



Linda Peeno:

Former Humana Insurance Medical Examiner

Former Blue Cross/Blue Shield Medical Director I'm here today to make a public confession. In the spring of 1987, as a Physician, I denied a man a necessary operation, that would have saved his life. And thus caused his death. No Person, and No Group has held me accountable for this. Because in fact what I did, was I saved the Company a half a million dollars, for this. And furthermore, this particular act secured my reputation as 'a Good Medical Director', and it ensured my continued advancement in the Health Care field. I went from making a few hundred dollars a week, as a Medical Reviewer, to an escalating 6-figure income, as a Physician Executive. In all my work I had one primary duty, and that was to use my medical expertise, for the financial benefit of the Organization for which I worked. And I was told repeatedly that, 'I was not denying Care, I was simply denying Payment'. I know how Managed Care maims and kills patients. So I'm here to tell you about the 'dirty work' of Managed Care. And I'm haunted by the thousands of pieces of paper, on which I have written that deadly word: Denied. Michael Moore: How did we get to the point that Doctors at Health Insurance Companies, actually being responsible, for the Deaths of Patients?



Who Invented this System? How did this all begin? Where did the HMO's start?

The Confession of a Managed Care Medical Director

Complete Testimony: As heard by a Congressional Subcommittee, May 30, 1996



SO

Is Health Care a Commodity, or a basic Human Right?

Well according to this former Health Insurance CEO, the Insurance Company he worked for, would routinely and actively look for "sick people to dump".

And in their spare time, Insurance Company are very focused on "cost shifting" the "Payment for Care" from themselves, to the workers, and their employers.

MSNBC's Ed Schultz Interviews Wendell Potter



http://www.youtube.com/...

ED SCHULTZ: Welcome back to THE ED SHOW. The Republican sound machine is in full force against health care. We gave you the "Playbook," in fact back on May 6th on this program, we went through the right wing‘s messaging machine playbook; it‘s a 28-page strategy memo from Republican pollster Frank Luntz. He told the Republicans to hammer basically four things when it comes to reform,

that reform would be: -- a "government takeover" by Washington bureaucrats.

-- It would "ration" your health care.

-- And get "between you and your doctor."

[...] ED SCHULTZ: Big insurance is lining is pockets of lawmakers. Big insurance only cares about their profits. They want lawmakers to protect their backyard, their profits. They‘re voting against reforms that would really be good for consumers. But I don‘t want you to take my word for it. I want you to pay attention to this next interview. We have a former insurance insider. Joining me now is Wendell Potter. He is a senior fellow on health care for the center for media and democracy. He‘s also a former vice president for the insurance giant Cigna. Mr. Potter, good to have you with us tonight. I appreciate your time. Is the industry telling the truth to the American people and telling the truth to those in the Congress? WENDELL POTTER, SENIOR FELLOW, CENTER FOR MEDIA & DEMOCRACY: No, they‘re not. And that‘s one of the reasons why I left my job at Cigna and why I decided to speak out. I didn‘t want to be a part of that--those lies and misleading statements once again. I‘ve been a part of them in the past and I just didn‘t want to do that again. SCHULTZ: Where are the insurance companies making their big profits when it comes to health care? What are they doing to consumers? POTTER: What they‘re doing to consumers is, number one -- they‘re shifting a lot more of the financial burden from them and the employers onto the shoulders of working men and women. And they also are very actively looking at claims when they‘re submitted. And they‘re acting -- taking action to dump people when they‘re sick, either in the individual market or in the small groups. So a lot of small employers no longer can afford health care because of the actions taken by the insurance companies to get rid of them when their employees‘ claims are a little bit higher than the underwriters expected. SCHULTZ: Mr. Potter, do you think that there‘s a lot of people in the industry that feel the same way you did but just didn‘t follow the action you took? POTTER: Absolutely, I know there are. I‘ve gotten just dozens, actually hundreds of e-mails from people that I have worked with in the past. And most of them now former Cigna employees and employees of other companies who know me and have sent me communications to sell me, "I wish I had done that."

[...] SCHULTZ: How much do you think they want to defeat the public option? POTTER: Well, they‘re pulling out all the stops. That‘s why you‘re seeing the same talking points they‘ve used over the years being trotted out again. They‘re ever green talking points. They will say one thing on--the industry is engaged in what I call the charm defense in saying that they‘re all for reform; but behind the scenes, working with their allies to gut it. The public option is one of the things that they pretty much have drawn a line in the sand saying, "We can‘t accept that."

[...]

POTTER: I think the president is winning. I think the advocates for health care reform are winning. It may not seem that way, when we see a headline like we saw the other day in the "Wall Street Journal," about the CBO estimating that we can‘t afford it. We can‘t afford not to do this. I think the president can communicate that more as time goes by and as Congress really gets down to business. I think that we‘ll see reform this time and meaningful reform.

http://www.msnbc.msn.com/...



Question: Are the Patients, who are Denied Care, to save the Insurance Companies Money -- DO those Patients have a RIGHT to their Health Care?

Or are Those Patients simply a Commodity -- a "Cost Center" -- that must be placated, cajoled, and finally ignored?



Mind you this Business of Care Denial is not just ancient history. It is alive and well, to this day. Although the same, probably can not be said, for the victims of these "behind the scenes", real-life, Death-Panel-Deciders:

HMO claims-rejection rates trigger state investigation

By Lisa Girion, LA Times -- Sep 4, 2009

California Atty. Gen. Jerry Brown is joining state regulators in scrutinizing how HMOs review and pay insurance claims submitted by doctors, hospitals and other medical providers. His announcement came Thursday as regulators said they had stepped up scrutiny of the payment practices of the state's seven largest health plans in response to complaints from physicians and hospitals. The increased attention also comes on the heels of a first-of-its-kind report issued this week that said the California health insurers reject 1 in 5 medical claims. Six of the state's largest insurers rejected 45.7 million claims for medical care, or 22% of all claims, from 2002 to June 30, 2009, according to the California Nurses Assn.'s analysis of data submitted to regulators by the companies. The rejection rates ranged from a high of 39.6% for PacifiCare to 6.5% for Aetna for the first half of 2009. Cigna denied 33%, and Health Net 30%. Anthem Blue Cross, the state's largest for-profit health plan, and Kaiser, the state's largest nonprofit plan, each rejected 28% of claims.

Where is the 'Good Housekeeping Seal of Approval' for these guys?



Health Care and Profits do not mix. Never have, Never will.



When Insurance 'Experts' get bonuses, and raises, from Denying us Care -- something is definitely Wrong with our system.

When 1 out of 5 Health Care Claims get denied proper Payment -- something is definitely Wrong with our system.



The People don't need 5 more years, to know there is something wrong with the Health Insurance system. The Insurers may need such a Time Trigger, but the People DON'T -- The People have NEEDED Real CHANGE, FOR DECADES, now!

We don't need a little more Time, to know that Private Insurers and HMOs don't work; that they will put their own Profits above paying for Treatment, when ever they can. Murphy's Law kind of "insures" that will happen!



Since they -- Private Insurance Companies -- can Choose to Deny us care, so systematically, We simply need a minor System "Tweak", that lets US Choose to Deny THEM, their 'routine and customary' payments, of our ever-increasing Health Insurance Premiums.

And giving us a Choice of Public Payment Plan, no fuss-no muss, similar to Medicare, (aka the Public Option), does just that! Having a strong Public Option, would LET US CHOOSE, a different Health Management Model -- One based on providing "Healthy Results", NOT one based on providing "Healthy Profits"!

And isn't that what Health Care SHOULD be all about, "Healthy Results"?



Is Health Care a Commodity, or a basic Human Right?

Well according to these "Senate Watchers" -- the Senate "is finally starting to think of Health Care as a basic Human Right" ...

It's just HOW TO deliver that Care, that is the "sticking point" ...

Is Health Care a Human Right?



http://www.youtube.com/...



What do you think, is Health a just a Commodity, a Luxury, a Benefit, for ONLY those who can afford it?

Or is it, like Education, a Basic Human Right -- a necessary Condition for simple Human Dignity?



Despite the Scare Tactics funded by Industry Lobbies, that warn us of the "Dangers of a Government Run" Health Care system like Canada has -- the Canadian People who depend on their "No-Nonsense" Nationally-paid system, would tell you a different story ...

Canadians discuss the realities of their single payer health care system, and take exception to the American right wing's insulting of it:

Real Canadians Talking Real Health Care



http://www.youtube.com/...



And according to the World Health Organization:

Health Performance Rank By Country

United States of America: Performance: On level of health : 72nd Performance: Overall health system: 37th Health expenditure per capita in international $'s

Country Rank: USA: 1st

http://www.photius.com/...



We're Number One! alright -- BUT only in terms of HOW MUCH WE PAY PER PERSON, for our Health Care! (1st in the World, in terms of Cost)

FACTBOX: Europe's major health systems and how they work

Matthew Goldstein - Reuters, Aug 19, 2009

pg 2

UNITED STATES Americans spend more per capita on healthcare than any other country at more than $7,400 per person, according to a recent report by the U.S. Centers for Medicare and Medicaid Services. Yet studies suggest Americans overall get poorer care than people in other industrialized countries. Private insurance pays 35 percent of this; [...] and 12 percent is paid out-of-pocket by patients.

[...]

The U.S. Census Bureau says 46 million Americans, or 15 percent of the population, have no health insurance.

http://www.reuters.com/...



Is Health Care a Commodity, or a basic Human Right?

Those of us who believe it IS a basic Human Right would do well, to learn from another strong Advocate of this "socially responsible" position:

Rep. Anthony Weiner Discusses Public Option Health Care Reform on Morning Joe - Part 1



http://www.youtube.com/...

[... 5:40 ]

Anthony: But this isn't a Commodity, Joe. Health Care is NOT a Commodity. Joe: You say Health Care is different than everything else? Anthony: Health Care is NOT a Commodity! If I tell you tomorrow --

[... 6:35 ] Anthony: ... you know, if you say to a 50-year old laid-off guy -- 50 -- 'you're going to get Medicare.' -- he's going to be pretty darn happy! Because he can't get Private Insurance for anything affordable. Medicare doesn't have to go Advertise, they don't have to put Profits into Administration ... Joe: yeah, yeah, OK ... Anthony: And Joe I asked you a Question: What is -- What are Health Insurance Plans doing to produce Health care? ... just tell me? Health Insurance Companies? Joe: Again, the Question, ah ah, I don't even understand the Question -- other than it's you trying to make the point, that 'We don't need Private Industry involved in Health Care, at all'. Anthony: Correct Joe: You are advocating with us today a complete take over, complete Government take over ... Anthony: Only if you think Medicare is a Government Take-over, do you?

Rep. Anthony Weiner Discusses Public Option Health Care Reform on Morning Joe - Part 2



http://www.youtube.com/...



The United States claims to stand up for Human Rights around the World -- it's just in our own Backyard, where we have a little problem spotting the Victims, and helping them avoid Exploitation!

True, the United States is Number One in a lot of important ways -- it's just that we need to get over our own myopia, when it comes to Helping our own People!



Here somewhere, WHERE we, as a Naton, CAN NO LONGER AFFORD to be Number One Two:

Total Health Expenditures as % of GDP 2002 -

2005 Country

Rankings SOURCE: The World Health Organization Rank Location 2000 2001 2002 2003 2004 2005 1 Marshall Islands 22 19.1 18.4 16.3 13.2 15.4 2 United States of America 13.2 13.9 14.7 15.1 15.2 15.2 ... 18 Canada 8.8 9.3 9.6 9.8 9.8 9.8 ... 22 Denmark 8.3 8.6 8.8 9.3 9.4 9.4 23 Iceland 9.3 9.2 9.9 10.2 9.9 9.4 24 Netherlands 8.0 8.3 8.9 8.9 9.0 9.2 25 Sweden 8.2 8.6 9.0 9.1 9.2 9.2 26 Norway 8.4 8.8 9.8 10 9.7 9.1 27 Italy 8.1 8.2 8.3 8.3 8.7 8.9 28 New Zealand 8.1 8.3 8.5 8.4 8.5 8.9 29 Australia 8.3 8.4 8.6 8.6 8.8 ... 38 Ireland 6.3 6.9 7.1 7.3 7.5 8.2 39 Japan 7.6 7.9 8.0 8.1 8.0 8.2 40 Spain 7.2 7.2 7.3 7.8 8.1 8.2 41 United Kingdom 7.2 7.5 7.6 7.7 8.0 8.2 ...

US Health Care "Best" in the World -- in Per Capita Cost

Something must Change in the Business of Delivering Care!



Giving the Health Care Brokers, 5 more years to straighten up and "Clean Up their Act", with a vague threat of a Public Option THEN -- Solves Nothing, NOW! Especially considering the Quarterly Profit business "drivers" and all.

Profiteers will always cut corners, and they will look for Loopholes, to cut costs, and to increase Profits -- ALWAYS!

It's what Capitalism is ALL ABOUT!

WELL, Somethings should NOT be Capitalized -- especially those things which are needed to provide for the "General Welfare of the People".

The only real solution is to take extreme Profits OUT OF the Human Health Care Equation. Providing a strong Public Option, similar to Medicare, is one small step in the right direction.



Is Health Care a Commodity, or a basic Human Right?

Question: How can American Citizens even "pursue Life, Liberty, and Happiness" -- when Good Health, like a Good Education, is NOT a guarantee and just a given, an essential part of our cherished Citizenship?





............................. also posted DocuDharma



