Tuesday, October 21, 2008

A Real Close Look at West Virginia

Tuesday's Tirade
First, Do No Harm

The care of human life and happiness, and not their destruction, is the first and only object of good government. ~Thomas Jefferson

Joe Manchin, III is West Virginia’s 34th Governor. Manchin has been a popular governor for four years. Charismatic. Handsome. Articulate. Determined. Ambitious. His speeches resound with promises of “responsible leadership” and improving West Virginia’s economic climate. It’s been all about jobs.

Take a listen to a sampling of Governor Manchin’s persuasive language:

State of the State Address, 2008

Our most immediate task was to demonstrate to everyone in this state and across this nation that West Virginia was not only serious about getting its house in order but was also committed to retaining and creating the good jobs with benefits that our people and their families deserve.

Democratic National Convention 2008

Governor Manchin, who addressed members of the U.S. House Democratic caucus this week, also highlights the success of Democratic policies in retaining and creating good jobs in West Virginia: “Governors work across party lines to get things done. We’re held accountable each and every day for finding ways to solve our states’ most pressing problems.

The 2008 Gubernatorial Debate

Manchin stated that West Virginia has done the right things and has positioned itself to better handle an economic crisis.

Governor Manchin is tackling the tough job of the economy. It’s been all about jobs, responsible leadership and solving “our most pressing problems.”

But many West Virginians are concerned about fundamental services that are the foundation of health and happiness. We feel a little more stressed today. Our general welfare is much more than, “It’s all about jobs.”

Are you aware that a majority of the new jobs in the U.S. economy are in industries and occupations at the lower end of the wage scale -- restaurant workers, for example? Are you aware that today West Virginia has one of the highest rates of poverty?

How many West Virginians know that our state received the 2007 distinction of being “the dirtiest state” in the union? That statistics on obesity, depression and smoking place us in very, very poor light? We rank 44th for the overall health of our citizens and received a poor rating for educational opportunities.

West Virginia’s failures overshadow her successes. Sadly West Virginians are so poor and illiterate, in such bad health, that they falsely believe it will all be better if we only have jobs. We so want to have confidence in the assertions of our heroes.

There’s an alarming trend in West Virginia. We have been losing ground and it is a disheartening experience.

Visit unitedforjustice.blogspot.com for links to all sources.

Today’s Tale
She Did Everything Right but….

Sometimes even healthy people can't get a company to sell them a policy
Msmbc.com, Oct. 6, 2008
Jacqueline Ruess was lying on a bed inside a hospital in Boca Raton, Florida, still woozy from anesthesia but hoping that, maybe just this once, she'd caught a break.

She'd had laparoscopic surgery in order to examine a growth her gynecologist thought might be ovarian cancer. Ruess, who was 34 at the time, in the fall of 2001, feared that her two young boys, whose father died from a congenital heart defect three years earlier, were on the verge of losing her as well.

"It was probably the darkest week of my life since my husband passed away," she recalls.

But as Ruess regained consciousness, she saw her own mother at her bedside, looking relieved. She began to process what she was hearing: You're going to be OK. The growth was on the fallopian tube, not her ovary — a far less worrisome situation. Soon after, a pathology report would confirm that the tumor itself was benign.

"The only thing I could think about was my boys," Ruess says, "and the great relief in knowing I was going to be around to raise them after all.

"But four months after Ruess's medical crisis passed, she faced a financial one. The Insurers Administrative Corporation (IAC), the company in Phoenix that managed Ruess's health care policy, completed what it says was a routine review of her records and discovered what it called evidence of a preexisting gynecological condition.

Because Ruess had not disclosed the symptom on her application, her insurer said she had never been eligible for coverage of gynecological problems. The result: Ruess was on the hook for the cost of her surgery, which, including doctor and hospital bills, amounted to more than $15,000.

Ruess was flabbergasted. "I was — please forgive me for lack of a better term — pissed off," she says. What IAC called a preexisting condition was a one-time notation in her file regarding "dysfunctional uterine bleeding" — that is, irregular periods, a common issue that at some point affects between 10 percent and 30 percent of women in their reproductive years. At the time she experienced erratic periods, Ruess had lost her husband and her father had died, too, which is why her doctor attributed the symptom to stress.

Reassured that there was nothing medically wrong, Ruess quickly put the problem out of her mind and didn't even bother to fill the prescription for the birth control pills her doctor had given her to regulate her cycle. Even though there was a question on her insurance application about "abnormal menstruation" in the past seven years, she didn't think it applied to her because her symptom hadn't been attributed to an underlying medical problem.

"It never crossed my mind to mention it on the form," Ruess says, noting that she'd been forthright about a more serious issue, her son's asthma, when she applied to another insurer for a policy for him. She'd correctly predicted that he would be declined coverage because of it. "If I was going to hold back anything," she says, "I would have held back that information."

Here, too, she'd acted in good faith, she explained to IAC. Her irregular periods had nothing to do with the growth on her fallopian tube. The insurer, she felt, was simply looking for an excuse to avoid paying her bills. But IAC wouldn't budge and further informed Ruess she actually owed a few hundred dollars to her insurer, because her premiums should have been higher. Frantic, Ruess contacted attorneys, journalists, even the governor of Florida.

"I am a healthy and honest 34-year-old widow raising two small children alone," she wrote in a formal complaint to the Arizona Department of Insurance in April 2002. "I am desperate." (A spokesman for IAC says that had the information on Ruess's application been "complete and accurate," she'd have been advised that the policy would have limitations, and she could have opted to apply elsewhere.)

1 in 4 Americans lack adequate coverage
Ruess never expected to find herself in such a circumstance. She'd grown up in a comfortable, middle-class household; even after her husband died in 1998, she was able to remain an at-home mom because of his generous life insurance policy. She'd taken pains to make sure she and her sons were insured, first with a policy carried over from her husband's job (the federal COBRA law allows a spouse to continue coverage for three years after a death), and then by carefully researching and purchasing insurance at a cost of $350 a month for her and one of her sons. (She was able to get coverage for her asthmatic son from the state.)

In other words, she did everything right.

Yet she was facing major debt and was soon to be without thorough coverage altogether. Ruess says she told a supervisor in IAC's underwriting department that she hoped he'd never find himself or a family member in a similar situation.

"I couldn't believe that I was an American citizen," she says. "As a middle-class woman who was more than willing to pay for my medical benefits, I was getting the short end of the stick." And the statistics suggest that women such as Ruess, who buy their insurance on their own, are particularly vulnerable to winding up in similar straits.

…To exclude people they deem poor risks, insurers today use sophisticated techniques. They can tap into databases that reveal your past prescriptions and use "predictive modeling" — a complex, computerized algorithm — to estimate how likely it is that your medical bills will exceed the amount you pay in premiums. Every insurer has its own list of medical conditions for which it may charge higher premiums (have you ever been treated for anxiety, an eating disorder, an ulcer, fibroids or even irritable bowel syndrome?) or, in some cases, nix coverage.

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