California's Real Death Panels: Insurers Deny 21% Of Claims More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released today by the California Nurses Association/National Nurses Organizing Committee. CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the five largest insurers operating in California rejected 31.2 million claims for care -- 21 percent of all claims. The data will be presented by Don DeMoro, director of CNA/NNOC's research arm, the Institute for Health and Socio-Economic Policy, at CNA/NNOC's biennial convention next Tuesday, Sept. 8 in San Francisco. The convention will also feature a panel presentation from nurse leaders in Canada, Great Britain, and Australia exploding the myths about their national healthcare systems. "With all the dishonest claims made by some politicians about alleged 'death panels' in proposed national legislation, the reality for patients today is a daily, cold-hearted rejection of desperately needed medical care by the nation's biggest and wealthiest insurance companies simply because they don't want to pay for it," said Deborah Burger, RN, CNA/NNOC co-president. For the first half of 2009, as the national debate over healthcare reform was escalating, the rejection rates are even more striking. PacifiCare denied 40 percent of all California claims in the first six months of 2009. Cigna, which gained notoriety two years ago for denying a liver transplant to 17-year-old Nataline Sarkisyan of Northridge, Calif. and then reversing itself, tragically too late to save her life, was still rejecting one-third of all claims for the first half of 2009. "Every claim that is denied represents a real patient enduring pain and suffering. Every denial has real, sometimes fatal consequences," said Burger. PacifiCare, for example, denied a special procedure for treatment of bone cancer for Nick Colombo, a 17-year-old teen from Placentia, Calif. Again, after protests organized by Nick's family and friends, CNA/NNOC, and netroots activists, PacifiCare reversed its decision. But like Nataline Sarkisyan, the delay resulted in critical time lost, and Nick ultimately died. "This was his last effort and the procedure had worked before with people in Nick's situation," said his older brother Ricky. California Blue Cross rejected 28 percent of claims in the first half of 2009. In 2008, six days before RN Kim Kutcher of Dana Point, Calif., was scheduled to have special back surgery, Blue Cross denied authorization for the procedure as "investigational" even though the lumbar artificial disc she was to receive had FDA approval. At the time of denial, which she calls "insurance hell," Kutcher notes she had "already gone through pre-op testing, donated a unit of blood, had appointments with four physicians." Kutcher paid $60,000 out of pocket for the operation and is still fighting Blue Cross. Kaiser Permanente denied 28 percent of all claims in the first half of 2009. Rejection of care is a very lucrative business for the insurance giants. The top 18 insurance giants racked up $15.9 billion in profits last year. "The routine denial of care by private insurers is like the elephant in the room no one in the present national healthcare debate seems to want to talk about," Burger said. "Nothing in any of the major bills advancing in the Senate or House or proposed by the administration would challenge this practice." "The United States remains the only country in the industrialized world where human lives are sacrificed for private profit, a national disgrace that seems on the verge of perpetuation," she said. CNA/NNOC supports an alternative approach, expanding Medicare to cover all Americans, which would give the U.S. a national system similar to what exists in other nations. Data released in late August by the Organization for Economic Co-operation and Development, which tracks developed nations, found that among 30 industrial nations, the U.S. ranks last in life expectancy at birth for men, and 24th for women. Source California Nurses Association
its funny that liberals do not see the difference between private enterprise rationing health care and the govt rationing health care. Death panels at a private company - which is not the sole provider is a hell of a lot loss threatening to you life and liberty than a govt death panel - I would have thought that was obvious. Don't people read... what ever happened to life liberty and the pursuit of happiness.... why don't people realize it is govt and the powers which control govt that we need to be concerned about.
Do health insurance companies have power over you...companies you pay to provide services to you...when they decide whether or not to approve a particular medical procedure? I don't think you are accepting that no matter which way you go...you will find yourself at some point powerless over your own health situation, and your life will depend on the whim of a doctor, government bureaucrat, or insurance paper pusher...
You do realize without the federal government's reasonable intervention, we would likely still have: Slavery Child labor No safety standards and reasonable working conditions for workers etc. The issue comes down to this: As a country (not a collection of independent states, but a country) do we want standards of decency and well being for all of our citizens? You do realize that, don't you? Bottom line, please explain how the government is preventing you from life, liberty, and the pursuit of happiness...and please be factual... America, love it...or leave it, right?
you do realize that the purpose of govt is to preserve the rights given to us by our Creator... inalienable rights. so lets look at your examples... 1. was freeing slaves the takeover of slavery by the govt? 2. did the govt come in a put children to work? 3. did the govt go in a take over the workplace? I don't see your point. You pointed out the good govt does when it promotes freedom (from govt and others) liberty from govt intrusion and life... how in your socialist brain does that compare to govt takeover of health care and the eventually use of govt care rationing death panels? You want that lady at the DMV deciding whether you should get a life saving operation. Whether the guy who is appointed by you senator who was bought by the insurance company deciding whether you can get a life saving operation from the only health care provider. You surely jest... you could not be that numb to the reality of govt.
You are comparing the human bondage, treating human beings as if they are property equivalent to modern day life for you in America? Please, try to be serious. It really doesn't matter who decides if you get health care, whether or not it is an insurance company bean counter, a doctor who thinks you are not worth trying to save, a hospital administrator, or a government employee... You think the pursuit of life, liberty, happiness and freedom is paying an insurance premium, and then being denied coverage or unable to afford the premium to begin with? An evolved society is going to allow people to die simply because they are poor? That is the idea of either secular enlightenment or Christian values? It is somehow better to be denied life because a company is looking to its bottom line, than a government worker, hospital administrator, or doctor who is looking to the cost? America, love it or leave it...right? We have rationing death panels right now, they are working in the insurance industry, hospital administration, etc. Your hatred of government and love of corporations is completely irrational...
No foolish one... Not love of corporations, far from it, they are the ones who buy the govt officials.... its my love of choice. We can choose providers, we can choose insurance companies... when govt gets involved it will be single payer and then single provider. Just look to our north and see what they do when they need an operation in a timely manner. The proper role for govt is to open up the insurance menu.... let companies and providers compete on nation wide basis. By the way, I am pretty happy with Kaiser right now. Why because my payments got knocked down when I joined a very larger plan. My deductible is still huge but 500 a month for a family of 6 is not bad. That is the first thing the democrats should of done opened up plans and made big groups. But they did not do it because they are bought and paid for by insurance companies. If you want to get sick to your stomach see the frontline special on how they beat up Congress and Obama.
Money dictates choice when it comes to health care today, where money is the bottom line for getting health care...so the poor don't get a choice in your world of God granting rights of life, liberty, and the pursuit of happiness. That's really the bottom line for you and many other right wingers, isn't it...life is only precious when you can afford it...
The poor already have better health care than my family. Don't give me that bullshit. Medi Cal is the best insurance around. When was the last time you paid a medical bill.
So the poor have better health care than your own family? What better reason is there than for universal health care that treats everyone with equality? You are not making sense...