A Swashbuckling Musical Interlude

A toe-tapping Austin Lounge Lizards take on the health insurance industry, only this time instead of Guido and the Goons, we get Cap’n Kaiser and his notorious crew of murder by spreadsheet bottom-feeders!

Enjoy!

Filed under Corruption, For-Profit Insurance, Health Care, Humor, RICO Lawsuits, Universal Care | Comment (0)

People of New York vs. Vampires

If you’re middle class (like most of us), you know about how health insurance premiums keep going up, covering less, and robbing you of more than your COL increments every year. In my post Health Insurance Racket as Organized Crime I outlined the details of how two of New York City’s major public health care providers filed RICO suits against UHC and its underlings.

Because it is a racket, it’s bankrupting citizens everywhere, and now it’s all the way to closing important hospitals DOWN because they can’t get insurance to pay for care to patients who *are* insured. A case study in how Corporate Greed and Unbridled Lust for Profit can end up destroying the entire fabric of the nation on which these corporate raiders depend for their very life.

Today New York state Attorney General Andrew Cuomo filed a formal Intent To Sue action against the database company Ingenix – owned by the same parent company as UHC – for its fraudulent manipulation of the database most insurance companies use to set reimbursement rates for out-of-network medical expenses.

The United insurers and many other health insurance companies relied on the Ingenix database to determine their “reasonable and customary” rates.  The Ingenix database used the insurers’ billing information to calculate a “reasonable and customary” rate for individual claims by assessing how much a similar type of medical service would typically cost, generally taking into account the type of service, physician, and geographical location.  However, the investigation showed that the “reasonable and customary” rates produced by Ingenix were remarkably lower than the actual cost of typical medical expenses.

Links:

Cuomo Announces Industry-Wide Investigation Into Health Care Insurers’ Fraudulent Reimbursement Scheme

The Health Care Plans: Worthless

The Health Insurance Racket as Organized Crime

The Truth About Insurance

NY Atty. Gen. announces investigation into health insurer fraud

Filed under For-Profit Insurance, Government Lawsuits, Health Care, RICO Lawsuits, Universal Care | Comment (1)

The Health Insurance Racket as Organized Crime

“…insurers are just like shoplifters, they devise a new scheme a day.”
Michael A. Sedrish, M.D.
Director of Utilization Management
MediSys Health Network

In comments to other posts on the subject of the health care crisis in America, I have been asked to list some of the practices of health insurers that require rectification, and asked if doing away with health insurance altogether might be the best option for the country.

It is difficult to use examples from other people’s health insurance horror stories or even my own – though such horror stories are common enough – as objective justification for my belief that insurers need to be stripped of their excessive profits retroactively for at least a decade and a half (by means of punitive fines), and that a complete realignment of health care in America to single-payer, universal care is the best possible option for our society in the 21st century.

Continue reading »

Filed under Corruption, For-Profit Insurance, Health Care, RICO Lawsuits, Universal Care | Comments (3)