory; both are escalating the battle with weapons of mass disgrace, slandering the other side but the DOCTORS have the big money to pay PUBLIC RELATIONS FIRMS to TILT PUBIC OPINION which they have done! See the foaming crowd of idiots above if you don't think so!
Now. Be certain of this. The big lucrative hospitals, HMO's and the AMA are fighting ANYbody who's encroaching on their massive profits. You're going for their DICK when you go for their MONEY. They scream at outraged workers who just want health care. They laugh at the fact that we believe that we can or SHOULD be able to get a hospital room for 70$ a day which is what it cost in 1969, (CITING MICHAEL CRICHTON's FIVE PATIENTS, a great book to read on this subject.) and not cost you $1500 a day per room like it does, everywhere, today. "REASONABLE hospital stays? Dream on!" The HMO AMA OCTUPUS challenges us brazenly: "We price ourselves so that we have Rolls Royces and you don't! You think you can get a doctor that comes with the room for under five grand a day? ? He costs ten times what the room costs. GET USED TO IT!"
My OCTUPUS TENTACLES will not be released. The dial
is set HERE at $tens of thousands and we're not turning it back!
In the meantime, inbetween time, millions of Americans are potentially innocent victims of the collateral damage both financially and physically. Read THE AVERAGE HMO USER's COMPLAINT HERE. But if you're among those upset at the Obama administration for trying to ram through a health reform bill, wait till you see what most health insurance companies are doing and have been doing for many years! They routinely overcharge you on premiums when you're healthy and deny your claims when you're sick. They welcome your policy when you don't need it and shred it when you do.
Adding financial insult to personal injury, they take the savings you've
worked so hard to earn and throw it into high-risk investments you'd
never touch with a ten-foot pole.
My 20-Year Battle With Insurance Companies
In a moment, I'll show you exactly how egregious their abuses can be;
name some of the worst and best; plus give you some simple tips on what
you can do.
But first, let me tell you about my own battles with health insurers,
starting in 1989 when Weiss Research began rating them.
At the time, several large life, health, and annuity companies had
loaded up with junk bonds, including Executive Life, Fidelity Bankers
Life, and especially First Capital Life.
That's the main reason I gave First Capital Life a D? rating ("weak"),
and I felt that was actually generous. It probably deserved an even
But within days of my widely publicized warnings on the company, several
of the company's lawyers and executives flew down to the Weiss Research
offices in Florida.
With their two Mercedes parked outside the door, they swore that if I
didn't give them a better rating, they'd slap me with a massive lawsuit
and put me out of business. "All the established ratings agencies give
us high grades," they said. "Who the hell do you think you are?"
I politely explained that I never let personal threats affect my
ratings. And unlike other rating agencies, we didn't accept a dime from
the companies. "I work for individuals," I said, "not big corporations.
Besides," I continued, opening up the company's most recent quarterly
report, "your own financial statements prove your company is in
That's when one of them delivered the ultimate threat: "Weiss better
shut the @!%# up," he whispered to my associate, "or get a bodyguard."
I did neither. To the contrary, I intensified my warnings. And within
weeks, the company went belly-up, still boasting high ratings from
established rating agencies on the very day it failed. In fact, A.M.
Best, the nation's leading insurance rating agency, didn't downgrade
First Capital Life to a warning level until five days after it failed.
(Click here for the evidence.)
It was a grisly sight ? not just for policyholders, but for shareholders
as well: The company's stock crashed 99 percent, crucifying millions of
unwitting investors. Then the stock died, wiped off the face of the
Earth. Two of the company's closest competitors also bit the dust.
Consequently, unwitting investors ? who did not have access to Weiss
Research's ratings ? lost $4 billion, $4.5 billion, and $13 billion,
Fortunately, those who had seen our ratings were ready. We warned them
long before these companies went under. No one who heeded our warnings
lost a cent.
In fact, the contrast between anyone who relied on Weiss Research and
anyone who didn't was so stark, even the U.S. Congress couldn't help but
notice. They asked: How was it possible for a small firm in Florida to
identify companies that were about to fail, when Wall Street told us
they were still "superior" or "excellent" right up to the day they
To find an answer, Congress asked the executives of all the major
agencies ? Standard & Poor's, Moody's, A. M. Best, Duff & Phelps (now
Fitch), and Weiss Research ? to testify. But I was the only one among
them who showed up at the hearings.
That's when Congress asked its auditing arm, the U.S. Government
Accountability Office (GAO), to conduct a detailed study on the major
ratings agencies, including Weiss Research. And after extensive review,
the GAO finally published its conclusions in 1994:
Weiss Research beat its leading competitor, A. M. Best, by a factor of
three to one in forecasting future financial troubles at life and health
For the largest insurers that failed, Weiss Research beat the other
rating agencies ? including Moody's and S&P ? by a factor of five to
Click here for the entire GAO report. Plus, be sure to scroll down
through the report to the paragraphs I have highlighted and to the
comments I've made in the margins.
I Thought This Report Would Help End My Battle With the Insurance
But I couldn't have been more wrong.
The American Council of Life Insurers ? the trade association and
lobbying group representing the larger companies ? had launched a
nationwide campaign to try to discredit my research and my company.
One major health insurer sued me for giving them a bad grade, and it
cost me close to $150,000 in legal fees to defend myself. And
ironically, soon after the GAO issued its 1994 report, another did the
same, this time costing me over $1 million in legal fees.
Worse, in both cases, they said they'd drop the suit immediately if I'd
just give them a better grade or simply remove it from circulation.
"That's what Moody's, S&P, and Best do. Why don't you?" they asked.
I refused to accept their underhanded practices, intimidation, or
threats. And today, I recommend you do the same.
How Americans Are Routinely Bullied, Cheated, And Abused by Their Health
The business battles I fought with insurers are inconsequential in
comparison to the life-and-death struggles fought by millions of
Americans with their insurance companies every day.
All I lost was time and money. In contrast, a young mother with bone
cancer who fought against the same company that sued me lost a lot more:
In a trial after her death, the jury read internal memos that revealed a
sinister plot: To reduce their costs, not only did the company's
executives pursue extreme measures to deny her the treatments that could
have saved her life ... they also discussed the cost benefits of
hastening her demise.
The jurors were so outraged, they awarded her family the largest
punitive damage award in the history of health insurers.
Think these are just isolated cases? Think again!
Here are just a few of the rampant abuses that continue to this day:
Abuse #1 Denial machines ...
Most health insurers spend substantial sums in order to develop computer programs and systems that automatically and repeatedly deny and delay claims payments; hire doctors specialized in poking holes in legitimate claims; and give extra bonuses to employees who can successfully deny the most
claims. In sum, health insurers build massive machines designed with the sole purpose of denying and delaying your claims. READ "THE RAINMAKER" by JOHN GRISHAM and you will be inspired to fight them.
They know that few policyholders will take legal action. Plus, even
though policyholders do win judgments, the companies can earn a lot of
extra income on the funds they hold back with delayed claims payments.
The longer you or your doctor has to wait for reimbursement, the more
income they can make on your money.
And unfortunately, this is not just about a few bad apples in the
industry. According to the National Association of Insurance
Commissioners (NAIC), in 2008 alone, policyholders filed 195,669
complaints against insurance companies. That excludes complaints in many
states which do not compile comparable data and, needless to say, it
also excludes the millions of Americans who do not file a formal
The two most common types of complaints of all: delays and denials.
"All too often," says New York Attorney General Cuomo, "insurers play a
game of deny, delay, and deceive." And, I might add, all too often,
people are bankrupted by the expenses or die waiting for the care.
But it gets worse ...
Abuse #2 After-the-fact policy cancellations ...
Just last Tuesday, the U.S. Department of Health and Human Services
released a study demonstrating that, in most states:
Insurance companies can retroactively cancel individual policies if any
condition was not disclosed when the policy was obtained. More to the
point, insurers can cancel the policies even if the medical condition is
unrelated and even if the person was not aware of the condition at the
time. (Italics are mine.)
Coverage can also be revoked for all members of a family, even if only
one family member failed to disclose a medical condition.
And again, companies institute sophisticated systems and procedures that
maximize the savings with these underhanded tactics, including special
compensations for employees who can deploy them most effectively.
Two major insurers have admitted to Congressional committees that they
automatically investigate the medical records of every policyholder with
certain conditions, including leukemia, ovarian cancer, brain cancer,
and becoming pregnant with twins.
For example, in one case, after a Texas resident was found to have a
lump in her breast, the insurance company investigated her medical
history and concluded that she had been diagnosed previously with
osteoporosis. Although that condition was unrelated to breast cancer,
the company used it as an excuse to cancel her policy.
No, I don't support the notion that underwriting ? the process of
denying coverage or charging higher premiums due to known risks ? is
Quite the contrary, if insurers do NOT protect themselves from those
risks, they may not be financially capable of fulfilling their promises
to all other policyholders. But systematically leveraging contract
loopholes to cancel policies after a condition is diagnosed fails to
pass the most basic of smell tests.
The most insidious abuse of all: Direct interference with medically
recommended procedures ...
"One of our big frustrations with insurance companies," says GOP
Congressman Tim Murphy, "is they control the market place, they control
what's done," and what doctors decide.
Indeed, in 50 out of 300 U.S. metropolitan areas, a single health
insurer controls at least 70 percent of customers. And in many more
areas, just two health insurance companies dominate the market.
That puts both you and your doctor at a great disadvantage.
End result: Your doctor's decisions about what's best for your health
are frequently overruled by the insurer's decisions about what's best
for its bottom line.
Most patients don't realize how widespread this is and how deeply it can
impact the quality of care. Most doctors, meanwhile, are so sick and
tired of insurance company interference, they've given up complaining.
Which Companies Are the Worst Offenders?
For the most part, government officials are loathe to give you straight
answers. But I do. Based on my review of customer complaint data
compiled by key states, here's my partial list:
Some Major Health Insurers and HMOs With The MOST Frequent Customer
Complaints American International Group Atlantis Health Plans, Inc.
Celtic Insurance Company CIGNA Healthcare of NY, Inc. Fortis Group GHI
HMO Select, Inc. Mutual of Omaha Group Oxford Health Plans of NY
Not all insurers routinely resort to bad business practices. In fact,
some bend over backwards to pay claims promptly and avoid customer
Some Major Health Insurers and HMOs With The LEAST Frequent Customer
Complaints CNA Insurance Group Mass Mutual Life Ins. Co. Northwestern
Mutual Sun Life Assurance Company of CN Universal American Financial
UNUMProvident Corp. Group
Our Recommendations TO FIGHT YOUR HMO Are Very Straightforward ...
First and foremost, do everything within reason to avoid the worst
providers and stick with the best. Our lists above are not complete, but
I'm confident in my conclusions for each company cited.
Second, be sure to keep all your medical records and correspondence with
insurers. Superb xeroxes, nothing blurry!
Third, if your insurer tries to stiff you for bills you feel should be
covered, file a formal complaint. Some states let you file your
complaint online. Others require you do it via mail. Either way, do not
let insurance companies get away with behavior that you feel is unfair
or abusive. Go online with your article, make it readable. Send it to every
EZINE with related themes or interests. Publish it on your own website.
See how even a tyro can do their own website. RUN YOUR OWN SITE
Fourth, if you can't get satisfaction, seriously consider legal action.
The good news: Most of the time, plaintiffs with good documentation do win.
found online, written by Martin D. Weiss, Ph.D. but I wrote over it a great deal! Anita Sands.
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