Monday, May 01, 2006

Doing What's Right

Someone... okay, it was Joared... asked if I had any thoughts on the stories about Wellpoint's Blue Cross of California and Blue Shield denying coverage to beneficiaries.
This item in the April 26 L.A. Times (registration required) presents information given by Blue Cross employees during depositions. This second item in the April 28 L.A. Times reveals that Blue Shield has also been named as a defendant in three similar suits.
Let me just say at the outset that... to me... this stinks. Maybe it's just that no one has ever loved me as much as Mr. Shernoff, the attorney making his living from these cases and similar cases over the years, apparently loves his clients. Maybe it's that I deal with temptation pretty regularly since I now have a history of cancer that makes applying for life insurance... problematic.
The plaintiffs, bless their hearts, have purchased individual coverage policies all of which require a detailed medical history and most of which offer limited coverage for pre-existing conditions. Mr. Norris, one of the plaintiffs, would have the reader believe that he had no idea that disclosure of his son's history of ear aches and speech problems was important for the application, and is aghast that Blue Cross has denied coverage for the $15,000 surgery to remove the child's adenoids.
Listen I know why people do it... and I know why insurance companies have become suspicious when chronic disease suddenly and acutely rears its ugly head immediately after the insurance coverage kicks in. The plaintiffs probably aren't bad people... they are people in need. The insurance companies may very well be run by bad people, but they aren't in business to lose money; and if they don't catch fraudulent (or "oops" or whatever) applications at the front end then they have to raise all of our premiums to cover the losses. Consumer needs versus corporate fiduciary duty... or greed.
What we need is Universal Health Coverage. Until we get that these stories are going to go on and on.
Oh, and I'm happy that Mr. Shernoff and Mr. Flanagan got their names in the paper. Way to go, guys!

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Anonymous joared said...

Am always interested in reading your view of what's happening with all issues, but especially some of the ones we're encountering here in our part of the country.

Must confess, I missed a few accounts of the particulars on this insurance matter, so hoped you might address some of the particulars.

Some aspects of the issues you mentioned are of special interest to me, so really appreciate your shedding some light on the matter.

I've been wondering what might be happening, if anything, out here on ownership of water rights i.e. municipalities vs private companies; whether or not cities are setting up wireless broadband operations vs private company ownership i.e. heard Cerritos went wireless.

If you run across any info or data on those subjects, I, for one, would be interested.

Was really surprised you responded to my inquiry, as am sure you have many other fish to fry. Thanks!

12:30 AM  

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