Tuesday, July 29, 2008

Open Secrets

Tuesday's Tirade
Secrets Kill

Today, Americans are desperately seeking security for themselves and family. Security is oftentimes quite elusive and challenges appear. Many Americans tell tales of hurricanes, heart attacks, diseases, bankruptcy that laugh at our silly hopes and dreams.

Tuesday’s tirade is about a misconception. An important one. Because we Americans pay our health insurance premiums monthly, we believe we have health insurance for future inevitabilities. Not so.

You know? The crisis we experience in health care is not news. Neither is greed or slaughter. Today’s Bible reading caught my attention. It has relevance for each of us at this moment in time:

“I cannot stop my crying, for my people have been run through with a sword and lie mortally wounded on the ground….yet the prophets and priests alike made it their business to travel through the whole country, reassuring everyone that all is well.” Jeremiah 14:17-20

Health plans are like that. Health Plans go out of their way, I believe, to assure us that all is well. In their magazines, in speaking with representatives, in press releases. As many more astute about advertising might say, "Be cautious. Do not believe it all. It seldom tells a true story."

What is most disturbing? These injustices, these harmful treatments are “open secrets.”

One individual after another on the internet has published hundreds of frightening accounts that counter the public image of many HMOs. We just don’t get it. And that's what the high-paying executives are counting on. That's what pays for some of those obscene pay packages. Yes. Many would describe $32 millions dollars for one year as obscene.

And so the deceitful, open secrets continue to be told about innocent victims of our health insurance system today who like those people slain in the time of Jeremiah, are, some would believe, murdered. Don't you want to cry for these who suffer injury, loss or death?

Three years ago I came across a website by Advocates.com. It warned the reader of some of the tactics health plans use to make money: http://www.freewebs.com/courageoffaith/8%20%20Stupid%20Things.doc

I experienced four out of eight actions described. For instance: They Expect You to Anticipate Every Conceivable Obstacle They Might Put in Your Way. That’s my case. Until the ruling of the Final Order 06-AAP-024 of the West Virginia Insurance Commission against my HMO, denouncing them for their egregious behavior and demanding that they authorize my medically necessary surgery.

Do not gloss over this. Having to overcome each obstacle cost me dearly in time and money. More significantly, there was a huge emotional cost that most people would not have endured.

Secondly, They Assume You're Not Covered Until You Prove You Are. At least three service representatives informed me that I was not covered for the medically necessary surgery I requested as it was a “non-covered” benefit. Got them here. My HMO authorized a “non-covered” benefit earlier that year. Additionally, Two different medical doctors with two different rulings, stated there was an exemption and I was not covered. Under questioning at the formal hearing before the West Virginia Insurance Commission both the current medical director and the attorney had difficulty explaining the procedure to the judge.

And the rare laugh comes. After my 38th month fighting for justice I reread the testimony from my hearing and the Final Order 06-AP-024. I experience the arrogance of Carelink once again, and, once again, I see just how foolish my HMO is. And I become emboldened. http://www.freewebs.com/courageoffaith/2006%2012%2014%20Final%20Order.pdf

It does not take much searching the internet to locate scathing indictments of the insurance industry like that published in 2007, Insurance Industry Cheating http://www.freewebs.com/courageoffaith/Insurance%20Industry%20Cheating%20and%20abusing%20Consumers%20-%20Topix.mht

Another open secret, huh? Maybe. Maybe not. There are many others like myself who employ blogging as a means to publish the truth. We are connecting daily. More people are responding. We are working together and some day, not too long in the future, there will be an accounting. Life works that way. Always has, always will, even back in biblical times.

If you think there is rage about the economy, the oil companies, greenhouse gases, any number of issues, just imagine the reaction of Americans to learning that they have very little control over their health care. That there are many open secrets that will harm them and family members.
With HMOs there is little, or sometimes, no security. When you’re dead, you’re dead, and the bad guy wins again. Until….that not too distant future.

Tuesday's Tale
Making a Killing

This comes with my warning: What you are about to read is not open knowledge. It truly is a secret. The secretive nature of this evil will astound Americans. So please read carefully. Reread. Google "erisa" and you will be amazed. Attorneys are not amazed. But subscribers will be. http://www.freewebs.com/courageoffaith/Getting%20Away%20with%20Murder%20chapter%205.mht

Initially, when I was first denied my surgery, I wondered why my HMO ignored one clause after another of their written publications of the Patient Bill of Rights and Governance. I do learn quickly. My HMO hid behind a federal law which precludes a subscriber from suing his HMO for damages.

It’s that simple. Erisa, a law passed in the name of justice, today is abused by many HMOs. An HMO can tighten that screw as tightly as it desires, without having to ever be accountable for actions that some might say are otherwise criminal and heinous.

I could not agree with the author more: HMOs are a threat to your health! The consequences of HMOs business tactics can be great.

When will we have the courage to make a difference? One courageous person joining hands with another person of courage. Revealing secrets to the right people can open floodgates. I am not dreaming. It's happened in history before.

When is too much just that, too much? Let me know at United for Justice when you have your answer. I am interested. Very interested.

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