The Liz Fowler Connection: WellPoint Commits Fraud, Targets Patients For Wrongful Cancellation

Federal investigators have revealed that the largest health insurance company in the country, WellPoint, is using a computer program to identify women with breast cancer. Why? To drop their coverage. Murray Waas, a well-respected investigational journalist, states WellPoint “specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies.” Last month, Waas reported that AIDS patients were being similarly targeted for rescission. That practice has been going on since at least 2002, as is well-evidenced by the unlawful cancellation and subsequent cover-up in the Jerome Mitchell case.

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Doctor: You Promised My Before and After Website Pictures Would be Anonymous

Many aesthetic surgeons place before and after pictures on their websites. Obtain patient’s detailed written permission before moving forward. Check. Place a black strip over identifying features if not highlighting facial features. Check. That’s it. Right? RIGHT?? Wrong. One surgeon learned that a de-identified photo had the patient’s name embedded in file name / properties … Read more

Health Care Reform Bill: Now Comes The Hard Part

It took Congress over a year to compile and construct it. It took creative maneuvers to pass it into law. Already unfounded fears are sticking doctors in the middle of what it means to their patients. Now comes the hard part. The Obama Administration now has to turn 2400 pages of words into changes in Health Care. Here’s the latest on the teams that are supposed to do it:

  • Jay Angoff, consumer advocate, known nemesis of the insurance industry, heads up implementation of the regulation of insurers and insurance markets.
  • Jeanne M. Lambrew comes back with experience from the Clinton administration to work on expanding coverage.
  • Phyllis C. Borzi, a top Labor Department official, is assigned to ensure that employers are following the rules for some 150 million American insured persons.

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Doctors Already Besieged by Questions About the new Health Care Laws

Though they wouldn’t have time to read the 2400 pages that are in it, though they had no real say in its contents and may even have been opposed to it, physicians all over the country are finding themselves bogged down by questions about the new health care reform law. Like most people, their patients are afraid of change. Some want to know if they will still be able to see their doctor. Others want to schedule surgeries before they even need them, out of fear that they may not be covered later. All of these questions are reasonable concerns, considering the relative vacuum of information on the practical implications and implementations of the new law. Nevertheless, they’re already starting to bog down some practices.

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Georgia First State to Rebel Against High Risk Pool in Healthcare Reform

The official version is that it’s a budgetary issue – that seems unlikely. John Oxendine, Georgia’s insurance commissioner, a Republican, has his eye on the Governor’s mansion in the upcoming election. The rebellion is cleverly wrung; no patients will lose any benefits nor will it affect the cost of insurance for Georgians. What it does is make a statement; while putting the burden on the Federal government to oversee the distribution of funds to those in need within the state.

Further proof of the real cause of the insubordination is found in Oxendine’s letter to Kathleen Sebelius, U.S. Secretary of Health & Human Services. In that letter, he said that he would not involve Georgia in “a scheme which I believe the Supreme Court will hold to be unconstitutional, leads to the further expansion of the federal government, undermines the financial security of our nation, and potentially commits the State of Georgia to future financial obligations.” Obviously it wasn’t really about the state’s cost of administering the funds provided by the Federal government. Using the fate of uninsured high-risk citizens as a soapbox for a political statement is transparent. The Republican Primary for Governor is coming up in July. Oxendine hopes to distinguish himself from the field with this move, even though the action changes nothing – amounting to nothing more than token blustering.

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Access Issues; Are Nurse Practitioners The Key To Functional Health Care Reform?

The news is shifting away from health care reform. Speculation is even starting to wind down a bit. Maybe now we can get down to the nuts and bolts, the real practical aspects of healthcare and what the new legislation means for both patients and providers. In a recent discussion between physicians, it was noted that the 32 million people (who are expected to join the ranks of the insured in just under a decade,) are not new patients. They exist right now, get ill and need treatment already. They’re just not getting it in efficient or conventional ways.

That’s a good thing. Our system is already overburdened, so adding 32 million new patients would be untenable, if they were actually new patients. But our country still needs more physicians and more access to health care providers.

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Medical law concept with gavel and stethoscope on desk

Healthcare Bill Lies

President Obama is talking about healthcare reform a lot, pushing hard to win public favor for the bill. Representative Dennis Kucinich is amongst those who have yet to decide how they will vote. He was also present at one of the speaking engagements in which the people yelled out their support, their desire to have health care reform. In a passionate speech, the President cited a 50 year old cancer survivor, Natoma Canfield, and how she could not afford the heath care premiums any more. It was even more pointed that she couldn’t attend herself, because she was lying in a hospital bed again, fighting through chemotherapy after 11 cancer-free years. President Obama emphasized that detractors were lying about losses of coverage via Medicare/Medicaid, etc. And all of that may very well be true. But the President isn’t telling the whole truth either.

The Natoma Canfields of America will find no relief in this bill. It’s very possible that they may not live to see the benefits kick in at all. Though taxes would be raised effective in the current tax year; those 30 million uninsured won’t see any relief for about 9 years. Some aspects may commence sooner, but we’re still talking about something that is going to take 10 years to happen, if we start now.

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Patient’s Bill of Responsibilities: #1 Take Good Care of Yourself

It seems people are always talking about (and demanding) Rights. With Rights, though, come Responsibilities. Here are a few thoughts on how patients can be more responsible for their own well-being.

The single most valuable piece of advice, a refrain echoed time and time again by physicians, is taking proper care of one’s body to avoid problems in the first place. This is something that the individual (and family) must practice, but the government can promote. Our current system rewards getting ill while providing little direct incentive to practice wellness. It costs a lot less to address obesity in a child than to perform a coronary bypass operation. It costs less to prevent smoking (or help a smoker quit that addiction,) than to treat lung cancer, emphysema, and heart problems, premature births and infant deaths (amongst the problems caused by first-hand smoke, let along second-hand smoke.)

Even what we eat makes a profound difference. A finding within The China Study

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