Archive for the ‘health insurance weasels’ Category


Well, the cat’s out of the bag. By a 5-4 vote the SCOTUS largely upheld Obamacare, including the mandate to purchase private insurance.

Consider this an open thread to post your thoughts on both the bill, the case, and the odd political meaning behind Chief Justice Roberts’ being the swing vote. There are stories all over the web as everybody is casting this story in some way to support their take on health care and politics.

What do I have to say? Well, it’s no secret I’ve hated the individual mandate to purchase private insurance. In fact, I’ve equated it with just another step in the fascistization of America. You can read what I had to say about Obamacare almost 3 years ago, pointing to the IRS tax as being its saving grace, as Chief Justice Roberts just ruled. But my opinion is  not the important one today, and I have accepted that there is some good in the bill. Inevitably, though, I come back to hating to have to swallow Baucus’ bitter pill in order to get the meager reforms that currently enjoy popularity.

While I’ve been committed to single payer from the get-go, there are still some avenues in Obamacare that offer some interesting alternative approaches to health care insurance, particularly the cooperative model, which is being aggressively pursued in Montana.

Have away!

most of us now realize that max’s plan didn’t work out very well, did it?!

by problembear

the next citizens initiative i would like to see in the 2012 election cycle is for: Montana Public Option health care insurance. check this site out and let’s get the ball rolling here:

first order of business:

we should start drafting legislation that will enable employers of this state to pool their health insurance premiums into a public option insurance policy that actually uses the money for paying for health care for the insured rather than simply create more profits for private health insurance companies who are raising our rates and increasing our deductibles with impunity since max baucus’s gift to his friends in the health insurance lobby.

montana could enact legislation to develop a public option health insurance program which would:

  • lower most insurance rates by 33%
  • guarantee coverage for all insured who opt in
  • provide stability to employers tired of searching for decent HC plans
  • attract businesses to MT who want our plan for their employees.
  • increase participation of all health care providers who want in.
  • bring costs back in line with benefits for both insured and vendors
  • take away the uncertainty of dealing with private insurers.
  • make private insurers who do business in montana more competitive

now who can argue with that?

(besides max and his friends, i mean.)

By Duganz

I have a thing for wine. It’s not that I have good taste, because I cannot tell you the difference in grape by region or picking; I cannot describe wine by its “subtle hints of mint and apple.” No.  The thing I have for wine is that it gets me drunk.

Thus I found myself in Liquid Planet on an otherwise normal Sunday morning – before the rush – buying several bottles of wine––among them a plaintive white that upon finishing this evening I threw from my deck. When I sober up I will of course seek the remnants of the label and tell you its name, because I think it tasted okay, and it went down rather well. Continue Reading »

by JC

For those of you who are following the vote in the House on health care reform instead of watching March Madness, consider this an open thread.

boehner & McConnell

Since it cost a lot to win
and even more to lose
You and me bound to spend some time
wondring what to choose

And for a treat, check out the Grateful Dead video and full lyrics, Knickerbocker Arena, March 28th, 1993…
Continue Reading »

by jhwygirl

I wrote here just the other day of what many view as the galling move by WellPoint to increase health insurance rates of 34 million people across 8 states.

That increase will help increase profits by an estimated 7% for this year. This, from a company that made $4.7 billion in profit off of $60 billion in sales.

Stop, take a breath and read that again.

Not gonna happen here? Blue Cross Blue Shield of Montana controls 75% of Montana’s health insurance market share. And now here comes The Missoula Independent reporting that Blue Cross Blue Shield of Montana has recently sent out notices of rate increases, as high as 43%.

Apparently this is an anomaly that perhaps we shouldn’t be worried about:

Tim Warner, the company’s senior director of external affairs, says most rate hikes this year fall between 10 and 20 percent, on par with recent years.

Make sure you read that last paragraph with a heavy dose of sarcasm, folks.

Make sure to read that Indy link – Blue Cross Blue Shield of Montana put out a notice on February 10th telling its customers that their health insurance rates (not their cable costs, or their internet costs – all things that people can really do without) would be going up by as much as 43% on April 1st.

State auditor’s office spokesperson Jackie Boyle said that while they lack any authority to crack down on the rate increases, “anybody who has bought into a health insurance product from our company and there’s a premium increase that high, they really should…contact us so we can work with them to see if there’s a better solution.”

The Indy’s Matthew Frank is looking for Montanans that have gotten these rate increase letters. If you can help him out with that, check out that post and give him a holla. This story deserves thorough investigative coverage.

I haven’t given up on expecting some real reform. After last week’s WellPoint showdown in the Senate, with the rate increases meeting press release on the eve of this past week’s bi-partisan health reform summit, patience is wearing pretty thin with those that know something has to be done.

Think me crazy if you will, but these reckless increases by health insurance corporations only serve to make me renew my calls for a public option. Here in Montana, there is no competition, and competition is key to affordability.

Think about this, readers: If Blue Cross Blue Shield of Montana just put out notices raising rates as high as 45% – and it is (fact) the state’s largest insurer – it makes sense that other minor insurers will be following.

Think about what that means – because every single taxpayer in this state – whether you have health insurance or not, whether you obtain it from your employer or whether you obtain it on the free market – all of you should be expecting another larger bill here sometimes in the future. That’s because as a taxpayer, you not only have your very own health insurance that you either pay for or you don’t, you are paying for all sorts of local, state and federal employee’s health insurance.

And they are pulling out of the same market (or lack thereof, as is the case here in Montana) as everyone else.

Expect that bill in the mail sometime before the next legislative session. At some point, the insurers start negotiation with the state. Probably Department of Administration. Will the state negotiate any impending 45% rate increase? Rates that have – by their own admittance as linked to above – normally increased between 10 and 20% annually over the last decade?

Seriously – imagine your heating costs or your mortgage or rent going up by 10 to 20% annually. Those kind of increases – let’s take gasoline as an example – strap this nation and bring it to its knees. Yet Montana Blue Cross Blue Shield puts that out there very matter-of-factually. That that’s OK…and here we are standing around debating the need for health reform.

The status quo is not acceptable when it comes to healthcare in this nation.

I hope I’ve sufficiently fired you up. Remember some main points: WellPoint, Blue Cross Blue Shield of Montana and 45%. Now fire off an email, ever how brief, telling Sen. Tester, Sen. Baucus, and Rep. Denny Rehberg that you want real meaningful reform…and remind them (by mentioning WellPoint, Blue Cross Blue Shield Montana and that 45% figure) that you are watching.

Silence, in this case, is not golden.

by jhwygirl

You simply couldn’t even write this into a movie, unless it was some sort of sick comedy. No one would believe it.

Against the backdrop of a renewed call for health reform WellPoint/Anthem Blue Cross, based in Indiana, and a provider of health insurance in 14 states with 34 million customers – 8 million of them in California alone – has announced significant rate increases across 8 states.

WellPoint/Anthem Blue Cross earned $4.7 billion on $60 billion in sales last year.

The announced planned rate hikes as high as 39 percent in California and 34 percent in Indiana. Internal memos project an addition 7% profit in 2010 as a result of this newest rate increase.

What else do they show?:

WellPoint Inc.’s internal documents show the health insurer sought to raise rates in California to boost company profits and cover costs ballooned by executive salaries and corporate retreats, U.S. Rep. Henry Waxman said.

Gutsy, huh?

Congress wasn’t too happy.

How much has WellPoint spend on lobbying?:

The largest spender among the insurance companies though was Wellpoint. Headquartered in Indianapolis, Ind., the company spent about 4.7 million in 2009 on lobbying, 21 percent more than its K Street expenditures in 2008.

They also acquired a larger share of the California market (translate: decreased competition) by purchase of Blue Cross of California – by having its very own consumers pay for it in the form of higher premiums – and have continued, now, to increase profits at the cost of cutting services and raising rates. Not only that, they continue to siphon billions off of Blue Cross CA to other Anthem subsidiaries for “unspecified services.”

A White House report on Feb. 18 highlighted additional health premium increases last year in other places like Michigan, Connecticut and Maine that it said were five to 10 times higher than the growth rate in national health spending. Health and Human Services Secretary Kathleen Sebelius said WellPoint, UnitedHealth Group Inc., Aetna Inc., Cigna Corp. and Humana Inc., the top U.S. health plans, were trying to preserve executive pay and profits “way over anybody’s estimates.”

There’s a group out there working on 1,000,000 calls to congress between today and tomorrow. If you aren’t incline to do that, maybe take a couple of links in this article and send it Baucus’, Tester’s and Rehberg’s way. Let ’em know your watching.

I will say – sometimes it can be fun to get a staffer up on the phone. Especially Rehberg’s, because you know they love taking calls on health reform.

Do remember – Always be nice.


by problembear

the first time i met susan i was helping to bag up some groceries for her and her two children at a food bank in a small town in montana. there was sleet and ice piling up on the street outside and you could see the ice rime building on the corners of the big front window as a north wind blew straight at us direct from canada. susan asked me if we had any milk left.

it was late in the afternoon and the volunteers had loaded the shelves with food early in the morning but even with a strict allottment of only 1/2 gallon per family, we had run out. i found some dry milk packets that had been overlooked on our boxing and bagging shelves. some of the volunteers who are more experienced at this than me sometimes hide a secret stash for these emergencies and i was grateful to find it  for her. susan seemed very tired and a little lost in her thoughts. she was very appreciative, but a little shy, which is not unusual for first time food bank clients. i asked her how far she was traveling and she told me it was a ranch about 40 miles away in a pretty dangerous white out zone. i asked her how the roads are and susan said they were ok this morning but she was worried about the last two mile stretch to the house where a northern wind sometimes can drift families in for days.

i helped her load the groceries in the back of her pickup and she thanked me and i walked inside. i started to turn out the lights and i noticed she was still parked there a few minutes later. i unlocked the door to go outside again to see if something was wrong but i could see the tailpipe was trailing exhaust and the kids seemed ok in their car seats. then i noticed she was slumped slightly over the wheel dabbing at her eyes with a handkerchief.  we have talked many times since but this time i did not intrude on the private grief of a young widow who seemed to require the privacy of her pickup to finally let go of her stoic courage for just an instant. after a few seconds she jammed the truck into gear and drove off through the storm….it seemed to me to be the very picture of what real courage is all about in this sometimes entirely too nonchalant world.

after a few more visits i got up the courage to break through and i asked her how many head they raised and susan said they once had about 1800, but they had to sell the stock last year to pay the hospital bill for her husband jim, who suffered a cerebral hemorrhage  during the hottest part of last summer. one of the hands found jim slumped over in the tractor. they called life flight out of billings and the paramedics got a steady pulse back with all his vital signs looking ok before they reached the hospital. susan was hopeful because jim seemed to be responding to her when she grabbed his hand in the emergency room. they whisked jim away immediately and the surgery lasted 6 hours. jim never regained consciousness and he passed away about a month later after several last ditch expensive attempts to bring him out of his coma failed.

susan’s family had always used aetna, but a friend in the insurance business had recently talked them into switching to a high deductible plan from a well known montana provider to save some money out of their tight budget. their premiums were lowered from 763.97 per month for the four of them down to 698.34. the deductible was 10,000.00 but susan and jim always figured they could come up with that much if they really needed to. the plan was in effect for about 5 months when jim had the stroke.

the day after the funeral in september, bills began to show up in susan’s mailbox from the helicopter flight. denial of payment because a closer hospital ( in plan) was not used. of course, the hospital which jim was flown to had the best reputation for dealing with his problem, so the flight crew chose the better place to bring him. this logic had no effect whatsoever on the decision to deny coverage.

then bills from the (out of plan) hospital arrived unpaid and denied also. seems that the insurance susan and jim had paid almost 700 /month was actually proving to be worthless. well, not quite. there was one doctor which they did approve for the surgery. his bill came to 9756.49 which conveniently just about matches exactly how much susan had to pay as the co-payment on the deductible. virtually everything was denied. a life insurance policy of 150,000.00 barely paid the helicopter and the first surgery bills. susan called the stock auctioneer last october and had him liquidate the herd which paid about half of the rest of the bills. susan hired an attorney to fight the insurance company but the HMO’s attorneys have tied up everything on appeals and she can no longer afford to pay her attorney fees so the case is in limbo until she can come up with another 1800.00 to start the process again. her case is not unusual. she knows that, but with two kids to raise and a ranch to pay for and mounting debts susan was still feeling quite distraught. she has put the ranch up for sale, but the broker told her that the price of land is so depressed right now she would probably not even clear the mortgage much less put a dent in the rest of the bills she owes, including the 67,892.00 balance still owing to the hospital.

susan and jim always paid their bills on time and she still wants to pay everyone she owes. susan is still very proud that way.

to make ends meet now susan is on food stamps and must rely on government ssi checks and occasional food bank visits to survive. the place is lonely and the drive back home is even lonelier. even now, when the summer is hot and most of the place is now leased out to the neighbors to grow alfalfa, susan sometimes wishes she could somehow hang on because jim loved that place so much. it was in his family for 104 years this year, she tells me.

she takes a handful of dirt and crumbles it in her hand. the wind carries the dirt away.she looks up at me with tears welling in that rancher montana tough blue set of eyes and declares….

“it is just so disheartening to do all the right things and be treated this way.”


by problembear

1. are you just telling us what we want to hear or are you telling us the truth when you tell us you want a public option too?

2. that’s nice that you want a public option too, but when are you going to start working for it?

baucussponsorjackethey max- i hate to tear you away from your sponsors but……………


by problembear

by problembear

a few months ago i began to develop an inspector dreyfuss twitch in my left eye every time someone mentioned the very name of max baucus…..his bumbling and stumbling on health care reform has been infuriating….then about a month ago it began to look like obama was going to take control and some meaningful health care reform appeared to be on track….now baucus has managed to delay his committee’s assignment so long that meaningful health care reform appears to be in jeopardy again. DENY, DELAY, DISPUTE. these are the triple D’s of the health insurance industry.

health insurance companies are very adept at this kind of tactic. have you ever been denied payment by your health insurer while they conducted “a review of your policy” or just plain out and out denied payment for any number of corporate bureaucratic reasons complete with medical insurer’s code words and byzantine numbers that mean nothing to anyone except a handful of accountants buried deep beneath the ground in their bunker at ground zero of the “optimizing profitability department”?  the insurance adjusters try to make your claim go away by denying, delaying decisions and disputing claims. it works an astounding amount of the time and the success rate increases commensurate with the age of the client who is denied. they use these tactics surrounded by attorney’s and physicians who are paid off to give an opinion guaranteed to “optimize profit” for the corporation. they hope to wear you down until you just say to hell with it and pay  it out of your pocket because you are tired of dealing with it.

max baucus and the health insurance industry is using the same tactic in wearing down the will of the american public. they hope we will go away and forget all about health care reform because we are tired of dealing with it……

that is why my eye is twitching and i laugh hysterically these days…….hhmmmm…hmmmm….hmm….hmm…hmm…

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