Tuesday, February 26, 2008

Health Net has to pay patient 9 million

http://www.medicalnewstoday.com/articles/98484.php

The California patient whose insurance was stopped for allegedly not giving full information to Health Net has received a nine million dollar award in a decision from an arbitration judge.

The case was a good one: Diagnosed with breast cancer, in the midst of treatment, her policy was rescinded supposedly for not giving full information.

The For-profit insurer was found to have acted in "bad faith" letting its greed get in the way of legitimate business.

Now there are going to be people who complain about awards of this type...after all, her expenses were only in the hundreds of thousands. But this is a good decision. When people are operating with the motivation of greed, money is where it hurts. There is no reeducation of the marketplace that will make corporations act with conscience and responsibility, ethics training is too late. And this is also why those who fear legislation further regulating the health care industry are also mistaken. Here's why. Whether it is defensive medicine that accounts for medical costs that in some other time might not be incurred, or the loopholes in coverage being slipped into multi-page insurance policies, our medical care environment functions at a minimal level, the least that needs to be done in order to justify billing, testing, while cya (covering your a..).

Maturity requires that we say a fond farewell to any notions we have of the kindly country doc taking payment in chickens for saving someone's life. And I truly hope that Hollywood will follow. Whether it's an office visit that lasts seven minutes, or a pile of referral and prescription slips, or an insurance policy that makes people jump through hoops to get the help in paying for medical care they thought they had, the big business of health has lost its focus...HEALTH. The priority has changed to profit and as such, any relationship the consumer has with the health industry must be one as a consumer, a shopper. Because when we are sick our focus is health, we have supported the neglect, tolerance, and defense of an industry that long ago changed its priorities from delivering health care to creating profits for the large segments of the population employed by the industry. Health care is a bureaucracy, just like the government with, if you can imagine it, with even fewer constraints and oversights than the government.

So, while some knee jerk reactors will be fair game for the predictable news blurb...WOMAN GETS 9 MILLION FROM HEALTH INSURANCE COMPANY and will start delivering their automated responses that it is lawyers and "guvment" that have created the problem, in fact it is the insufficiently monitored greed, enabled by laws that permit and lobbyists who gain laws that further the goals of an industry that focuses on PROFIT rather than care.

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