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Big_Bird
Joined: 31 Jan 2003
Location: Sometimes here sometimes there...
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 Posted: Sun Jul 26, 2009 7:58 pm Post subject: I just don't understand why Americans accept this |
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Whistleblower tells of America's hidden nightmare for its sick poor
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Wendell Potter can remember exactly when he took the first steps on his journey to becoming a whistleblower and turning against one of the most powerful industries in America.
It was July 2007 and Potter, a senior executive at giant US healthcare firm Cigna, was visiting relatives in the poverty-ridden mountain districts of northeast Tennessee. He saw an advert in a local paper for a touring free medical clinic at a fairground just across the state border in Wise County, Virginia.
Potter, who had worked at Cigna for 15 years, decided to check it out. What he saw appalled him. Hundreds of desperate people, most without any medical insurance, descended on the clinic from out of the hills. People queued in long lines to have the most basic medical procedures carried out free of charge. Some had driven more than 200 miles from Georgia. Many were treated in the open air. Potter took pictures of patients lying on trolleys on rain-soaked pavements.
For Potter it was a dreadful realisation that healthcare in America had failed millions of poor, sick people and that he, and the industry he worked for, did not care about the human cost of their relentless search for profits. "It was over-powering. It was just more than I could possibly have imagined could be happening in America," he told the Observer
Potter resigned shortly afterwards. Last month he testified in Congress, becoming one of the few industry executives to admit that what its critics say is true: healthcare insurance firms push up costs, buy politicians and refuse to pay out when many patients actually get sick. In chilling words he told a Senate committee: "I worked as a senior executive at health insurance companies and I saw how they confuse their customers and dump the sick: all so they can satisfy their Wall Street investors."
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Just horrible:
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Potter was also working for Cigna when it became embroiled in the case of Nataline Sarkisyan, whose family went public after Cigna refused to pay for a liver transplant that it considered "experimental" and therefore not covered by their policy. Cigna reversed this decision only hours before the Californian teenager died. "I wish I could have done more in that case," Potter said.
Such sentiments are rare in an industry that has given America a healthcare system that can be cripplingly expensive for patients, but that does not produce a healthier population. The industry is often accused of wriggling out of claims. Firms comb medical records for any technicality that will allow them to refuse to pay. In one recently publicised example, a retired nurse from Texas discovered she had breast cancer. Yet her policy was cancelled because her insurers found she had previously had treatment for acne, which the dermatologist had mistakenly noted as pre-cancerous. They decreed she had misinformed them about her medical history and her double mastectomy was cancelled just three days before the operation.
Last month three healthcare executives were grilled about such "rescinding" tactics by a congressional subcommittee. When asked if they would abandon them except in cases of deliberately proven fraud, each executive replied simply: "No."
To Potter that attitude has a sad logic. The healthcare industry generates enormous profits and its top executives have a lavish corporate lifestyle that he once shared. Treating patients for their expensive conditions is bad for business as it reduces the bottom line. Kicking out patients who pursue claims makes perfect economic sense. "It is a system that is rigged against the policyholder," Potter said. The congressional probe found that just three firms had rescinded more than 20,000 policyholders between 2003 and 2007, saving hundreds of millions. "That's a lot of money that will now go towards their profits," Potter said. |
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Manner of Speaking
Joined: 09 Jan 2003
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| Posted: Sun Jul 26, 2009 9:08 pm Post subject: |
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I think one of the roadblocks to implementing national health insurance in the US might be geographic...the story in your quote makes me think that in Europe most countries have a national health insurance system, but geographically and politically they are relatively small nations with homogenous populations.
But the US and Canada are large nations with federal governments; every province in Canada has public health insurance [ public (health insurance), not (public health) insurance ], but most people in Canada wouldn't want a public health insurance system at the national level because it would probably be too inefficient. The provincial systems are managed at the provincial level and are topped-up with cash transfers from the federal government.
A few states in the US have state-level health insurance, and obviously from your story it sounds like Tennessee needs one as well. |
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ManintheMiddle
Joined: 20 Oct 2008
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| Posted: Sun Jul 26, 2009 9:21 pm Post subject: |
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Good thread topic, Big Bird.
The insurance and pharmaceutical companies have often shown themselves to be avaricious to an immoral extent but I don't think it's as well tolerated in American society as you believe. There has been growing resentment over the past two decades toward these abhorrent practices and while still the exception they occur with enough frequency to warrant concern at a national policy level (Hillary Clinton actually seized the moment in 1993 but her campaign went down to defeat over questions about the scope of the proposed legislation).
It might interest you to know that as I write several committees in Congress are grappling with this very issue as part of the health care reform package. Insurance executives in particular are overpaid and have been for nearly four decades.
I'd be curious to know how this issue has been handled in the U.K. especially given the other problems with your health care delivery system?
Addendum:
Yes, MOS, and we have to contend with the massive influx of illegal aliens who cannot be denied emergency room procedures. We also have a ridiculous number of frivolous lawsuits, high punitive damages, and more than a few blood-sucking lawyers. John Edwards comes to mind... |
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Big_Bird
Joined: 31 Jan 2003
Location: Sometimes here sometimes there...
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| Posted: Sun Jul 26, 2009 11:20 pm Post subject: |
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| ManintheMiddle wrote: |
Good thread topic, Big Bird.
The insurance and pharmaceutical companies have often shown themselves to be avaricious to an immoral extent but I don't think it's as well tolerated in American society as you believe. There has been growing resentment over the past two decades toward these abhorrent practices and while still the exception they occur with enough frequency to warrant concern at a national policy level (Hillary Clinton actually seized the moment in 1993 but her campaign went down to defeat over questions about the scope of the proposed legislation).
It might interest you to know that as I write several committees in Congress are grappling with this very issue as part of the health care reform package. Insurance executives in particular are overpaid and have been for nearly four decades. |
You say it's not well tolerated, and yet it has persisted for decades.
| Quote: |
| I'd be curious to know how this issue has been handled in the U.K. especially given the other problems with your health care delivery system? |
The UK has had a national health system since the late 40s. All British residents are covered by it. You can also opt for private insurance, which can mean a faster nicer service, with private rooms in the hospital, but everyone is covered from cradle to grave and may visit their local GP anytime without having to pay.
It's financed by paying a certain percentage of your income (like tax) but if you can not pay (because you do not work) you are still covered.
There are no stories of people being turned away from life-saving treatments because of any fine print in their insurance cover. What I've read about the American system is just mindboggling, and doesn't make any sense at all - not in such a rich nation. It's lunacy on a national level.
While the NHS has its problems (there isn't an infinite fountain of cash to resource it) - and could do with studying the French example - it doesn't come anywhere near to approaching the horror story of the US model. How have you (collectively) accepted it for so long?
Last edited by Big_Bird on Sun Jul 26, 2009 11:30 pm; edited 1 time in total |
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Big_Bird
Joined: 31 Jan 2003
Location: Sometimes here sometimes there...
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| Posted: Sun Jul 26, 2009 11:28 pm Post subject: |
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| Manner of Speaking wrote: |
I think one of the roadblocks to implementing national health insurance in the US might be geographic...the story in your quote makes me think that in Europe most countries have a national health insurance system, but geographically and politically they are relatively small nations with homogenous populations.
But the US and Canada are large nations with federal governments; every province in Canada has public health insurance [ public (health insurance), not (public health) insurance ], but most people in Canada wouldn't want a public health insurance system at the national level because it would probably be too inefficient. The provincial systems are managed at the provincial level and are topped-up with cash transfers from the federal government.
A few states in the US have state-level health insurance, and obviously from your story it sounds like Tennessee needs one as well. |
Britain has 4 national health systems - NHS England, NHS Scotland, NHS Wales and Health and Care Northern Ireland. |
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ED209
Joined: 17 Oct 2006
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| Posted: Mon Jul 27, 2009 12:04 am Post subject: |
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| ManintheMiddle wrote: |
Yes, MOS, and we have to contend with the massive influx of illegal aliens who cannot be denied emergency room procedures. We also have a ridiculous number of frivolous lawsuits, high punitive damages, and more than a few blood-sucking lawyers. John Edwards comes to mind... |
NHS gets sued too. Often settling out of court. As for the illegals, so long as they keep the hospital clean why not let them use it. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Mon Jul 27, 2009 12:33 am Post subject: |
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America doesn't accept this.
That's why one of the top 3 issues in the '08 campaign was health care: and the national candidate advocating health care reform won by a comfortable margin.
P.S.,
The health care system in the developed world next less worse than the U.S.'s is probably Britain's. |
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mateomiguel
Joined: 16 May 2005
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| Posted: Mon Jul 27, 2009 12:44 am Post subject: |
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| See, there are these people in Tennessee. They live in the Appalachian Mountains. They believe that city folk are evil, corrupt, and evil. They refuse to participate in most forms of modern life. They are self-confessed rednecks who believe their own way of life is morally and ethically superior to mine and yours. They probably shunned hospitals and chose to live with their ailments. They probably went to the free clinic in a moment of weakness, and regret it even now. |
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Sergio Stefanuto
Joined: 14 May 2009
Location: UK
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ED209
Joined: 17 Oct 2006
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| Posted: Mon Jul 27, 2009 3:01 am Post subject: |
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| Kuros wrote: |
America doesn't accept this.
That's why one of the top 3 issues in the '08 campaign was health care: and the national candidate advocating health care reform won by a comfortable margin.
P.S.,
The health care system in the developed world next less worse than the U.S.'s is probably Britain's. |
Britain is rated by WHO as 18th, America is at 37th. Though these numbers are from 2000, has the gap closed that much? |
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Gopher
Joined: 04 Jun 2005
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| Posted: Mon Jul 27, 2009 4:32 am Post subject: |
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You are taking a violin-playing, muckraking journalist at face-value, Big_Bird. Worse: at a time when partisans from all sides are screaming bloody murder re: the other side's position on healthcare.
I was in Washington the last several weeks. I saw the ads and heard the talk.
This is unfortunately not a time for a cool-headed, fact-based dicsussion. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Mon Jul 27, 2009 4:38 am Post subject: |
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| ED209 wrote: |
| Kuros wrote: |
America doesn't accept this.
That's why one of the top 3 issues in the '08 campaign was health care: and the national candidate advocating health care reform won by a comfortable margin.
P.S.,
The health care system in the developed world next less worse than the U.S.'s is probably Britain's. |
Britain is rated by WHO as 18th, America is at 37th. Though these numbers are from 2000, has the gap closed that much? |
Depending on how you evaluate it, there are about 28 developed countries.
Congratulations, Brittannia, your health care system is better than Greece and the Czech Republic. Take that, Yanks!
I'm sorry, I can't take this thread seriously. Its more smug ignorance from the arch-Leftist bag lady. |
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Wangja
Joined: 17 May 2004
Location: Seoul, Yongsan
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| Posted: Mon Jul 27, 2009 4:57 am Post subject: |
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BB, fret not, it's all part of the Great American Dream.
"I have a dream that one day I will be able to afford medical insurance". |
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RufusW
Joined: 14 Jun 2008
Location: Busan
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| Posted: Mon Jul 27, 2009 6:37 am Post subject: |
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Britain: spends less gets better results, covers everyone.
If the Republicans actually introduced any real ideas for reform I'm sure people'd listen. But they don't because they want it to stay the same: rising costs for the citizen, rising profits for the companies. |
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Fox
Joined: 04 Mar 2009
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| Posted: Mon Jul 27, 2009 6:37 am Post subject: |
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This is in the nature of for-profit business. That doesn't mean for-profit business isn't a useful tool, just that it must be controlled carefully when people's health and lives are at stake.
American health care is terrible. It has one big edge it's proponents like to remind us of: technology. However, cutting edge medical technology often isn't availible to the majority of our citizens anyway. It's generally far too expensive for the average person -- even the average insurance holder -- to make use of the best technology availible. Like wealth in America, usage of ultra-advanced medical technology is highly concentrated within the upper echelons. Why should the average American worry about maintaining that situation? They'll probably die of old age before most of that becomes affordable for them on their expensive, deductible-ridden, "We're going to try to take away your coverage if you get sick," insurance plan.
We all ready have long waits, rationed care, and outside parties standing between us and our doctors. Everything people who are against socialized-medicine try to warn us of when speaking against socialized medicine is all ready true for the average person. |
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